Visual exam of the lining of the large intestine, also called the bowel or colon, with a colonoscope. A colonoscope is a flexible tube with a light and a viewing device. It allows the doctor to view the inside of the colon through a tiny video camera.

PARTS OF THE BODY INVOLVED

Large intestine (colon), rectum

REASONS FOR PROCEDURE

Colonoscopy is performed to visualize, diagnose, and sometimes treat problems inside the large intestine. The procedure is most often recommended for the following reasons:
Colonoscopy is performed to visualize, diagnose, and sometimes treat problems inside the large intestine. The procedure is most often recommended for the following reasons:

  • To locate the source of lower intestinal bleeding
  • To diagnose changes in bowel habits
  • To determine the cause of lower abdominal pain
  • To detect early signs of colon cancers or pre-cancers (polyps) in individuals without symptoms but who are at increased risk for these conditions
  • To obtain tissue samples for testing
  • To remove a polyp (an abnormal growth on the inside lining of the intestine)
  • To stop intestinal bleeding

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

  • Active colitis, diverticulitis, or other acute bowel disease
  • Previous treatment with radiation therapy

WHAT TO EXPECT

Prior to Procedure
Your doctor will likely do the following:

  • Physical exam
  • Health history
  • Review of medications
  • Test to check for hidden blood, called "occult blood"

IN THE DAYS LEADING UP TO YOUR PROCEDURE:

Your colon must be completely cleaned out before the procedure. Any stool left in the colon will block the doctor's view and limit the procedure's success. A number of cleansing methods may be used, including enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution that aids in the complete emptying of the colon. This preparation may start several days before the procedure.

  • Do not take bulk-forming laxatives or iron-containing medications or supplements for one week before the procedure, unless told otherwise by your doctor.
  • Do not take aspirin or other anti-inflammatory or blood-thinning drugs for one week before the procedure, unless told otherwise by your doctor.
  • Do not eat or drink anything for 8 to 10 hours before the procedure.
  • If you have insulin-dependent diabetes, ask your doctor about any adjustments to your insulin dose.
  • Arrange for a ride to and from the procedure.

During Procedure - Sedation

Anesthesia - None. Medication is given to sedate you and to decrease discomfort.

Description of the Procedure - You lie on your left side with knees bent and drawn up toward your chest. The gastroenterologist or endoscopist (may be a surgeon) slowly inserts the lubricated, pencil-sized colonoscope through the rectum and into the bowel. The colonoscope injects air into the colon, and a small attached video camera lets the doctor view the colon's lining on a video screen. The doctor will continue guiding the instrument through the bowel and assess the lining, while looking for abnormalities.

A tissue sample or polyps may be removed and analyzed. A biopsy is always necessary to diagnose cancer or pre-cancer. If tissue is removed, a small amount of bleeding may occur during the first 2 days after the procedure.

After Procedure - Laboratory exam of removed fluid or tissue

How Long Will It Take? The colonoscopy takes less than one hour. Expect to stay at the hospital or doctor's office for another hour or two or until the sedative wears off. Because of the anesthesia used, it is a good idea to have someone drive you home from the procedure.

Will It Hurt? Although most patients report little or no discomfort during the procedure, there may be feelings of cramping, bloating, fullness, or a need to have a bowel movement.

POSSIBLE COMPLICATIONS:

  • Bleeding
  • Perforation or puncture of the bowel

Average Hospital Stay - None

POSTOPERATIVE CARE:

  • Do not drive for at least eight hours
  • Rest for the remainder of the day
  • Feelings of bloating, gas, or cramping may persist for 24 hours
  • Resume medications as instructed by your doctor
  • Resume your normal diet, unless told otherwise by your doctor

OUTCOME

The doctor will usually give you a preliminary report after the medication wears off and you are more alert. The results from a biopsy can take as long as one to two weeks to be completed, so schedule a follow-up appointment with your doctor.

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  • Signs of infection, including fever and chills
  • Bleeding; notify the doctor if you pass a teaspoon or more of blood
  • Black, tarry stools
  • Severe abdominal pain
  • Coughing, shortness of breath, chest pain, severe nausea or vomiting

SOURCES:

American Gastroenterological Association

National Digestive Diseases Information Clearinghouse

· Treatment with certain medications, including aspirin and other drugs with blood-thinning properties

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