Colonoscopy Screening & Diagnostic Colonoscopy

Colonoscopy is procedure that enables your doctor to thoroughly examine the lining of your colon (large intestine). A colonoscope is the instrument used; it is a long (5-6 feet), thin, flexible tube that has a video camera and a light at the end. Your doctor will insert the scope into the rectum and slowly guide it through the entire length of the colon. Images are projected onto a high definition monitor to allow for a detailed examination. Photos can be taken to document findings or abnormalities. The colonoscope is equipped with additional channels through which special equipment can be inserted to remove tissue samples, perform biopsies or stop bleeding.

Polyps are small growths originating in the lining of the colon. Most polyps are non-cancerous (benign), but the physician cannot always tell a benign polyp from a malignant (cancerous) polyp by its visual appearance. For this reason, all polyps found will be removed and sent to pathology for analysis. You should feel no discomfort during the polyp removal. Removal of colon polyps is important in preventing colorectal cancer.

There are many reasons your doctor may request a colonoscopy

Screening for Colorectal Cancer

Colorectal cancer is the 3rd leading cause of death in the United States. Statistics prove that colon cancer is highly preventable. Screening colonoscopy may detect polyps. Removing these polyps reduces the likelihood of developing colorectal cancer in the future. Screening colonoscopy is recommended for all men and women at the age of 50. If you have a parent or sibling diagnosed with Colorectal Cancer it is recommended you have a screening colonoscopy 10 years prior to the relative’s onset of the disease.

Other symptoms you have may warrant your physician may to prescribe a colonoscopy;

  • Anemia
  • Abdominal Pain
  • Constipation
  • Change in bowel habits
  • Chronic Diarrhea
  • Weight loss
  • Rectal Bleeding

Certain medical conditions require periodic colonoscopies for monitoring;

  • Diverticulitis
  • Crohn’s disease
  • IBS (Irritable bowel syndrome)
  • Ulcerative colitis

Preparing for your colonoscopy

Your colon must be clean in order for your physician to get the best view possible. A special liquid diet followed by a laxative preparation is necessary to clear out any waste or solid residue. There are several different types of preparations and your physician will determine which is best for you. Some require a prescription and usually at least 24 hours of following a diet consisting of “clear” liquids.

It is very important that your physician’s instructions be followed carefully. The quality of the preparation can affect the physician’s ability to detect abnormalities in the colon. Any solid material retained in the colon may prolong the procedure or make it necessary to repeat the examination at another time. (link).

As with all procedures it is important to advise the surgeon of all medication, vitamins and dietary supplements you are taking. Some dosages may need to be adjusted or avoided completely for a few days prior to the procedure. All allergies must be discussed with the physician or nurse as well. If you have a medical condition, such as diabetes, heart or lung disease that may require special attention during the procedure, discuss this with your doctor.

When you arrive at the endoscopy center, one of our patient service coordinators will register you for your procedure. Your demographics and insurance information will be reviewed as well as your patient rights, responsibilities and privacy policy. The various consents which require your signature will be reviewed. You will be asked to change into a gown. A registered nurse or an anesthesiologist will review your medical history and current medication use. Updating this information will ensure that we take the best care of you that we can. Please be prepared to review your health history at this time. Bring a list of medications and drug allergies, if necessary.

All procedures are performed with the assistance of a board certified anesthesiologist who will monitor you before, during and after the procedure. You will be given an intravenous medication to make you feel relaxed. Your blood pressure, pulse rate, and oxygen saturation will be monitored before, during and after the exam.

During the procedure you will be positioned on your side and the colonoscope will be gently passed through your rectum and into your colon (large intestine). The physician will put air into your colon to help visualize the lining. Most sleep through the entire procedure, which lasts 20-30 minutes.

Animation

Following your procedure you will be monitored in the recovery area by a registered nurse until the effects of the sedatives have worn off. Most patients recover in 30-45 minutes. You may feel bloated or cramping after the procedure because of the air introduced into the colon during the procedure. This is normal and should disappear quickly when you pass gas. You will be able to resume your diet and take your routine medication after you leave the endoscopy center, unless otherwise instructed.

Some results from a colonoscopy are available immediately after the procedure. Results of any biopsy or tissue samples take approximately 5 days to return. You will meet with your doctor after the procedure and receive preliminary results and specific instructions prior to discharge. Your escort or caretaker is expected to be available to receive these instructions as well and must sign you out of the facility (escort policy).

The sedation used during your exam impairs judgment, memory, and equilibrium. Do not drive, operate machinery, make critical decisions, drink alcoholic beverages, or do activities that require coordination or balance for 24 hours.

  • If given medication for pain, take it, as instructed, so your pain is not overwhelming.
  • Because air was pumped into your colon you may experience cramping, bloating and expelling large amounts of air from your rectum. This is normal and may last for up to 24 hours.
  • You may not have a bowel movement for 1-3 days following your colonoscopy. This is normal.

Potential Complications: When performed by a knowledgeable and competent physician, a colonoscopy is a very low risk procedure. Very rarely (less than 1 in 1000 cases), bleeding or perforation (tearing of the lining of the colon) may occur. Other risks include a reaction to medication, irritation at the site of the injection, or complications related to other medical problems that you may already have.

  • A Perforation: Passage of the instrument may result in an injury to the lining of the colon wall. If this occurs, surgery to close the leak and/or drain the region may be required.
  • Bleeding: Bleeding, if it occurs, is usually a complication of biopsy or polypectomy or dilation. Management of this complication may occur immediately during the procedure or may occur within a few days and consist only of careful observation, a repeat colonoscopy, may require blood transfusions or possibly a surgical operation.
  • Medication Phlebitis: Medications used for sedation may irritate the vein into which they are injected. This causes a red, painful swelling of the vein and surrounding tissue. The area could become infected. Discomfort in the area may persist for several weeks to several months.
  • Conscious Sedation Medication and Pregnancy: There are risks involved with Anesthesia, especially as it relates to a pregnancy. If there is a question that a pregnancy is possible, a urine pregnancy test will be performed prior to the procedure. If you are breast feeding, do not breast feed for 48 hours after the procedure. You may speak with your obstetrician/gynecologist for more specific instructions.
  • Other Risks: Include drug reactions and complications from other diseases you may already have. Instrument failure and death are extremely rare but remain remote possibilities.

YOU MUST INFORM YOUR PHYSICIAN OF ALL YOUR ALLERGIC TENDENCIES AND MEDICAL PROBLEMS.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication.

Go directly to the emergency room and contact your physician if you notice any of the following:

  • Chills and/or fever over 101 degrees
  • Persistent vomiting
  • Severe abdominal pain, other than gas cramps
  • Severe chest pain
  • Black, tarry stools
  • Any bleeding exceeding one tablespoon

There are alternatives to gastrointestinal endoscopy: Although gastrointestinal endoscopy is an extremely safe and effective means of examining the gastrointestinal tract, it is not 100 percent accurate in diagnosis. In a small percentage of cases, a failure of diagnosis or misdiagnosis may result. Other diagnostic or therapeutic procedures, such as medical treatment, x-ray and surgery are available. Another option is to choose no diagnostic studies and/or treatment. Your physician will be happy to discuss these options with you.

If you have any questions, please contact your physician.

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