Dr Maré Du Plessis on Colonoscopy: Don’t put it off, screening saves lives

Many patients delay investigation of symptoms related to the gut, missing the opportunity for early, preventative intervention. 

Colonoscopy remains the most effective screening method as it enables both the early diagnosis of colon cancer and the removal of precancerous polyps before they progress to malignancy.

Dr Maré du Plessis, a specialist general surgeon practising at Mediclinic Milnerton, emphasises that colonoscopy is a well-established and routinely performed procedure with a strong safety profile.

“Outcomes are significantly improved when colon cancer is detected early, so patients should not wait for symptoms to progress, and in fact routine screening from the age of 45 is essential, especially as we are seeing colon cancer being diagnosed in younger patients.”

Despite advances in screening and increased awareness, many patients still postpone a colonoscopy until symptoms arise, thereby missing a critical window for early intervention, says Dr Du Plessis: “The procedure involves advancing a flexible camera through the colon under sedation, allowing for a detailed assessment of the intestinal lining,” he explains. “It is typically performed on an outpatient basis, and patients are able to return home the same day.”

Concerns around discomfort remain a common barrier. However, these are largely unfounded.
“There is often unnecessary apprehension surrounding colonoscopy,” says Dr Du Plessis. “In reality, patients are sedated and generally tolerate the procedure very well. It is both safe and efficient, with immediate feedback provided following the examination.”

While colonoscopy is frequently pursued when symptoms such as rectal bleeding, abdominal pain, persistent diarrhoea, or changes in bowel habits occur, its role in routine screening is equally important: “From a preventative perspective, screening colonoscopies are invaluable,” Dr du Plessis notes. “Our goal is to detect early changes before symptoms develop. This is where we can make the greatest impact in reducing the incidence of colorectal cancer.”

He recommends that individuals from the age of 45 consider routine screening, with earlier evaluation advised for those with a family history of colorectal cancer, inflammatory bowel disease, or a history of polyps. Colonoscopy is also indicated in cases of unexplained iron deficiency, which may point to chronic, low-grade bleeding within the gastrointestinal tract.

A key advantage of colonoscopy is that intervention can often occur during the same procedure. Polyps and certain abnormal lesions can be removed immediately, reducing the need for further treatment.

“The earlier we investigate, the better the outcomes,” Dr du Plessis concludes. “Colonoscopy is not only diagnostic - it is a preventative tool that can significantly reduce the burden of colorectal cancer.”

A colonoscopy should form part of your routine health screening in order to protect long-term gastrointestinal health.