A colonoscopy is a procedure that detects abnormalities in the lining of the colon. It allows the doctor to look inside the intestines with a camera type of instrument. It is performed for persons whom the doctor suspects an intestinal pathology such as the indications below. The information entails all aspects of these multiple procedures from the start, during and following the tests. For additional query that is not focused on in great detail in this piece, recently, the use of MRI’s have been employed as an alternatives to the colon scope type procedures. The MRI can show more and is less invasive.
• Crohn’s Disease
• Ulcerative Colitis (Pancolitis)
• Celiac disease
• Diverticulosis
• Polyps
• Tumors
• Irritable Bowel Syndrome
• Intestinal Bleeding
• Impacted bowel or chronic constipation when a suspect of a twisted colon may be involved or strictures in the colon.
Colonoscopy is performed with a colon scope, a flexible telescope with a camera at the end that allows the inside of the colon to be viewed and assessed. The doctor inserts the colon scope through the anus where the cause of symptoms can be studied in depth.
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Symptoms That Often Lead to a Colonoscopy
• Chronic diarrhea
• Change in bowel habits (constipation does not respond to high-fiber diet or laxatives)
• Rectal bleeding or blood loss in the stool (melena)
• Anemia, which is the decrease in the amount of red blood cells or decrease in the amount of hemoglobin contained within the cells. Iron holds oxygen in the blood, therefore the supply of oxygen to the cells will be impacted. Anemia always produces a lack of energy and fatigue along with pale mucous membranes.
In some cases, a colonoscopy is performed not only to diagnose a disease or condition, but also to analyze the state of the mucosa and the extent or severity of the illness. This procedure is a common recommendation for the following conditions: ulcerative colitis, Crohn’s disease, bowel cancer or intestinal polyps.
Colonoscopy can be performed to confirm the results of other tests such as a barium enema and fecal occult blood (FOB). During the colonoscopy, the doctor may take small tissue samples for analysis (biopsy) to detect malignancy. It is common to remove polyps (small formations in the colon mucosa) as they may be precursors to cancer in the future.
Alternatives to Colonoscopy
Although colonoscopy is a detailed study, it is not appropriate for all patients. For those who cannot take part in a colonoscopy, the doctor may order other tests.
MRI’s are being used as of late more frequently than the customary scoping of the colon. Set backs often times return following colon scopes such as a resurfacing of symptoms that had calmed down. Rather like undoing the progress that has been made in some cases. Investigate all of your options before hand.
• Barium enema: A barium liquid (a substance that can be seen through X-rays) is placed in your intestines through the anus and then, a radiograph is taken to see inside the bowel.
• Virtual colonoscopy: This is a test involving a scan of the abdomen area. To accomplish this, the camera uses X-rays which allows viewing the inside of the colon and rectum through the 3D images it generates.
• Sigmoidoscopy: A procedure similar to colonoscopy, but the instrument used is shorter. It is primarily used to view the sigmoid colon and rectum area.
How to Prepare For a Colonoscopy
Colonoscopy’s are performed at the hospital. On the same day, the patient returns home. This study requires advance preparation. The doctor will indicate the steps to be followed before the colonoscopy. The colon must be completely clean.
Steps Prior to Colonoscopy
1. Stop taking iron capsules. The iron contained in the supplements
(ferrous sulfate) is converted into another chemical compound with the digestive juices and becomes black. This does not allow the doctor to see clearly inside the bowel.
2. Follow a recommended special diet before the study day.
3. Drink at least 6 to 8 glasses of clear liquids (water, clear tea, vegetable broths)
4. Take stimulant laxatives as prescribed.
If you are taking other medication, you should consult a doctor before the colonoscopy. They will tell you if it is necessary to suspend the drugs or not. Usually, the doctor indicates the interruption of those remedies which tend to cause constipation. Furthermore, if you take drugs that affect blood clotting (clopidogrel, warfarin); you may need to suspend these for a few days until after the colonoscopy. Notify your physician about all medications that you are taking.
