Colonoscopy
What is a colonoscopy?
Colonoscopy is a procedure that enables your surgeon to examine the
lining of your colon, or large bowel.
A narrow flexible tube with a tiny light and camera at the
end is gently inserted and advanced through the colon. Your surgeon
may also remove polyps, take a biopsy, or cauterize a bleeding
vessel. All specimens
are sent to pathology for analysis, and results are expected in 2-3
days.
Indications for Colonoscopy
A colonoscopy is usually done 1) as screening for tumors or polyps,
2) in patients with known or previous polyps, 3) to evaluate for
bleeding or anemia (low blood level), 4) for symptoms such as
diarrhea, constipation, abdominal pain, change in bowel habits, 5)
before, during, or after some surgeries, 6) to follow up on an
abnormality found on examination or another study.
Limitations of Colonoscopy
It is not always possible to see the entire colon.
Incomplete examination can be due to inadequate bowel
preparation, a difficult twist or tortuous colon, or an obstructing
lesion. Your surgeon
may schedule a barium enema if this occurs.
There are also blind spots in the colon where a lesion may be
missed. Although most
polyps or lesions are seen, the accuracy will never be 100%.
It is also impossible to see outside the colon.
Only a small portion of the small bowel is seen.
Polyps or problems may develop in the interval period between
colonoscopies.
Preparation
The colon must be completely emptied of stool for the procedure to
be performed. You will
be given instructions regarding the cleansing routine to be used.
If you do not get instructions, are unable to take the
preparation, or do not feel that your preparation has worked
properly, please call your surgeon.
Instructions are located on this website under the patient
information tab.
If
the bowel is not cleansed of solid stool, your procedure may have to
be cancelled or rescheduled.
Most medications may be taken as usual, including the morning of
your procedure. If you
take medications to thin your blood (aspirin, heparin, or Coumadin),
tell your doctor. In
general, these medications are stopped for 4-5 days prior to the
procedure. If you are
diabetic, ask your doctor if you should take your insulin or pills
the day of your procedure.
If you have a prosthetic joint, heart valve, history of
endocarditis, or need antibiotics for dental procedures, please tell
your doctor. You will
probably need to take an antibiotic before you come to the hospital.
Arrangements must be made to have an adult take you home after the
procedure. If you come
alone, your procedure will likely need to be cancelled or
rescheduled.
The hospital will call you on the
day prior to your procedure and assign you a time for your
procedure.
You will have an opportunity to meet your surgeon,
and ask any questions prior to the procedure when you arrive
at the hospital.
The
day of your procedure
You will be asked to arrive
approximately 1 hour prior to your procedure.
A nurse will admit you, and insert an IV (intravenous
catheter). You will meet
your surgeon, and then be transported to the procedure room.
Sedation will be given in your IV.
The procedure is usually well tolerated, but you may
experience a feeling of pressure or cramping at various times.
The procedure usually lasts 15-60 minutes.
After the procedure is completed, you will be observed until
most of the effects of the sedative have worn off, usually 1-2
hours. You may have some
mild cramping or bloating from the air that is placed during the
examination. This should
quickly improve with the passage of flatus.
You should be able to eat and otherwise resume normal
activities. You may not
drive, operate heavy machinery, sign legal documents, or make
important decisions after your procedure.
If you do not remember your results, or
have any questions, contact your surgeon.
Complications
Complications are rare, but do
occur. They include
bleeding and perforation.
Should this occur, it may be necessary for your surgeon to
perform an abdominal operation to stop bleeding or repair the
intestinal tear. Blood
transfusions are rarely required.
Reactions to the sedatives can occur.
Irritation to the vein may result in a tender lump.
It is important to contact your surgeon immediately if you feel that you may have suffered a complication, have abdominal pain, fevers, chills, chest pain, shortness of breath, or more than a small amount of bleeding.