Colonoscopy
Colonoscopy enables your physician to examine the lining of the colon for abnormalities by inserting a flexible tube approximately as thick as your finger into the anus and advancing it slowly into the rectum and colon. During the procedure you are sedated and the procedure is virtually painless.
What can be expected during colonoscopy?
Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating or cramping at times during the procedure. Your doctor may give you medication through a vein to help you better tolerate any discomfort from the procedure.
You will lie on your side or back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the lining is carefully examined. The procedure usually takes 15 to 60 minutes.
In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The physician will decide if the limited examination is sufficient or if other examinations are necessary.
What about my current medications?
Most medications may be continued as usual, but some medications can interfere with the preparation or the examination. Inform your physician of your current medications as well as any allergies several days prior to examination.
You should alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to colonoscopy as well.
What are polyps and why are they removed?
Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. The majority of polyps are benign (non-cancerous) but the doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.
How are polyps removed?
Tiny polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon, which could require emergency surgery.
What if the colonoscopy shows something abnormal?
If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining). This specimen is submitted to the pathology laboratory for analysis.
If colonoscopy is being performed to identify sites of bleeding, these areas may be controlled through the colonoscope by injecting certain medications or by coagulation (sealing off bleeding vessels with heat treatment). If polyps are found, they are generally removed. None of these additional procedures typically produce pain.
Remember, the biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.
What happens after a colonoscopy?
After colonoscopy, your physician will explain the results to you. If you have been given medications during the procedure, someone must accompany you home from the procedure because of the sedation used during the examination. Even if you feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for you to drive or operate machinery.
You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with passage of flatus (gas). Generally, you should be able to eat after leaving the endoscopy, but your doctor may restrict your diet and activities, especially after polypectomy.
What are the possible complications of colonoscopy?
Colonoscopy and polypectomy are generally safe when performed by specially trained, experienced physicians.
Possible complications include a perforation or tear through the bowel wall that could require surgery. Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the colonoscope. Rarely, blood transfusions or surgery may be required.
Other potential risks include a reaction to the sedatives and complications from heart or lung disease. On rare occasions localized irritation of the vein where medications were injected cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot, moist towels may relieve discomfort.
Although complications are uncommon, it is important for you to recognize early signs of any possible complication. Contact your physician who performed the colonoscopy if you notice any of the following symptoms: severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Bleeding can occur several days after polypectomy.
