Colonoscopy
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Colonoscopy
is a procedure that enables us to evaluate the appearance of the
inside of the colon (large bowel). This is accomplished by
inserting a flexible tube (fiberoptic scope) that is about the
thickness of a finger into the anus, and then advancing it slowly,
under visual control, into the rectum and through the colon. It is
performed with the visual control of either looking through the
instrument or with viewing a TV monitor. |
This test may be done for
a variety of reasons. Most often it is done to investigate the finding
of blood in the stool, abdominal pain, diarrhea, a change in the bowel
habits, or an abnormality found on colon x- ray or a CAT scan. Certain
individuals with previous history of polyps or colon cancer and certain
individuals with family history of particular malignancies or colon
problems may be advised to have periodic colonoscopies because they are
at a greater risk of polyps or colon cancer.
If the procedure is to be
complete and accurate, the colon must be completely clean. You will be
given detailed instructions about the preparation
of the colon.
Most medications should be continued as usual, but some may interfere
with the examination. Aspirin products, blood thinners (Coumadin, etc.),
arthritis medications, insulin, and iron preparations are examples of
medications that may require special instructions. Certain foods should
be avoided for a couple of days prior to the procedure such as stringy
foods, foods with seeds, or red Jello.
Prior to the procedure an IV is
started and you will be connected to monitors for continuous monitoring
of the heart, blood pressure, and oxygenation of the blood. Intravenous
sedation is routinely administered. Colonoscopy often gives a feeling of
pressure, cramping, and bloating, however, with the aid of the
medication it is generally well tolerated and rarely causes any
significant pain.
You will be lying on your left side or
back as the instrument is slowly advanced. Once the beginning of the
colon (cecum) or the last portion of the small bowel is reached, the
colonoscope is slowly withdrawn and the lining is again carefully
examined. The procedure usually takes 15 to 60 minutes.
If an area needs to be better
evaluated, a forceps is passed through the instrument and a biopsy (a
sample of the tissue) is obtained and is submitted to pathology for a
microscopic exam. If infection is suspected a specimen may be obtained
for culturing of any possible bacteria or viruses. If the exam is
performed because of bleeding, the site can be identified, sample of
tissue obtained (if indicated), and the bleeding controlled by several
means. Should there be polyps (benign growths that can lead to cancer)
they can frequently be removed through the colonoscope. Removal of these
polyps is an important method of preventing colorectal cancer.
You will be kept in an observation
area for an hour or two, until any medication given adequately wears
off. You may have some cramping or bloating which should be relieved
quickly with the passage of gas and you should be able to eat upon the
returning home.
Fortunately, colonoscopy
complications are rare and usually minor when performed by doctors who
have been specially trained and are experienced in these endoscopic
procedures.
Bleeding may occur at the
site of biopsy or polypectomy, is usually minor and self-limited, or can
be controlled through the colonoscope. An even less common complication
is a perforation or a tear through the bowel wall that could require
emergency surgery. Other potential complications are reactions to the
sedatives used and localized irritation to the vein where medications
were injected. While these complications are rare, it is important for
patients to recognize any early signs. The doctor that performed the
colonoscopy should be contacted if you notice any of the following
symptoms: severe abdominal pain, rectal bleeding of more than half a
cup, or fever and chills.
Colonoscopy is the best
test available to detect and treat abnormalities within the colon. The
alternatives to colonoscopy are quite limited. Barium enema is a less
accurate test performed with x-ray. It misses lesions more often than a
colonoscopy, and, if an abnormality is found, a colonoscopy may still be
required to biopsy or remove the abnormality. At times, an abnormality
or lesion detected with a barium enema is actually stool or residual
food in a poorly cleansed colon. Colonoscopy may then be necessary to
clarify the issue.
We are pleased to be able
to offer the benefits of colonoscopy to our patients in addition to
operative surgery. Please call the office should you have any further
questions.
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