Understanding Colonoscopy Risks

Colonoscopies have always had concerns because of rare complications but there are also deeper concerns with troubling data. A major report, Complications of Colonoscopy in an Integrated Health Care Delivery System, found that nearly 70,000 people in the U.S. are seriously injured or die each year from colonoscopy-related issues. This is nearly equal to colon cancer deaths.

 

Despite 15 million colonoscopies performed annually, colorectal cancer cases rose by over 30,000 between 2000 and 2007. Some studies, such as the Telemark Polyp Study and the Minnesota Colon Cancer Study, found minimal benefit, or even increased mortality, in individuals who were screened. Detection rates in the right colon are especially poor, sometimes as low as 0%, meaning more polyps can be missed than found.

 

Add in risks like internal bleeding, bowel perforation, and unnecessary removal of benign polyps, and it becomes clear that the idea of colonoscopy as a “gold standard” is deeply flawed. This is especially concerning for people with chronic gut issues, who are often pushed into annual procedures with little proven benefit.

 

Before undergoing a colonoscopy, especially as a routine screening, it’s important to understand the real, research-backed risks. Let’s break down these complications, who’s most at risk, and why informed, personalized decisions matter.

 

What Are Colonoscopies?

 

 

A colonoscopy is a common screening test that helps doctors check the health of the colon or large intestine. It’s most often recommended as a preventive measure to detect early signs of colon cancer, which is one of the leading causes of cancer-related deaths. The main goal of the procedure is to find problems before they become serious.

 

For many adults, especially those over the age of 45, a colonoscopy is considered part of routine health care. It is also recommended earlier for people with a family history of colon cancer or polyps, or those experiencing ongoing digestive symptoms like blood in the stool, chronic constipation or diarrhea, persistent bloating, or unexplained weight loss.

 

During the procedure, doctors are primarily looking for polyps, which are small, often benign growths that can develop in the lining of the colon. While many polyps are harmless, some types can eventually turn into cancer if left untreated. Doctors also use colonoscopies to check for inflammation, ulcers, or other abnormalities that can explain digestive symptoms or point to more serious conditions.

 

The idea behind routine colonoscopy screening is that by catching these issues before symptoms even begin, doctors can treat or remove them before they turn into something more dangerous.

 

Colonoscopies are so widely promoted because they’re seen as a way to detect potential problems early when they’re most treatable. However, there’s growing debate about how effective and safe this approach truly is for everyone.

 

Why Do We Get Colonoscopies?

 

 

Colonoscopies are generally recommended because they’re believed to help doctors catch problems in the colon early, sometimes before any symptoms are experienced. As mentioned above, the main reason people are encouraged to get a colonoscopy is to screen for colon cancer and potential polyps.

 

In addition to cancer screening, colonoscopies are also used to investigate ongoing digestive problems. If someone has symptoms like blood in their stool, long-term constipation or diarrhea, frequent stomach pain, or unexplained weight loss, a practitioner might recommend a colonoscopy to figure out what’s going on. The procedure is also believed to help diagnose other conditions like inflammation or ulcers.

 

We usually only recommend colonoscopies when we find occult blood in our clients and patients’ stool test results. Our first testing recommendations will always be a PCR stool test.

 

The Colonoscopy Procedure and Process

 

 

Here’s a step-by-step look at the full colonoscopy process, from how to prepare, to what happens during the procedure, to what recovery is like afterward.

 

Preparing for the Procedure

Before the colonoscopy, your colon needs to be empty so the doctor can get a clear view. This process is called “bowel prep.” It usually starts one or two days before the exam. You’ll be asked to stop eating solid foods and stick to a clear liquid diet like water, broth, and tea. Then, you’ll drink a special solution that helps clean out your bowels. This part often involves several trips to the bathroom and can be uncomfortable, but it’s a crucial step to make the test accurate.

 

During the Colonoscopy

On the day of the procedure, you’ll go to a clinic or hospital. You’ll change into a gown and lie on your side. Most people are given medicine through an IV to help them relax or lightly sleep during the procedure. Once you’re comfortable, the doctor gently inserts a thin, flexible tube with a small camera at the end into your rectum and slowly moves it through the colon. This allows them to look for any problems, such as polyps, inflammation, or other changes in the colon lining. If they find a polyp, they can remove it right away. The procedure usually lasts between 20 and 45 minutes.

