Colonoscopy

Last updated date: 31-Jan-2023

Originally Written in English

Colonoscopy

colonoscopy refers to an outpatient procedure that examines the inner part of the large intestine (colon and rectum). It involves the use of a colonoscope to perform the inspection, sometimes known as a scope. This long, flexible device features a camera and the capacity to extract tissue. 

If necessary, doctors can remove polyps and other forms of abnormal tissue using the scope when performing the procedure. A biopsy (extracting tissue samples) can as well be done during a colonoscopy. In addition, this procedure is normally performed to assess gastrointestinal symptoms, including bleeding, abdominal pain, or bowel movement changes.

 

Why Colonoscopy is done 

Medical providers can suggest a colonoscopy procedure in order to; 

Colon cancer screening: If you are 50 or above with a slight possibility of colon cancer (you have no other risk factors for colon cancer besides age), the doctor can suggest a colonoscopy after every ten years or even sooner. Colonoscopy is one method for detecting colon cancer. You can as well discuss your alternatives with your doctor. 

Examine the signs and symptoms of an intestinal disorder: Your doctor can use a colonoscopy to look into the potential reasons for abdominal pain, chronic constipation, rectal bleeding, chronic diarrhea, or any other intestinal issues. 

Find more polyps: If you've previously had polyps, the doctor can suggest a follow-up colonoscopy to search for and eliminate any new polyps. This is performed to lower your chances of getting colon cancer. 

 

Colonoscopy Risks 

While colonoscopy is a regular procedure, it’s associated with a few lasting side effects. However, in most cases, the advantages of finding problems and starting the treatment outweigh the complication risks from the procedure. 

Some of the rare yet possible risks of colonoscopy include; 

  • An adverse reaction to the sedative administered 
  • With a colonoscopy biopsy, bleeding can occur on the extraction site 
  • A tear in the colon or the rectal wall 

 

Preparing for Colonoscopy 

Before undoing colonoscopy, the doctor will ask you to clean out or empty the colon. Any remains in the colon can interfere with the rectum and colon view during the examination. The doctor can ask you to do the following as you prepare for the procedure; 

Eat a special diet a day before the examination: One day before you undergo the procedure, you should not eat any solid meals. Instead, clear liquids, such as plain water, coffee and tea without milk and cream, carbonated beverages, and broth are recommended. Keep off red liquids during the procedure because they can be mistaken for blood. After midnight during the night prior to the examination, you should avoid eating or drinking anything. 

Take a laxative: The provider is likely to advise you to take a laxative, which can come in the form of a liquid or pill. He or she can recommend taking the laxative on the night prior to the colonoscopy. Alternatively, you might be required to take it during the night before and the day of the operation.

Use an enema kit to empty the colon: You might be required to use an over-the-counter enema kit to empty the colon in some situations. This could be on the night before the examination or some hours before undergoing the procedure. This method is usually only useful for clearing the lower colon. However, it is not suggested as a primary method of colon emptying.

Make changes to your meds: If you have high blood pressure, diabetes, heart disorders, or if you are using iron-containing drugs or supplements, tell your doctor about them at least one week before the procedure. 

In addition, inform the doctor whether you're using the following;  

  • Aspirin or any other blood-thinning medications like warfarin; 
  • New anticoagulants like dabigatran, which can help prevent blood clots and strokes; 
  • Or heart drugs like clopidogrel, which influence platelets.

At times, you might be required to alter your dose or temporarily stop taking your prescriptions.

 

What Happens During Colonoscopy?

undergoing a colonoscopy

While undergoing a colonoscopy, you will most likely wear nothing but a gown. In most cases, sedation is advised. A moderate sedative is sometimes administered in the form of a pill. To alleviate any form of discomfort, the sedative is sometimes mixed with an IV pain medicine.

The procedure will begin with you lying on the examination table by your side, and your knees are drawn to the chest. The physician will then put a scope into the rectum. The scope is usually long such that it reaches the whole dimension of the colon. 

