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What is a colonoscopy?
A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, abdominal pain, or changes in bowel habits. Colonoscopies are also performed in individuals without symptoms to check for colorectal polyps or cancer. A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings or children with a history of colorectal cancer or polyps.
Who should have a colonoscopy?
Colonoscopy is routinely recommended to adults 50 years of age or older as part of a colorectal cancer screening program. Patients with a family history of colon or rectal cancer may have their colonoscopy at age 40. Your physician may also recommend a colonoscopy exam if you have change in bowel habit or bleeding, indicating a possible problem in the colon or rectum.
A colonoscopy may be necessary to :
- Check unexplained abdominal symptoms
- Check inflammatory bowel disease (colitis)
- Verify findings of polyps or tumors located with a barium enema exam
- Examine patients who test positive for blood in the stool
- Monitor patients with a personal or family history of colon polyps or cancer.
What happens before a colonoscopy
To complete a successful colonoscopy, the bowel must be clean so that the physician can clearly view the colon. It is very important that you read and follow all of the instructions given to you for your bowel preparation well in advance of the procedure. Without proper preparation, the colonoscopy will not be successful and the test may have to be repeated.
If you feel nauseated or vomit while taking the bowel preparation, wait 30 minutes before drinking more fluid and start with small sips of solution. Some activity (such as walking) or a few soda crackers may help decrease the nausea you are feeling. If the nausea persists, please contact your health care provider.
Where a colonoscope is passed
You may experience skin irritation around the anus due to the passage of liquid stools. In order to prevent and treat skin irritation, you should :
- Apply Vaseline or Desitin® ointment to the skin around the anus before drinking the bowel preparation medications; these products can be purchased at any drug store.
- Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
- Sit in a bathtub filled with warm water for 10 to 15 minutes after you finish passing a stool; after soaking, blot the skin dry with a soft cloth, apply Vaseline or Desitin ointment to the anal area, and place a cotton ball just outside your anus to absorb leaking fluid.
What happens during a colonoscopy
During a colonoscopy, an experienced physician uses a colonoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the colon. The colonoscope is inserted into the rectum and advanced through the large intestine. If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (a biopsy) and polyps can be identified and entirely removed. In many cases, a colonoscopy allows accurate diagnosis and treatment of colorectal problems without the need for a major operation.
- You are asked to wear a hospital gown and remove eyeglasses.
- You are given a pain reliever and a sedative intravenously (in your vein); you will feel relaxed and somewhat drowsy.
- You will lie on the left side, with your knees drawn up towards your chest.
- A small amount of air is used to expand the colon so the physician can see the colon walls.
- You may feel mild cramping during the procedure; cramping can be reduced by taking slow, deep breaths.
- The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
- The procedure lasts from 30 minutes to one hour.
What happens after a colonoscopy
If you are unable to keep your appointment or if you have any questions or concerns, please call the location at which you are having your procedure.
- You will stay in a recovery room for observation until you are ready for discharge.
- You may feel some cramping or a sensation of having gas, but this quickly passes.
- If medication has been given, a responsible adult must drive you home; avoid alcohol, driving, and operating machinery for 24 hours following the procedure.
- Unless otherwise instructed, you may immediately resume your normal diet, but we recommend you wait until the day after your procedure to resume normal activities.
- If polyps were removed or a biopsy was taken, avoid taking aspirin, products containing aspirin, or anti-inflammatory drugs (such as ibuprofen [Advil®, Motrin®], naproxen [Naprosyn®] or indomethacin [Indocin®]) for two (2) weeks after the procedure to help decrease the risk of bleeding; you may take acetaminophen (such as Tylenol®) if needed.
- If you are taking Coumadin®, Plavix®, Ticlid®, or Agrylin®, the physician performing your colonoscopy will advise you when it is safe to resume your blood thinners.
- If a biopsy was taken or a polyp was removed, you may notice light rectal bleeding for one to two days after the procedure; large amounts of bleeding, the passage of clots, or abdominal pain should be immediately reported.
What are the benefits of colonoscopy?
Colonoscopy is more accurate than an x-ray exam of the colon to detect polyps or early cancer. With colonoscopy, it is now possible to detect and remove most polyps without abdominal surgery. Removing polyps is an important step in the prevention of colon cancer.
What are the alternatives to colonoscopy?
A colonoscopy is the most sensitive test for detecting polyps. However, depending on your symptoms, it may be possible to diagnose your bowel condition using a different imaging test, such as an X-ray using a barium enema, a CT (computed tomography) scan or a flexible sigmoidoscopy.
What are the risks?
Colonoscopy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted, but mostly mild and temporary effects of a successful procedure.
After having a colonoscopy you may :
- Feel bloated and have slight discomfort due to trapped wind
- Feel sleepy as a result of the sedative
- Have slight bleeding from your back passage if you have had a biopsy or polyp removed
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