Indications for Colonoscopy and Flexible Sigmoidoscopy / What Is an Enteroscopy?

According to the STOP Colon/Rectal Cancer Foundation:

• Beginning at age 50, you should have a screening colonoscopy every 10 years. If you are completely asymptomatic (without any symptoms) and you have no history of colorectal disease, you still need to be screened.

• Beginning at age 40 or earlier, you should have a colonoscopy if you have a personal or family history of benign colorectal polyps, colorectal cancer, ovarian cancer, uterine cancer, breast cancer, ulcerative colitis or Crohn's disease.

According to the 2007 Medicare guidelines for colorectal cancer screening:

• A colonoscopy is recommended once beginning at age 50, then once every 10 years.

• For a patient with high risk factors (defined as: having a sibling, parent, or child with an adenomatous polyp or colon cancer; a family history of adenomatous polyposis or hereditary colorectal cancer; or a personal history of adenomatous polyps, colorectal cancer, or Inflammatory Bowel Disease), a colonoscopy is recommended every 2 years (without regard to age).

• A flexible sigmoidoscopy is recommended once beginning at age 50, then once every 4 years, for patients with normal risk factors; and can be done in lieu of screening colonoscopy. For patients with high risk factors (above), a screening colonoscopy should be performed.

WHAT ARE THE POSSIBLE COMPLICATIONS OF CAPSULE ENDOSCOPY?

Although complications may occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. A potential risk could be retention of the capsule. It is important for you to recognise early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing chest or abdominal pain, tell your doctor immediately.

If any of your questions have not been answered here, please feel free to discuss them with the nurse or your doctor before the procedure begins.

What Is an Enteroscopy?

An enteroscopy is a medical test which examines the small intestine. The test can provide a detailed view of the entire digestive system, including the esophagus and stomach. Most people are sent for this test after complaining about disruptive digestive symptoms such as unexplained constipation and diarrhea. A previous diagnostic imaging test, which revealed abnormalities such as gastrointestinal bleeding or tumors in the small intestine, may also lead to the need of an enteroscopy.

This test uses a flexible scope with a small camera attached to it. Generally, the scope passes through the mouth to gain entrance into the stomach. Most people will be sedated and will not feel the scope as it travels down into the small intestine. A double-balloon enteroscopy will include the use of balloons. In this event, the balloons will be used to inflate the area and provide a wider space to view organs and obtain a tissue sample if needed.

The doctor will generally inform a patient if any preparations are needed before having an enteroscopy. Fasting, or going without food or drinks for a certain period of time, leading up to the procedure is a common prerequisite. This is typically to ensure that the stomach is empty during the test. To decrease the possibility of bleeding, most patients will also be asked to stop taking aspirin-containing products for several days to a week before the test.

On the day of the test, the patient will arrive at the test site, which is usually a hospital or in some cases a doctor's office. The patient will be asked to sign a consent form, granting permission to the doctor to perform the enteroscopy. Generally, all clothes will need to be removed and are typically replaced with a hospital gown. Next, intravenous fluid containing some type of sedative will most likely be given for relaxation. In most cases, numbing medications are also provided to numb the throat, so it will not become irritated by the passing of the flexible scope.

After the enterscopy, the patient is commonly moved to a recovery room to recuperate from the sedative. During this time period, a health care professional will be available to monitor the patient's vital signs and check for any side effects of the procedure. Although, not very common, side effects such as bleeding, nausea and vomiting can occur. The doctor may have the results available immediately after the test, or within a few days if a tissue sample was taken.