Furthermore, it is illuminated and has a tube or channel which enables the provider to push in carbon dioxide or air into the colon. This will inflate your colon, giving a clearer view of the lining. You might experience abdominal cramping or bowel movement urge whenever the colonoscope moves or air gets introduced. 

The scope is also attached to a small video camera at one of its ends. It works by transmitting pictures to the external computer, making it easy for the doctor to assess the inside of the colon. If necessary, the doctor can as well insert devices via the tube to remove small tissue samples (a biopsy) and take out polyps or a part of the abnormal tissue. 

Typically, the entire colonoscopy procedure takes approximately 30 to 60 minutes. 

 

What Happens After Colonoscopy?

It takes roughly an hour for the sedation to wear off after the procedure. The sedative's full effects could take up to one day to wear off completely. Hence, you need to find someone who will drive you home. Also, for a few days following the exam, avoid driving, making crucial decisions, or returning to work. 

If a polyp was removed during the colonoscopy, the doctor might recommend following a particular diet for a while. As you remove the air from the colon, you might feel bloated and pass out gas for several hours following the procedure. Walking could be helpful in the relief of any discomfort. 

After the procedure, you are likely to notice a small quantity of blood in the first bowel movement. Normally, this is not a cause for any concern. But if you keep on passing blood or blood clots, or experience constant abdominal pain and fever, see your doctor. Although unlikely, this could happen right away or within a few days of the procedure. However, it could take up to two weeks. 

 

Colonoscopy Results 

After the procedure, the provider will carefully review the outcome of the colonoscopy and discuss it with you. You should thus expect any of the following colonoscopy results

Negative outcome:

If your doctor does not find any abnormality in the colon, the colonoscopy will be rendered negative. The doctor can suggest an additional colonoscopy if; 

  • You have an average possibility of colon cancer in ten years, but you don’t have any colon cancer risk factors apart from your age.
  • You have a previous history of polyps from colonoscopy examinations; you should have another colonoscopy in five years. 
  • There was a remaining stool within the colon after a year that affected a full exam. 

Positive outcome

colonoscopy outcome

If your doctor discovers polyps or an unusual tissue within your colon, the colonoscopy exam is considered positive. Although the majority of polyps are not cancerous, some could be precancerous. However, colonoscopy polyps will be taken to the lab for evaluation to determine if they are malignant, precancerous, or benign. 

You might have to adopt a more accurate surveillance program in the future to check for more polyps. This will, however, depend on the number as well as the size of the polyps. 

Based on the other colon cancer risk factors, your doctor may suggest another colonoscopy in five to ten years. This is especially if one or two polyps are 0.4 inches (1 centimeter) or less in diameter. 

You may be required to have an additional colonoscopy as soon as possible if; 

  • There are more than two polyps
  • There is a giant polyp is one that is larger than 0.4 inch in diameter (1 centimeter)
  • Polyps, as well as a remaining stool in the colon, prevented a thorough examination.
  • Polyps having cell characteristics that show an increased risk of cancer in the future
  • Polyps that are cancerous

If a polyp or an abnormal tissue was not extracted during the procedure, the doctor might suggest a follow-up examination with a gastroenterologist specialising in the removal of large polyps or surgical operation. 

 

Having issues with your colonoscopy?

Sometimes, the doctor may be worried about the quality of the outlook via the scope. In such cases, a repeat colonoscopy or a shorter wait time between colonoscopies might be recommended. Also, if the doctor could not get the scope through your colon, a virtual colonoscopy or barium enema may be recommended. This will help look at the rest of the colon.

 

Conclusion 

During a colonoscopy, the medical provider examines your colon for any abnormalities or disorder. This is achieved using a colonoscope, a tiny flexible tube with a light and camera connected. The colon is a part of the gastrointestinal tract's lower section. It absorbs food, takes in nutrients, and eliminates waste. 

In addition, the doctor can take out tissue samples for biopsy or extract abnormal tissue like polyps during this procedure.