Colonoscopy

A colonoscopy is a common procedure in which the doctor examines the entire inner lining of the large intestine, which includes the colon and rectum.  It is used to diagnose colon and rectal problems and to perform biopsies or removed colorectal polyps.  These polyps can gradually transform into cancer over a period of years.  Removing the polyps will reduce or prevent someone from getting colon cancer.

Why is a colonoscopy ordered?
The most common reason for having a colonoscopy is screening of the large intestine for colon and rectal cancer.  Everyone at or over the age of 50, without any risk for polyps and cancer, should have a screening colonoscopy.  If you have risk factors for colon cancer, such as a family history, your doctor may recommend earlier colonoscopy.  African Americans have a higher risk and death rate from colon cancer than any other ethnic group.  The exact reason isn’t known.  African Americans should begin screening colonoscopy at the age of 45 rather than the age of 50.

Additional reasons for a colonoscopy include:

*Unexplained abdominal symptoms

*Anemia or low blood count

*Blood in the stool, hidden or obvious

*Diarrhea

*Change in bowel habits

*Suspected inflammatory bowel disease such as Ulcerative Colitis or Crohn’s disease

How does one prepare for a colonoscopy?
Often with a colonoscopy, the procedure is relatively easy and the day before the procedure is harder.  Patients should therefore read through the complete instructions and information concerning the colonoscopy and the bowel prep at least one week before the procedure.  They should make sure that all information and instructions are understood before starting the bowel preparation.  Remaining on a clear liquid diet the day before the colonoscopy and completing the bowel preparation solution are the greatest challenges to undergoing a colonoscopy.  The prep simply doesn’t taste very good; however, cleaning the colon is an absolutely critical part of an effective procedure.  A bowel prep is a prescription medicine the doctor gives to prepare the colon for inspection during a colonoscopy.  The goal of the bowel prep is to remove all solid waste from the colon for the best evaluation.  Without a clean colon, a thorough examination of the colon becomes much more difficult for the doctor.  Additionally, it is essential to stay well-hydrated while doing the bowel prep, as patients need to replace the fluids they’re losing.

What happens the day of the procedure?
Since patients are sedated for the colonoscopy, they may not eat or drink anything the morning of the procedure. The exception to this rule is if a patient takes important blood-pressure medications or other medications in the morning.  They may be consumed with a small sip of water.

On arrival to the facility, patients are asked to change into a hospital gown. After an IV has been started, patients are taken into the procedure room.  When the procedure is ready to begin, the patient will  be asked to roll over onto the left side.  Sedation will be given through an IV in the hand or arm.  The most common method of sedation for a colonoscopy, puts the patient into a sleepy, dreamlike state to make sure he or she is comfortable during the procedure.  The medication is very short acting, so as soon as it stops being administered, the person wakes up very quickly with minimal side effects or hangover effects.

During the course of the colonoscopy, if the doctor sees a polyp or other growth or lesion, it will be removed through the colonoscope.  The entire procedure usually takes less than half an hour.  Afterwards, patients are in the recovery room for 30 to 45 minutes.  Doctor and patient will then discuss the colonoscopy’s results.  Because of the sedation, patients will need someone to drive them home.

What happens after the colonoscopy?
Most people prefer to rest after having a colonoscopy since they may not have had much sleep while doing the bowel prep. Patients may eat what they like, unless specifically instructed otherwise by the doctor. Furthermore, patients should not drive, operate heavy machinery, or make any major legal or financial decisions the day of the colonoscopy.  The following day life can resume as usual.  If any biopsies were taken during the procedure, patients will be called with the results in a few days.  Should the person develop any abdominal pain, fevers, chills or have any questions, he or she should call the office for immediate attention.