 

After the Procedure

Once it’s over, you’ll rest in a recovery area while the sedation wears off. You might feel a bit bloated or gassy since air is used during the exam to help the doctor see better. This usually goes away within a few hours. Because of the sedative, you won’t be able to drive yourself home and will require scheduling a ride. Most people feel back to normal by the next day and can return to their usual activities.

 

Getting Your Results

The doctor will talk to you briefly after the procedure, but if any tissue samples were taken, it can take a few days to get full results. Your provider will follow up with you to explain what they found and any other potential next steps.

 

The Risks of Colonoscopies

While colonoscopies are intended as an important screening tool, their actual impact can be surprisingly limited.

 

For example:

 

• The Telemark Polyp Study found a 157% increase in overall mortality among patients who underwent colonoscopy screening compared to those who did not, while the reduction in colorectal cancer incidence was just 2%.
• The Minnesota Colon Cancer Study, which tracked 46,000 adults over 18 years, demonstrated only a 0.6% reduction in colorectal cancer incidence.

 

These findings challenge the idea that colonoscopy is an unequivocal lifesaver and suggest its benefits may be far more modest for certain populations.

 

Colonoscopy is not perfect at finding polyps, especially in the ascending (right) colon. Studies have shown that detection rates can be alarmingly low in this area, with some reporting that a significant percentage of polyps go undetected entirely. This means cancers can still develop despite regular screenings.

 

Common Risks and Complications

 

 

Colonoscopy is an invasive procedure that carries several well-documented risks:

 

• Internal bleeding: Particularly after polyp removal (polypectomy), which can sometimes require hospitalization or even lead to cardiovascular complications from blood loss.
• Perforation: A rare but severe complication where the colon wall tears, potentially requiring emergency surgery and carrying the risk of life-threatening infection.
• Sedation-related issues: Reactions to sedatives can suppress breathing, affect heart rhythms, or lead to prolonged confusion, especially in older adults.
• Unnecessary polyp removal: Not all polyps pose a cancer risk. Removing benign ones can add unnecessary risk and cost without meaningful benefit.
• Missed lesions: Even skilled practitioners can miss early cancers or polyps, reducing the effectiveness of screening.
• Infection or inflammation: Though uncommon, introducing instruments into the colon can lead to infections or provoke inflammatory responses.
• Bowel prep side effects: The strong laxatives required to empty the colon can cause dehydration, electrolyte imbalances, and kidney stress, especially problematic for older or compromised patients.

 

Safer Alternatives

 

 

While colonoscopy is the most widely used screening method for colorectal cancer, it’s not the only option, and for many people, it is not the best one. Several less invasive alternatives are available that carry fewer risks, are more affordable, and offer a greater level of comfort.

 

One of the most popular options is the Fecal Immunochemical Test (FIT). This simple at-home test checks for hidden blood in the stool, which can be an early sign of cancer. It doesn’t detect polyps, but when done annually, it’s highly effective at catching early-stage cancers and is often enough for people at average risk.

 

Another option is the flexible sigmoidoscopy, a procedure similar to a colonoscopy but shorter and less invasive. It examines only the lower part of the colon, where many cancers begin. While it doesn’t cover the entire colon, it can still be useful, especially when paired with regular stool tests like FIT. Sigmoidoscopy requires less preparation, no sedation, and a quicker recovery time, making it a more manageable option for many.

 

Cologuard is a non-invasive, at-home stool-based screening test for colorectal cancer that detects both DNA mutations and hidden blood in the stool, which can signal cancer or precancerous polyps. Compared to the fecal immunochemical test (FIT), which only detects blood, Cologuard has a higher sensitivity for detecting both colorectal cancer and advanced precancerous lesions, making it more comprehensive for early detection.

 

Its main benefit is convenience, as it doesn’t require bowel prep, sedation, or dietary changes like a colonoscopy. However, it carries a higher false positive rate than FIT, which can lead to unnecessary follow-up colonoscopies. Cologuard is generally recommended for average-risk individuals over 45 and is not a substitute for diagnostic colonoscopy, especially in high-risk populations.

 

Virtual colonoscopy, or CT colonography, is a non-invasive scan that uses imaging technology to look for abnormalities in the colon. Air is introduced into the colon, and a CT scan produces detailed images. This method can detect larger polyps and cancers and is often preferred by those who want to avoid sedation or the invasiveness of traditional colonoscopy. However, it still requires bowel prep and if something suspicious is found, a traditional colonoscopy can still be needed for removal or biopsy.

