Reasons for a Colonoscopy

Colonoscopy

Colonoscopy is a complete examination of the large intestine (Colon). A fl exible lighted tube fi tted with a tiny camera is inserted through the anus.

The inside of rectum and colon can be viewed for polyps, cancer, or diseases such as ulcerative colitis or Crohn’s disease. Tissue and polyps can be removed during the procedure. 

Reasons for a Colonoscopy

Screening Colonoscopy

A screening colonoscopy is done to check for cancer and infl ammatory diseases like ulcerative colitis. Most colorectal cancers (CRC) start as non-cancerous polyps (tiny, fast growing cells that may become cancer). Removing polyps or fi nding cancer at an early stage can increase your chances for a full recovery.

During the colonoscopy, polyps can be removed with tiny instruments such as snares or forceps.

● In the U.S., CRC is the second leading cause of cancer death for both men and women. The lifetime risk of CRC is 5% or 1 of 20 adults in Western countries.

● The risk of developing CRC is increased if you have ulcerative colitis or Crohn’s disease or have a parent or sibling who had CRC before age 60.4

● Blacks have a higher risk and death rate than whites in the U.S.

Diagnostic Colonoscopy

A diagnostic colonoscopy is done to check for certain medical conditions such anemia, a change in bowel habits, or abdominal pain.

Therapeutic Colonoscopy

A therapeutic colonoscopy can treat a known problem inside the colon such as bleeding or narrowing.

● For bleeding, your doctor may seal off the bleeding location by injecting medication, heat treatment, or clipping the bleeding site.

● Strictures (narrowing or partial blockage of colon) can be widened by inserting a balloon through the endoscope and infl ating it inside the colon. A small stent (tube) may be left in the narrowed area to keep it open.

Surveillance colonoscopy

A surveillance colonoscopy is a follow-up for patients with a history of colon polyps, cancer, or infl ammatory bowel disease. 

Procedure Options and Risks for Colorectal Screening .

Expectations: Preparing for a Colonoscopy

The Procedure and Recovery Safety Check

If you are having the procedure done in a hospital or ambulatory center, an identification bracelet with your name will be placed on your wrist. This should be checked by all health care team members before providing any procedure or giving you medication.

Sedation

You will be placed on your side usually with your knees drawn toward your chest. You will be given medication usually though an IV line to help you relax and remain comfortable. You may or may not fall completely asleep during the procedure, but most patients will not remember their colonoscopy. Talk to your doctor about the type of sedation and side effects. Common drugs are benzodiazepines (midazolam/Versed); opioids (Fentanyl), and other agents (Propofol).

The Procedure

Your doctor will guide a scope that is inserted into the anus and passed up to the colon. Small amounts of air are inserted to open the colon and allow viewing of the surrounding area. The tube has a light and camera at the end and sends a picture to a TV screen.

Your heart rate, breathing, and oxygen level will be monitored during the exam. The procedure will take about 15 to 60 minutes. If your doctor sees abnormal tissue or polyps, they will be removed or biopsied.

Your Recovery

You will be monitored until you are fully awake. Most patients can go home within 30 to 90 minutes.

If you receive sedation or relaxation medication, you may feel tired following the procedure. You may feel groggy and you should not make any big decisions, drive, or return to work for the rest of the day. 

Diet

You may be eager to eat a large meal after fasting, but it is a good idea to start with light meals and ease into solid food for the first day.16

Pain 

Severe pain is rare after the procedure. You may have minor cramping and gas; after you pass gas, the cramping should be gone.

Bowel Movements

You should return to your normal bowel pattern within 2 to 3 days after your procedure.

If you had a biopsy or polyps removed, your doctor will let you know:

● When and how you will be informed about your results.

● If you need to avoid aspirin or ibuprofen for 10 days after the procedure. 

Common Colonoscopy Prep Solutions

GoLytely®, Colyte®, NuLytely®, TriLyte®

Contain Polyethylene glycol (PEG)

HalfLytely®

2 liters of the PEG solution taken with another laxative

Sports Drink and MiraLAX®

Dulcolax laxative tablets containing 5 mg of bisacodyl each 1 – 8.3 oz. bottle Miralax (238 grams) 64 oz. clear liquid

MoviPrep®

Polyethylene Glycol 3350: Sodium sulfate, sodium chloride, sodium ascorbate, and ascorbic acid

Suprep®

Sodium/potassium/magnesium

sulfate solution

Visicol® or OsmoPrep® 

Sodium phosphate monobasic monohydrate and sodium phosphate dibasic anhydrous tablets

Prepopik®

Oral sodium picosulfate, magnesium oxide, and citric acid

When to Contact Your Surgeon

Call your doctor if you have:

● Severe abdominal pain or if your abdomen feels hard; this could be a symptom of colon perforation

● Bleeding for more than 2 bowel movements or bright red bleeding that fills a shot glass

● Fever greater than 100.4°F or 38°C

● Swelling, redness, or drainage at the IV site

● Weakness, shortness of breath, or fainting

● Nausea or vomiting blood