Understanding Colonoscopy

 

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What is a colonoscopy?

Colonoscopy is an examination the lining of the large intestine (colon) for abnormalities by inserting a thin flexible tube, as thick as the finger, into the anus and slowly advancing it into the rectum and colon. This instrument, called a colonoscope, has its own lens and light source that allows viewing the images on a video monitor.

Why is colonoscopy recommended?

Colonoscopy may be recommended as a screening test for colorectal cancer. Colorectal cancer is the third leading cause of cancer deaths in the United States. Annually, approximately 150,000 new cases of colorectal cancer are diagnosed in the United States and 50,000 people die from the disease. It has been estimated that increased awareness and screening would save at least 30,000 lives each year. Colonoscopy may also be recommended to evaluate for symptoms such as bleeding, chronic diarrhea and change in bowel habits.

What preparations are required?

Detailed instructions will be provided on dietary restrictions to follow and what cleansing routine to use. In general, the preparation consists of limiting your diet to clear liquids the day before and consuming either a large volume of a special cleansing solution or special oral laxatives. The colon must be completely clean for the procedure to be accurate and comprehensive, so be sure to follow the instructions carefully.

Can I take my current medications?

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Please Inform us about medications you’re taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel (Plavix) , insulin or iron products. Also, be sure to mention allergies you have to medications.

What happens during colonoscopy?

Colonoscopy is well-tolerated and rarely causes much pain. You might feel pressure, bloating or cramping during the procedure. Typically, you will receive a sedative or painkiller to help you relax and better tolerate any discomfort. You will lie on your side or back while the scope is slowly advanced along your large intestine to examine the lining. The lining will be examined again as the scope being slowly withdrawn. The procedure itself usually takes less than 45 minutes, although you should plan on two to three hours for waiting, preparation and recovery. In rare cases, the scope cannot pass through the entire colon to where it meets the small intestine. You will be advised whether any additional testing is necessary.

What if the colonoscopy shows something abnormal?

If there is an area that needs further evaluation, an instrument maybe passed  through the colonoscope to obtain a biopsy (a small sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions even if cancer is not suspected. Polyps maybe found during colonoscopy, and will most likely be removed 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. It’s hard to tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so usually they get removed for analysis. Because cancer begins in polyps, removing them is an important means of preventing colorectal cancer.

How are polyps removed?

Polyps are usually removed with wire loops called snares or with biopsy instruments. This is a  technique called “snare polypectomy” where a wire loop is passed through the colonoscope to remove the polyp from the intestinal wall using an electrical current. You should feel no pain during them polypectomy.

What happens after a colonoscopy?

You will be monitored until most of the effects of the sedatives have worn off. 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. Your physician 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 should be able to eat after the examination, but rarely your diet and activities maybe restricted, 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 me immeadietly if you notice severe abdominal pain, fever and chills, or rectal bleeding. Note that bleeding can occur several days after the procedure.

 

 

 

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