Digestive Care

Colonoscopy

Colonoscopy is a procedure that uses a flexible or bendable tube or colonoscopeallows to allow your physician to view the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum.

Preparation Before the Procedure
Preparation After the Procedure
Day of the Procedure
Expectation After the Procedure
If Colonoscopy Shows Something Abnormal
Possible Complications

Preparation Before the Procedure:
For the best possible examination it is extremely important that the colon is clean. Your physician will give you detailed instructions about the diet and cleansing. In general, preparation is either drinking a large amount of a special cleansing solution or several days of clear liquids, laxatives and enemas before the examination. Follow your doctor's instructions carefully. If you do not, the procedure may have to be canceled and repeated later.

It is important for you to tell your doctor several days before the examination if you take prescription or over-the-counter drugs or if you have any allergies. Be sure to discuss with the physician whether you should adjust any of your usual medications before the procedure.

You should alert your doctor prior to procedure if you have conditions that require antibiotics, such as mitral valve prolapse or heart prosthesis.

Your doctor will discuss with you the reason for performing the procedure, whether alternative tests or procedures are available and any possible risks and complications from the procedure.  [Back to the top]

Preparation After the Procedure:
Because of the aftereffects of the anesthetic agents or sedatives used during procedure, it is important that you make arrangement for someone to drive you home. For your safety, you will be told to refrain from the following activities for at least 12-16 hours:

· Driving any vehicle or operating machinery because your reflexes and coordination are altered.
· Operating any motorized or non-motorized vehicles or modes of transportation on the day of the procedure.
· Going anywhere other than home after being discharged from the hospital.
· Returning work on the day of the procedure.
· Consuming alcohol or using recreational drugs on the day of the procedure.
· Operating appliances (i.e., stove, iron, lawn mower) on the day of the procedure.
· Signing any important papers or making any important decisions on the day of the procedure.

You may need to make arrangement prior to procedure for home supervision due to the sedation.

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Day of the Procedure
While you are positioned on your left side, the colonoscope is passed through the rectum then gently moved up through the colon or large intestine.

As the colonoscope is slowly taken out, the lining of the colon is again carefully examined by your doctor. The procedure usually takes 15 to 60 minutes. During the procedure, the doctor or nurse may give you medication through a vein to help you relax and better tolerate any discomfort from the procedure.

There is often a feeling of pressure, bloating or cramping at times during the procedure, but colonoscopy is usually well tolerated by patients and rarely causes much pain.  [Back to the top]

If Colonoscopy Shows Something Abnormal
If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (or a sample of the colon lining). This specimen is submitted to the Pathology Department for further analysis. Biopsies are taken for many reasons.

If polyps are found, they too are usually removed and sent to Pathology Department for further analysis.

If colonoscopy is being done to look for sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or sealing off bleeding vessels with electrocautery (electric heat) and/or laser.

Usually, none of these additional procedures produces pain. [Back to the top]

What to Expect After the Procedure
After the procedure, you will be monitored in the GI lab or endoscopy area until the immediate effects of the medications have worn off, usually 45 to 60 minutes.

In most cases, your doctor can tell you the results the day of the procedure, however, results may take several days if samples for biopsy or cytology were taken during procedure.

You may have some cramping or bloating because of the air put into the colon during the examination. This should disappear quickly with passage of flatus (gas).

Generally, you should be able to resume your usual diet, unless you are instructed otherwise.

Because of sedatives given during procedure, please read "Preparation After Procedure"  [Back to the top]

Possible Complications of Colonoscopy
Colonoscopy is generally safe when performed by physicians who have been specially trained and are experienced in endoscopic procedures. However, all of the below complications are possible. Your doctor will discuss their frequency with you, if you desire. Ask your doctor if you have any unanswered question about the procedure.

· Bleeding: May occur as a complication of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled during colonoscopy.
·Perforation or tear: Passage of the instrument may result in an injury to the gastrointestinal tract wall with possible leakage of gastrointestinal contents into the body cavity. If this occurs surgery to close the leak and/or drain the region is usually required.

· Drug reactions: It is extremely important that you inform your doctor of all the medications that you are taking including prescriptions and over-the-counter drugs and of all your allergic tendencies.
· Medication phlebitis: Medications used for sedation may irritate the vein in which they are injected. This causes a red, painful swelling of the vein and surrounding tissue. Discomfort in the area may persist for several weeks, but will go away eventually.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact the physician who performed the colonoscopy immediately if you notice any of the following signs or problems: severe abdominal pain, fever and chills, or rectal bleeding. Remember, bleeding can occur several days after polypectomy. [Back to the top]