What is a colonoscopy?

A colonoscopy is examination of the colon or large intestine (bowel). Colonoscopy is a safe procedure that provides information other tests may not be able to give. It is performed by using a device called colonoscope. The colonoscope is inserted via the anal opening and is used to examine the complete colon.

Prior to performing the colonoscopy the colon has to be cleared of all the faecal material using combination of medications called bowel prep. Most people find the bowel prep to be the hardest part of the procedure, however over last few years the bowel prep has become easier, safer and less intensive. There are various options available for bowel prep including tablet bowel prep which can be discussed with your doctor or staff at the Complete Gastro Health.

When should i have a colonoscopy?

Colonoscopy is used to diagnose various diseases and to investigate various symptoms like diarrhoea or constipation. 

One of the most important indications of colonoscopy is surveillance for colon cancer in people with family history of bowel cancer or high risk of bowel cancer in general. Colonoscopy can help in identifying polyps and premalignant lesions which can be removed during the procedure thus preventing bowel cancer.

Other indications for considering a colonoscopy include:

1) To screen for colonic polyps (growths of tissue in the colon) or colon cancer
2) Bleeding from rectum/anus
3) A change in bowel habit, like persistent diarrhea or constipation
4) Iron deficiency anemia (a decrease in blood count due to loss of iron)
5) A family history of colon cancer
6) Personal history of colon polyps or colon cancer
7) Chronic, unexplained abdominal or rectal pain
8) Abnormal finding on a X-ray or CT scan

The procedure is normally done in theatre or a procedure room. Prior to the procedure you will be greeted and admitted by an admission nurse who will go

through with you in detail regarding your health and will check your vital signs such as heart rate, blood pressure and oxygen saturation. You will also have discussion with the anaesthetist and the gastroenterologist (endoscopist) prior to the procedure.

The procedure is done under sedation. Most of the patients are not aware of the procedure being done and by the time they wake up they are already in recovery. As the procedure is done under anaesthesia/ sedation its important to remember that you will need someone to take your home.

The colonoscope is a long black flexible tube, approximately the diameter of the index finger. The doctor will gently insert air and sterile water or saline through the scope into the colon to inflate it and allow the doctor to see the entire lining. Various instruments can be passed through the colonoscope to take biopsies(samples from the colon lining) and removing the polyps.

Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most polyps are benign (not cancerous). However, some polyps can become cancerous if allowed to grow for a long time. Removal of polyp does not hurt.

After the colonoscopy, you will be observed in a recovery area, usually for about 30 to 60 minutes until the effects of the sedative medication wears off. The most common complaint after colonoscopy is a feeling of bloating and gas cramps. You should pass gas and not feel embarrassed doing this either during or after the procedure. This will relieve your feelings of bloating and cramping. You should not return to work, drive, or drink alcohol that day. Most people are able to eat normally after the procedure. Ask the doctor or nurse when it is safe to restart aspirin or other blood-thinning medications.

Colonoscopy is a safe procedure, and complications are extremely rare but can occur:

  • Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled
  • The colonoscope can cause a tear or hole in the colon. This is a serious problem, but it is rare.
  • It is possible to have side effects from the sedative medicines. These are rare due to the very short acting medications used.
  • Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.

You should call your doctor immediately or present to emergency if you have any of the following:

  • Severe abdominal pain
  • A firm, bloated abdomen
  • Vomiting
  • Fever
  • Rectal bleeding

1) Discuss with your doctor and nurse in regard to blood thinners like Aspirin, Plavix, Warfarin etc. Some of these might have to be stopped up to 10 days prior to procedure to decrease the risk of bleeding

2) Some of the diabetic medications including insulin might have to be modified to avoid low blood glucose levels while you are on modified diet and fasting prior to the procedure.

3) It is extremely important that the bowel or colon is clear prior to the procedure. Try to follow the instructions for bowel preparation as closely as possible. Some people face mild nausea due to bowel prep. Discuss with your doctor in regards to this as various alternatives are available

4) If you feel the bowel preparation is not clean on the day of procedure (Passing solid motion), please let the nurse know as extra bowel preparation and enema can be given to clean the bowel further on the day of procedure

5) Please inform the health staff about all your health conditions

Please contact the staff at Complete Gastro Health if you have any queries or concerns

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