 

Many patients and doctors are now opting for these alternatives because they offer a better balance between effectiveness and safety, especially for those at average risk, those with medical conditions that increase the risk of complications, or those simply looking for a less stressful experience.

 

Gastrointestinal (GI) Issues

 

 

For individuals struggling with chronic digestive issues such as bloating, abdominal pain, constipation, diarrhea, or general digestive discomfort, colonoscopies are often one of the first tools used to search for answers. While this may help rule out serious conditions like cancer or inflammatory bowel disease, many patients find themselves referred for repeated colonoscopies, sometimes as often as once a year, when their symptoms don’t improve or return without explanation.

 

This pattern is especially common when standard lab work or imaging doesn’t reveal a clear cause. Doctors rely on colonoscopy as a default next step, hoping to uncover something that previous tests missed. However, in many cases, these chronic GI symptoms are not caused by structural issues that a colonoscopy would catch. Instead, they stem from imbalances in gut bacteria, food intolerances, nervous system dysregulation, or chronic inflammation that requires a different type of care.

 

Relying on repeated colonoscopies to manage ongoing GI symptoms can lead to unnecessary risk, discomfort, and cost without bringing patients closer to true relief. It can also delay more targeted approaches that focus on gut healing, dietary changes, or nervous system support.

 

While colonoscopy can be a useful tool in the right context, it’s not always the most effective way to manage long-term digestive issues. A more personalized and holistic approach is essential to discover the root cause(s) and support lasting healing.

 

Safer alternatives for investigating chronic digestive concerns include:

 

• Carnivore elimination diet
• Comprehensive stool analysis
• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT)
• SIBO breath test
• Lactose/fructose intolerance breath tests
• Celiac blood panel
• Inflammatory markers blood work
• Nutritional marker blood work
• Abdominal ultrasound
• MRI enterography
• CT scans
• Capsule endoscopy

 

All of these screening and testing measures have their own pros and cons, making it essential to work with a trusted practitioner to create a personalized investigative approach for your case.

 

Real Talk On Cancer and GI Issues

Let’s be real: while cancer screening is important, true prevention starts with understanding and addressing the root causes of disease, not just signing up for procedures by default.

 

Too often, the medical approach to gut health and cancer risk is to leap straight to invasive testing without asking why someone is struggling with chronic digestive issues in the first place. There’s a better way to think about this—one that focuses on prevention, healing, and informed choice.

 

For example, the BMJ’s 2019 clinical guidelines recommend using the fecal immunochemical test (FIT) for colorectal cancer screening. FIT is a simple, affordable, at-home test (usually around $49) that can be done annually or every other year, depending on your risk level. Many countries rely on these kinds of stool-based tests as first-line screening tools, rather than defaulting to colonoscopies for everyone.

 

In our practice, if someone’s gut symptoms don’t fully resolve with the Carnivore Cure’s meat-only elimination diet and gut-healing protocol, we often recommend a PCR-based stool test, like a GI-MAP. These tests go beyond cancer screening: they can reveal infections, inflammation, microbiome imbalances, digestive insufficiency, and even occult blood. That means they deliver far more insight into overall gut health, helping us tailor true root-cause interventions.

 

This perspective matters because diet and lifestyle are among the biggest drivers of colorectal cancer risk. Research shows poor diet quality is strongly linked to colorectal cancer development, and obesity alone raises the risk by about 19%. By working to reduce chronic inflammation, improve body composition, and heal the gut lining, we address the actual conditions that set the stage for cancer.

 

If blood is detected on a FIT or GI-MAP test, then yes, further investigation, like a colonoscopy, can absolutely be appropriate. Colonoscopy can be lifesaving when used thoughtfully to confirm or treat concerning findings. But it doesn’t need to be the first choice for everyone, especially when so many people undergo these procedures repeatedly without resolving the underlying problems that brought them to the GI doctor in the first place.

 

It’s also worth recognizing the financial incentives baked into our healthcare system. The colonoscopy market was valued at over $30 billion in 2021 and is expected to grow to nearly $50 billion by 2030. That’s a powerful motivator to keep recommending procedures—even when safer, less invasive, and more holistic strategies exist.

 

Ultimately, the best approach is to invest in understanding your gut health at its foundation. Prioritize meat, minimize inflammation, test wisely, and work with a practitioner who focuses on personalized, root-cause healing. Colonoscopies have their place, but they shouldn’t be the only plan for protecting your health.

