What is a colonoscopy?
In colonoscopy, a gastroenterologist uses a special kind of endoscope (long, flexible, lighted tube) called a colonoscope to view the inside of the entire large intestine (colon) and rectum. Experts agree that colonoscopy is the most important diagnostic tool for a number of important and common conditions such as bloody stools, rectal bleeding or pain, change in bowel habits, or persistent diarrhea.
What happens during colonoscopy?
For the procedure, you will lie on your left side on the examining table and be given pain medication and a mild sedative to keep you comfortable and to help you relax during the exam. Dr. Ahmed will insert a long, flexible, lighted tube, which is about the thickness of a finger, into your rectum and slowly guide it into your colon to examine the lining. The scope bends, so the physician can move it around the curves of your colon.
What if the colonoscopy shows something abnormal?
If Dr. Ahmed thinks an area needs further evaluation, he might pass an instrument through the colonoscope to obtain a biopsy (a sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn’t suspect cancer. If colonoscopy is being performed to identify sites of bleeding, your doctor might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Dr. Ahmed might also find polyps during colonoscopy, and he or she will most likely remove them during the examination. These procedures don’t usually cause any pain.
What are polyps and why are they removed?
Polyps are abnormal growths in the colon lining that are usually benign (noncancerous). They vary in size from a tiny dot to several inches. Your doctor can’t always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so he or she might send removed polyps for analysis. Because cancer begins in polyps, removing them is an important means of preventing colorectal cancer.
How are polyps removed?
Dr. Ahmed might destroy tiny polyps by fulguration (burning) or by removing them with wire loops called snares or with biopsy instruments. Dr. Ahmed might use a technique called “snare polypectomy” to remove larger polyps. That technique involves passing a wire loop through the colonoscope and removing the polyp from the intestinal wall using an electrical current. You should feel no pain during the polypectomy.
What happens after a colonoscopy?
Dr. Ahmed will explain the results of the examination to you, although you’ll probably have to wait for the results of any biopsies performed. If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day. You might have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly when you pass gas.
You should be able to eat after the examination, but Dr. Ahmed might restrict your diet and activities, especially after polypectomy.
What are the possible complications of colonoscopy?
Colonoscopy and polypectomy are generally safe when performed by doctors who have been specially trained and are experienced in these procedures.
One possible complication is a perforation, or tear, through the bowel wall that could require surgery. Bleeding might occur at the site of biopsy or polypectomy, but it’s usually minor. Bleeding can stop on its own or be controlled through the colonoscope; it rarely requires follow-up treatment. Some patients might have a reaction to the sedatives or complications from heart or lung disease.
Although complications after colonoscopy are uncommon, it’s important to recognize early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Note that bleeding can occur several days after the procedure.
What preparation is required?
Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure patients go on a clear liquid diet for 24 hours prior to the procedure and take a bowel-cleansing preparation. A liquid diet means fat-free bouillon or broth, strained fruit juice, water, plain coffee, plain tea, or diet soda. Gelatin or popsicles in any color but red may also be eaten. You will also take one of several types of laxatives the night before the procedure. Also, you must arrange for someone to take you home afterward—you will not be allowed to drive because of the sedatives. Dr Ahmed may give you other special instructions. Inform your physician of any medical conditions or medications that you take before the colonscopy.
Can I take my current medications?
Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform Dr. Ahmed about medications you’re taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners), insulin or iron products. Also, be sure to mention allergies you have to medications. Alert Dr. Ahmed if you require antibiotics prior to dental procedures, because you might need antibiotics before a colonoscopy as well.