What is a colonoscopy?
Colonoscopy is a procedure in which a trained specialist uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside your rectum and colon. It can provide a visual diagnosis to try to detect tumors, polyps, ulcers, and bleeding or inflammation of the colon. Tissue samples may also be taken during a colonoscopy, and any growths that are abnormal may be removed as well.
Why is a colonoscopy needed?
A colonoscopy can help a doctor find the cause of unexplained symptoms, such as:
- changes in your bowel activity
- pain in your abdomen
- bleeding from your anus
- unexplained weight loss
Doctors also use colonoscopy as a screening tool to check whether cancer or precancerous growths in the colon or rectum (polyps). Screening is testing for diseases when you have no symptoms. Screening may find diseases at an early stage, when a doctor has a better chance of curing the disease.
Other tests include sigmoidoscopy, stool tests, and computed tomographic colonography (CT scan of the colon). To decide which screening test you choose, depends on your risk, your preference, and your doctor as well. Your physician at Medicover Hospital will advise you about the risk of the different tests and what is the best for you.
What happens during a colonoscopy?
You will need to take off most of your clothes. You will be given a gown to wear during the test. You may lie on your left side with your knees pulled up to your belly.The examination is done under sedation or general anesthesia according to your preference therefore you probably won’t remember much, if anything, until you wake up after the procedure.Your gastroenterologist will place an intravenous needle in a vein in your arm to give you sedatives, so you can relax or sleep during the procedure. The Hospital health care staff will monitor your vital signs and keep you as comfortable as possible.
For the procedure, you’ll be asked to lie on a table while the doctor inserts a colonoscope into your anus and slowly guides it through your rectum and into your colon. The scope pumps air into your large intestine to give the doctor a better view. The camera sends a video image of the intestinal lining to a monitor, allowing the doctor to examine your intestinal tissues. The doctor may move you several times on the table to adjust the scope for better viewing. Once the scope has reached the opening to your small intestine, the doctor slowly withdraws it and examines the lining of your large intestine again.
During the procedure, the doctor may remove polyps and send them to a lab for testing. Colon polyps are common in adults and are harmless in most cases. However, most colon cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.
How does the colonoscopy work?
The colonoscope is a thin, flexible tube with a small video camera attached to the it so that your doctor can take pictures or video of the large intestine (colon). The colonoscope can be used to look at the whole colon and the lower part of the small intestine.
At our Hospital we use cutting-edge colonoscope for the outmost imaging of the rectum, colon and distal part of small intestine.
What are the benefits and risks of colonoscopy?
- The most effective screening tool for colon cancer
More than a million people worldwide are diagnosed with colorectal cancer each year, and about half a million people die of the disease. Colonoscopy involves a flexible fiberoptic scope with a video camera, which is threaded through the large intestine to search for and remove polyps before they become malignant. It is considered the most effective screening tool for colorectal cancer.
- If needed malignant tissue sample can be taken for laboratory test during the procedure.
- Smaller growths like polyps can be removed during treatment
- The general risks involved with a colonoscopy are relatively rare. In some of the cases (around 1 in 500) a colonoscopy can cause there to be a tear or perforation in the wall of the intestine.
- In the case where a polyp or growth is removed during a colonoscopy, there can be excessive bleeding. This is less common, only happening in about 1 case of 1000.
- The sedatives that are used in a colonoscopy can cause problems as well, but these are even more rare.
- If you are pregnant, unless there is an immediate health concern, you will probably be advised to wait until after delivery before you have a colonoscopy. A colonoscopy that is being performed electively or for diagnostic purposes can generally be postponed without too much trouble. If your health care provider suggests that you must have this type of exam while pregnant, she may choose to do a more limited type of an examination, such as a sigmoidoscopy.
How should I prepare for a colonoscopy?
Cleaning out bowel and diet
You will need to clean out your colon (colon or bowel prep) before screening colonoscopy. Your gastroenterologist orders a bowel prep so that little to no stool is present in your intestine and will ask you to follow the directions before the procedure. A complete bowel prep lets you pass stool that is clear. Stool inside your colon can prevent your doctor from clearly seeing the lining of your intestine.
Colon prep takes 1 to 2 days, depending on which type of prep your doctor recommends. Some preps may be taken the evening before the test. The bowel prep may be uncomfortable, and you may feel hungry on the clear liquid diet. Plan to stay home during your prep time since you will need to use the bathroom often. The colon prep causes loose, frequent stools and diarrhea so that your colon will be empty for the test.
Your doctor will recommend a medicine for you to use to prepare for colonoscopy. It will most likely be a prescription laxative tablet and/or a laxative solution.
Call your health care professional at the Hospital immediately if you have side effects that prevent you from finishing the prep.
Manage your medicine
You should talk with your gastroenterologist about any medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take. You may be asked to stop taking aspirin products or iron supplements 7 to 14 days before the test. If you take blood-thinning medicines regularly, it is recommended to discuss with your health care practitioner at Medicover Hospital how to manage your medicine.
What shall I do after the colonoscopy?
After a colonoscopy you can expect the following:
- You may have abdominal cramping or bloating during the first hour after the procedure.
- The sedatives or anesthesia takes time to wear off completely.
- You should expect a full recovery by the next day, and you should be able to go back to your normal diet.
- A friend or family member will need to drive you home after the procedure.
- You will receive instructions on how to care for yourself after the procedure. You should follow all instructions.
If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal. Some results from a colonoscopy are available right after the procedure. After the sedatives or anesthesia has worn off, the doctor will share results with you. A pathologist will examine the biopsy tissue. Biopsy results take a few days or longer to come back.
What are the limitations of the colonoscopy?
- Colonoscopy seems to be less effective at preventing cancer deaths from tumors that originate in the right side of the large bowel (ascending colon). The reason for this is that the colon has four different parts, including the ascending and descending colon (left side), which are physically very different. One possibility is the polyps on the left side of the colon are sort of mushroom-shaped with a stem, thus making them easier to see (and to remove). Whereas the right side often has squattier-looking polyps that don’t have stems, or are sometimes flat and thus harder to see.
- In some cases it’s harder for an endoscope to reach the right side than the left side
- Detecting polyps and other malignant growth is less effective if the laxative you drink to clean out the colon before you get screened isn’t being taken properly.