 

Leveraging the Carnivore Diet and Targeting Inflammation

 

 

 

The carnivore diet, built around whole, unprocessed animal foods, offers a simple yet powerful modality to support foundational gut health and reduce systemic inflammation. Many people find that this elimination-style diet can be a critical tool for discovering and addressing the root causes of digestive issues, chronic inflammation, and even cancer risk.

 

At its core, the carnivore diet removes common inflammatory triggers found in many modern diets. Through eliminating ultra-processed foods, refined sugars, industrial seed oils, grains, legumes, fiber, and plant-derived anti-nutrients, it creates the optimal setting that can help the gut lining heal. In our clinical practice, clients and patients dealing with chronic GI conditions experience dramatic relief because they’re no longer bombarding their gut with irritants that trigger inflammation and immune responses.

 

But the benefits don’t stop at the gut. Chronic inflammation is a well-established driver of cancer development throughout the body. Inflammatory cytokines can damage DNA, disrupt normal cell signaling, and create an environment where abnormal cells can grow unchecked. Reducing inflammation systemically is a key pillar of any cancer prevention strategy.

 

The carnivore diet is inherently low-inflammatory because it’s based on nutrient-dense, bioavailable proteins and fats without added chemicals or sugars. This kind of eating naturally reduces glycemic variability, supports stable insulin levels, and avoids the constant immune stimulation that many plant foods or processed additives can provoke in many individuals.

 

It’s also important to understand that inflammation doesn’t just come from food. Environmental toxins, like mold, heavy metals, pesticides, and air pollution, can chronically activate the immune system. Lifestyle factors like poor sleep, unmanaged stress, and sedentary behavior can also drive systemic inflammation. While no single diet can eliminate all these exposures, the carnivore diet gives the body a simplified, anti-inflammatory nutritional foundation that can make it more resilient to other inflammatory stressors.

 

In this way, adopting a carnivore diet can act as a preventative tool, not only for GI issues like ulcers, gastritis, and inflammatory bowel disease, but also for reducing broader cancer risk. By lowering baseline inflammation, supporting gut barrier integrity, and providing highly bioavailable nutrients critical for immune regulation and tissue repair, Carnivore offers a way to work with the body’s natural defenses instead of simply waiting for disease to develop.

 

Closing Thoughts on Colonoscopy Risks

Colonoscopy has long been promoted as the gold standard for colorectal cancer screening, but growing research and patient experiences suggest it’s time to take a closer look. While the procedure can be valuable in specific situations, it is not without risks. Complications such as internal bleeding, perforation, and sedation reactions are real concerns.

 

Studies have also shown that polyps, especially in the right colon, are often missed and that colonoscopies do not significantly reduce cancer rates as once believed. For individuals with chronic GI issues, the repeated use of colonoscopy can feel more like a revolving door than a path to healing.

 

One of the most important takeaways is that colonoscopy shouldn’t be a blanket recommendation. Many people are referred for the procedure without fully understanding the risks, alternatives, or potential root causes of their symptoms. Inflammation, poor diet, stress, and lifestyle factors often go unaddressed while procedures are repeated year after year.

 

Patients deserve more than automatic compliance. They deserve an informed choice. This means understanding the full picture, such as the limitations of colonoscopy, the availability of safer alternatives, and the powerful role that diet and lifestyle play in gut health. Whether through Carnivore, stress reduction, more personalized care, or a combined protocol, addressing the root cause should always be the goal instead of endlessly screening symptoms.

 

Ultimately, the best healthcare decisions are made when patients feel empowered, not pressured. Colonoscopies can be helpful, but they have a time and a place. Ask questions, weigh the risks, and choose the option that supports you and your personalized health story.

 

Work With Our Trusted Carnivore Diet Functional Medicine Practitioners

Our Empower Functional Health practice is honored to be trusted carnivore diet functional medicine practitioners, supporting patients and clients from around the globe. We’re passionate about helping individuals achieve root-cause healing in order to live the life they are meant to, nearly symptom-free. We provide holistic health thought leadership and evidence-based insights, paired with clinical pearls, to help you achieve your wellness goals. We welcome you to explore our free resources, and if you find that self-troubleshooting falls short, we’re here to guide you with personalized support and protocols. Our Personalized Health Plan (PHP) is the ideal starting point for uncovering your root causes. You can learn more about this powerful, proprietary tool in-depth here.   

 

 

DISCLAIMER: This content is for educational purposes only. While we are board-certified in holistic nutrition and are functional practitioners, we are not providing medical advice. Whenever you start a new diet or protocol, always consult with your trusted practitioner first.