If you have diabetes and receive insulin, you can consult with the department that gives the procedure, and they will tell you what you can eat before a colonoscopy and what steps to follow in relation to the application of insulin.
The doctor will give you all required information regarding your colonoscopy. This time is ideal for you to receive as much information as possible. You can ask your doctor about the risks and other alternative diagnosis. Then, you’ll be instructed to sign the informed consent and follow through with the procedure.
What Occurs During A Colonoscopy?
A colonoscopy usually takes no more than 30 to 60 minutes to be completed. Before the procedure, the nurse will give you a pain reliever and a sedative intravenously. These drugs will help you not to feel pain or discomfort during the procedure. The nurse will place an oxygen mask on you. Your pulse, heart rate and breaths per minute will be monitored.
A colonoscopy is performed with the patient their side, and the doctor will insert the colon scope into the anus along with a lubricant to facilitate the process.
During a colonoscopy, air is injected allowing the doctor to move the colon scope gently. It is normal to feel some discomfort. The doctor will move the colon scope according to the area of the intestine that needs investigation. This is facilitated by the curves of the intestine and the flexibility of the colon scope. At the end of the colon scope is a lens that sends images to the monitor. The doctor will look at the pictures and ask you to change your position if it is necessary.
During the colonoscopy, the doctor may take a tissue sample (biopsy) or remove polyps. This is accomplished by using long forceps that are inserted through the scope, which allows for the removal of tissue. Samples are sent to the pathology laboratory for analysis to determine whether any malignancies exist.
Post Procedure Expectations
When the colonoscopy is completed, the colon scope is easily removed as
well as the air that was introduced. You will need to rest until the anesthesia has passed. You cannot drive home; therefore transportation arrangements will be necessary following the procedure.
Before you leave the hospital, the doctor can talk to you about their findings. If the doctor has removed polyps or taken a biopsy, the results will be sent to the hospital, and you will require a follow-up appointment. The physician will discuss this with you.
Several hours after the colonoscopy, you may feel pain. The doctors would recommend over the counter medication such as analgesics (paracetamol, ibuprofen) or other medication for pain that the doctor has prescribed. The process of sedation disqualifies you from certain tasks and your ability to focus and coordinate movements are diminished for a period of time. You must avoid drinking alcohol, other sedative drugs, drive a car or operate machinery.
Following the colonoscopy procedure, if you experience any of the below symptoms, consult your doctor:
• Rectal bleeding
• Abdominal swelling
• Pain
• Inflammation
• Fever
Side Effects
There are certain side effects that often occur after colonoscopy:
• Gas or bloating
• Light bleeding if a biopsy was performed or removal of polyps
Complications Following Colonoscopy
Complications that can occur after a colonoscopy are rare but still happen:
1. Inability to see inside the bowel: This occurs if the colon’s fecal matter has been completely removed or due to the inability to move the colon scope into the loops of intestine. In such cases, a colonoscopy would be recommended again or other tests could be performed.
2. Reaction to anesthesia: This may alter the heart rate or the number of breaths. This is strictly controlled and, in such situations as a reaction, you will be treated immediately. Beware, it is not completely uncommon for patients to die on the operating table due to anesthesia. It affects the heart. It seems to be difficult in determining a safe dosage for everyone and perhaps the patient had a weaker heart of other anomaly that would be a contributing factor.
3. Intestinal wounds caused by colon scope: Doctor performs the procedure safely, but in cases of damage from the passage of the colon scope, surgery is indicated.
4. Bleeding can occur due to the resection of polyps
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Conclusion
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While close attention was given to the accuracy of information in this article, the author accepts neither responsibility nor liability to any person with respect to injury, damage, loss or any circumstances involving alleged causes directly or indirectly related to the information in this article. The sole purpose is to educate and broaden ones awareness. This information is not meant to replace medical advice or services provided by a health care professional.
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