A colonoscopy is an exam of the lower part of the gastrointestinal tract, which is called the colon or large intestine (bowel). Colonoscopy is a safe procedure that provides information other tests may not be able to give. Patients who require colonoscopy often have questions and concerns about the procedure.

Colonoscopy is performed by inserting a device called a colonoscope into the anus and advanced through the entire colon. The procedure generally takes between 20 minutes and one hour.

Reasons For Colonoscopy

The most common reasons for colonoscopy are to evaluate the following:

  • As a screening exam for polyps or colon cancer
  • Rectal bleeding
  • A family history of colon cancer
  • A change in bowel habits, like persistent diarrhoea
  • Iron deficiency anaemia (a decrease in blood count due to loss of iron)
  • As a follow-up test in people with colon polyps or colon cancer
  • Chronic, unexplained abdominal or rectal pain
  • An abnormal x-ray exam, like a barium enema or CT scan

Colonoscopy Preparation

Before colonoscopy, your colon must be completely cleaned out so that the Dr Yoganathan can see any abnormal areas. My office will provide specific instructions about how you should prepare for colonoscopy. Be sure to read these instructions as soon as you get them so you will know how to take the preparation and to find out if you need to make any changes to your medications or diet. If you have questions, call my office in advance. You will need to avoid solid food for at least one day before the test. You should also drink plenty of fluids on the day before the test. You can drink clear liquids up to several hours before your procedure, including. To clean the colon, you will take a strong laxative and empty your bowels.

What to expect

Before the test, Dr Yoganathan will review the procedure with you, including possible complications, and ask you to sign a consent form. An IV line will be inserted in your hand or arm. Your blood pressure, heart rate, and breathing will be monitored during the test.

The Colonoscopy Procedure

You will be given fluid and medicines through the IV line. With sedation/analgesia provided by the anaesthetist many people sleep during the test, while others are very relaxed, comfortable, and generally not aware. Dr Yoganathan will request an anaesthesiologist give you an anaesthetic agent (Propofol), which is a stronger sedative and will put you to sleep while you are being closely monitored. The colonoscope is a flexible tube with a fibre optic camera, approximately the diameter of the index finger. The scope gently pumps carbon dioxide into the colon to inflate it and allow the doctor to see the entire lining. You might feel bloating or gas cramps as the carbon dioxide opens the colon. Try not to be embarrassed about passing this gas post procedure and let me know if you are uncomfortable. During the procedure, I might take a biopsy (small pieces of tissue) or remove polyps. Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most polyps are benign (not cancerous). However, some polyps can become cancerous if allowed to grow for a long time. Having a polyp removed does not hurt.

Recovery from Colonoscopy

After the colonoscopy, you will be observed in a recovery area until the effects of the sedative medication wear off. The most common complaint after colonoscopy is a feeling of bloating and gas cramps. You may also feel groggy from the sedation medications. You should not return to work or drive that day. Most people are able to eat normally after the test. Ask your doctor when it is safe to restart your blood-thinning medications.

Colonoscopy Complications

Colonoscopy is a safe procedure, and complications are rare but can occur:

  • Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled.
  • The colonoscope can cause a tear or hole in the colon (perforation). This is a serious problem, but it does not happen commonly.
  • It is possible to have side effects from the sedative medicines.
  • Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.
You should call your doctor immediately if you have any of the following:
  • Severe abdominal pain (not just gas cramps)
  • A firm, bloated abdomen
  • Vomiting
  • Fever
  • Rectal bleeding (greater than a couple of tablespoons [30 mL])

After Colonoscopy

Although many people worry about being uncomfortable during a colonoscopy, most people tolerate it very well and feel fine afterward. It is normal to feel tired afterward. Plan to take it easy and relax the rest of the day. Dr Yoganathan can describe the results of the colonoscopy as soon as it is over.

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