Colonoscopy

Colonoscopy is an exam that is performed to detect abnormalities or changes in the rectum (where stools are stored before being excreted) and large intestine (colon).

A colonoscope is a thin, flexible instrument with a camera that helps in transmitting the images of the inside of the colon to a video screen.
The colon and rectum together make up the large intestine or large bowel, which is a long, hollow organ in the abdominal area and plays an important role in digestion by removing the water from the digested material and forming stools or feces.

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Purpose: A colonoscopy is recommended in the following cases:

  • To find out the possible causes of intestinal symptoms 
  • To screen for colon cancer in the case of people who are 50 years or older
  • To look for and remove polyps (abnormal growth of tissue on a mucous membrane), which reduces the risk of colon cancer

Symptoms: The following lower gastrointestinal symptoms may indicate the need for a colonoscopy:

  • Stomach pain
  • Bleeding from rectum
  • Chronic or long-term diarrhea
  • Chronic or long-term constipation
  • Bloody stools
  • Black, tarry stools
  • Unexplained loss of weight

Cleansing the bowel is needed for a successful colonoscopy. This can be done in the following ways:

  1. Changes in diet: Certain dietary changes are recommended the day before the procedure, like eating a light breakfast and lunch and skipping dinner, or consumption of a liquid-only diet.
  2. Consumption of only clear liquids: The doctor may recommend drinking only clear liquids, like broth, water, tea or coffee without milk the day before the procedure.
  3. Laxatives: The doctor may recommend taking laxatives a day before the procedure, either in liquid or pill form. Sometimes, it may be necessary to take them on the morning of colonoscopy.
  4. Enemas: An enema kit may be used the night before or a few hours before the procedure.
  • Tell your doctor about any medications that you may be taking, especially if you are suffering from heart problems, high blood pressure, or diabetes.
  • Tell the doctor if you are taking any supplements or medications containing iron.
  • The doctor may recommend stopping blood-thinning medications like warfarin and aspirin a few days before the procedure. The doctor may also recommend an adjustment in the doses or stopping other medications that you may be taking.

 

Procedure:

  • The procedure is usually performed on an outpatient basis, that is, the patient goes home on the same day of the procedure.
  • The patient lies on the left side and the knees are pulled up to the chest during the procedure.
  • The procedure is performed under a light sedative, which makes the patient drowsy and relaxed, and a pain-relieving medication.
  • In some cases, deeper sedation or anesthesia may be used.
  • The doctor gently inserts the colonoscope through the anus into the rectum and colon.
  • The image obtained is transmitted onto a video screen.
  • The doctor then inserts air or carbon dioxide into the colon to inflate it and give a better view of the intestinal lining.
  • The stools and fluids are removed through the colonoscope as required.
  • The doctor then slowly and gently pulls out the colonoscope from the colon and rectum and examines it for any abnormalities.
  • The doctor may perform other procedures like tissue biopsy (the removal of a sample of abnormal tissue growth and sending it to the laboratory for evaluation) during colonoscopy.
  • The procedure takes half an hour to one hour to complete.

 

The following risks are associated with colonoscopy:

  • Allergic reaction to the medications or sedative used
  • Bleeding
  • Infection
  • Dehydration
  • Puncture of the large intestine
  • Nausea
  • Vomiting
  • Rectal discomfort

 

  • It takes approximately an hour before the patient begins to recover from the effect of the sedative after colonoscopy.
  • It takes up to a day to completely recover from the effect of the sedative.
  • Avoid driving or going to work for the day after the procedure.
  • If the doctor removes a polyp during colonoscopy, the patient will be advised to eat a special diet temporarily.
  • It is normal for the patient to feel bloated or pass gas for some hours after the procedure, as the air from the colon is cleared.
  • Walking may help in relieving patient discomfort.
  • It is normal to notice a small amount of blood in the first bowel movement following a colonoscopy examination.
  • The patient should consult the doctor if he/she continues to pass blood, has a fever, or has abdominal pain.