Colonoscopy

What is a colonoscopy and why is it necessary?
Colonoscopy is a minimally invasive endoscopic examination that allows your doctor to look at the interior lining of your large intestine (rectum and colon) through a thin, flexible viewing instrument called a colonoscope. It may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions.

Colonoscopy is done to:
· Detect problems or diseases of the anus, rectum, or large intestine (colon). These tests are often done to investigate symptoms such as unexplained bleeding from the rectum, prolonged diarrhea or constipation, obvious or hidden (occult) blood or pus in the stool (feces), or lower abdominal pain.
· Evaluate the source of internal bleeding.
· Screen for colorectal cancer or polyps.
· Evaluate abnormal results from a barium enema test.
· Monitor the growth of polyps that cannot be completely removed.
· Screen for recurrence of colon or rectal cancer in people who have had surgical treatment for colon or rectal cancer.
· Remove polyps or take tissue samples (biopsy) when colon cancer or other bowel disease is suspected.
· Monitor treatment of inflammatory bowel disease.
· Evaluate an unexplained drop in hematocrit (one sign of anemia), usually along with an EGD (oesophagoastroduodenoscopy), in older patients and sometimes in younger patients as well.
· Remove foreign bodies.
· Evaluate the cause of chronic diarrhea.
· Some patients may need to have the colonoscopy repeated regularly to make sure new abnormalities have not developed.

Due to the high mortality associated with colon cancer and the high effectivity and low risks associated with colonoscopy, it is now also becoming a routine screening test for people 50 years of age or older. Subsequent re-screenings are then scheduled based on the initial results found, with a five- or ten-year recall being common for colonoscopies that produce normal results.


Details of the procedure

What do I need to do before this procedure?
Before the procedure, you will also be asked to go on a clear liquid diet for 1-2 days to help decrease the formation of any stools.
For a colonoscopy, the colon needs to be very clean. For this reason, on the day before the colonoscopy, a laxative and large quantity of fluid will be given to you. This will cause significant diarrhea that will clean the colon of any stools. A whole bowel irrigation may also be performed to clean the colon.
You may be asked to stop taking aspirin products or iron supplements 7 to 14 days before the test to avoid the risk of bleeding if a polypectomy is performed during the procedure. If you take blood-thinning medications regularly, discuss with your doctor how to manage your medication.

What happens on the day of the procedure?
Your surgeon will explain the procedure in detail, including possible complications and side effects. He may use an enema 30 to 60 minutes before the test to completely cleanse your colon.

What type of anesthesia will be used?
During the test, you may receive a pain medication and a sedative through an intravenous (IV) line in your arm or hand. These medications reduce pain and will make you feel relaxed and drowsy during the test. You may not remember much about the actual test.

What happens during colonoscopy, and how is it performed?
You will lie on your side with your knees drawn up toward your abdomen. Once you are in position, the doctor will first check for tenderness or blockage by inserting a gloved finger into your anus. Then, the colonoscope will be inserted and advanced while the intestinal lining of the colon will be examined through the scope. In some settings, the doctor may also view your abdomen on an X-ray screen (fluoroscope) to check the position of the colonoscope.
Your doctor will try to examine the entire length of your large intestine. As the colonoscope is withdrawn, extra care will be taken to examine the entire inner lining of your colon.
The doctor may also insert tiny instruments (forceps, loops, swabs) through the colonoscope to collect tissue samples (biopsy) or remove growths. The biopsy test is completely painless.
The test usually takes 30 to 45 minutes, but it may take longer, depending upon what is found and what is done during the test.

Why is a tissue sample collected during colonoscopy?
In some cases, a sample of tissue (biopsy) may be collected during the colonoscopy. In that case, it will be sent to a lab for further analysis. Samples of colon tissue are usually sent to a pathology lab, where they are examined under a microscope for evidence of certain diseases. Other samples of colon tissue may be sent to a microbiology lab to determine whether certain kinds of infection are present. Your doctor may be able to discuss some of the findings with you immediately after the procedure. Other results are usually available in 2 to 4 days. Tests for certain infections may take several weeks.

How long will I be in the hospital?
A colonoscopy is an outpatient procedure. After the test, you will be observed for 1 to 2 hours until the medications wear off. When you are fully recovered, you will be released from the hospital.

What precautions will I need to take after the procedure?
You will not be able to drive or operate machinery for 12 hours after the test. Your doctor will tell you when you can resume your usual diet and activities. Drink lots of liquids after the test to replace the fluids you may have lost while you were taking the laxative solution but do not drink alcohol.

What are the risks/complications associated with colonoscopy?
A colonoscopy is a very safe procedure that could be life saving. However, as with other procedures, there are some risks and complications attached with it.
· There is a slight risk that a tear or hole in the lining of the colon may occur. This is called gastrointestinal perforation and requires immediate major surgery for repair.
· There is also a slight risk of causing a colon infection.
· Bleeding may occur but such complications can be treated immediately during the procedure by cauterization via the instrument.
· Delayed bleeding may also occur at the site of polyp removal up to a week after the procedure and a repeat procedure can then be performed to treat the bleeding site.
· People who have certain types of heart murmurs, artificial heart valves, or previous infections of a heart valve will need antibiotics before and after the test to prevent infection. An irregular heartbeat may occur during the test but nearly always subsides on its own without treatment.
· Complications due to anesthesia include cardiopulmonary complications such as temporary drop in blood pressure and oxygen saturation.

What should I watch out for?
After the test, you may have bloating or crampy gas pains and may need to pass some gas. If a biopsy was done or a polyp removed, you may have traces of blood in your stool (feces) for a few days. If polyps were removed, you may be instructed to avoid taking aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for 7 to 14 days after the test.

Be sure to call your doctor if any of the following symptoms appear:
· Heavy rectal bleeding
· Severe abdominal pain
· Fever
· Dizziness


Cost and availability

How much does it cost?
Click here for details.

Which countries/hospitals is it available in?
Click here to check the availability of colonoscopy with our partner hospitals.

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Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.