General Information
Colonoscopy is an endoscopic procedure that visually examines the entire colon. The preparation is with an oral solution that removes the waste from the colon. The inside of the colon is then examined for any abnormalities that may exist. During this procedure, polyps may be safely removed. This procedure is commonly performed for evaluation of abnormal radiographic studies, removal of polyps, assessment of bleeding and screening for colon cancer.
Indications
Colonsocopy is indicated for patients with inflammatory bowel disease, GI hemorrhage, polyp removal, screening for colon cancer and evaluation of abnormal x-rays of the GI tract.
Other Methods of Evaluation
An alternative exam to assess the colon is the barium enema. CT scans of the abdomen and pelvis are useful but do not always provide sufficient information about the colon itself. CT scans are not a good test for looking at tubular structures. They are, however, excellent tests for looking at structures surrounding the colon and intestines.
Before the Procedure (Preparation)
An oral laxative solution is given the day before the procedure. This will cleanse the waste from the colon. It is important that the preparation be followed completely. This procedure examines the inside of the colon. Thus, if feces are retained, or the preparation is inadequate, areas of the colon that may be of importance to your health may be missed or misinterpreted. Usually the preparations given for these are excellent. If you have specific difficulties with laxatives or the preparations, please inform your physician beforehand so that alternatives can be addressed.
Please make sure that your physician knows well beforehand if you are taking any blood thinners. Specific instructions regarding the preparation are available in the section regarding preparations for procedures.
Risks of the Procedure:
Colonsocopy is a safe and highly effective technique. In experienced hands, this procedure has the following risks:
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Bleeding |
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Allergic reaction to a medication |
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Perforation of the Colon |
An allergic reaction to a medication can occur. This is usually identified early since blood pressure, heart rate, oxygen saturation and general clinical condition are monitored during the entire procedure.
Perforation of the colon occurs when a hole is put through the colon. This can be associated with removal of polyps or simply passing the endoscope through the colon. This complication will usually result in a patient being treated in the operating room.
When all patients are included and all of the above are also included, the chance that one of the above complications will occur is about 1/1,000 cases.
Overall, colonoscopy is a well tolerated procedure that has many benefits and few complications when done for appropriate reasons by an experienced gastroenterologist.
The Procedure
In general, this procedure takes approximately 30 to 45 minutes to perform when done by a trained gastroenterologist. The procedure may take longer depending upon the intervention that may be required for any individual patient.
During the procedure, a fiber optic endoscope will be inserted into the anus. The scope will then be advance through the inside of the colon to the cecum (last part of the colon). Inspection, removal of polyps, etc. usually occur during withdrawal of the endoscope.
Patients undergoing this procedure usually receive a combination of intravenous anesthetics. These are usually Demerol (meperidine), Versed (midazolam) or Fentanyl. The exact combination, dose and frequency of each of these are individualized for each patient. In most cases, patients do not remember their procedure or are adequately sedated such that the discomfort is well tolerated.
During the procedure, the nurse assisting your physician with the procedure will continuously monitor your heart rate, oxygen saturation and blood pressure. Thus, should any difficulties occur, your physician and his team will be aware of the change quickly.
After the Procedure (Recovery):
After the procedure, the physician will discuss the results with the family and/or the patient. In many cases, the patient will not recall having talked with their physician. This is a natural, and understandable, event since some medications used during the procedure will induce a temporary amnesia.
After the procedure, patients are returned to a recovery area where they are monitored during their stay. When the patient is stable, he or she will be discharged.
Patients must have someone to drive him or her home after conscious sedation (analgesics) have been administered.
Most patients will be lethargic and forgetful during the afternoon after the procedure. During this period of time, someone should be available to check in the with patient insure their safety. No driving, complicated or important decisions or alcoholic beverages are allowed on the day of the procedure. By the next morning, most patient are able to continue with their daily activities.
To assist our patients, a written explanation of the procedure and its findings, in lay terms, will be given to the patient. Recommendations will be made regarding any further testing, treatments or office visits.
A copy of the endoscopic record is sent to all our referring physicians. Thus, your primary care physician will be aware of your procedure, the results and your gastroenterologist's recommendations.
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