Endoscopy Patients
What is a colonoscopy?
Colonoscopy is a procedure that enables your physician to examine the lining of the rectum and colon. A soft, bendable tube about the thickness of an index finger is gently inserted into the anus and advanced through the colon.
Colonoscopies are routinely performed for a number of reasons: 1) for routine screening for colorectal cancer, 2) for patients, and patients whose first degree relatives have previously had polyps, 3) before or after some surgeries, 4) to evaluate a change in bowel habits, 5) to diagnose or monitor known inflammatory bowel disease, 6) to evaluate a reason for blood in or on the stool.
What preparation is needed prior to colonoscopy?
The colon must be completely emptied of stool so the procedure may be performed. If the colon is not completely clean the procedure may have to be rescheduled or repeated. If you are unable to complete the preparation it is important that you contact your physician. (Monday-Friday 7:00am-3:00pm please call 617-414-6600, all other times please call 617-638-8000 and ask for the GI Fellow on call.) The day prior to your procedure you will need to follow a clear liquid diet, no solid food may be consumed the day prior to the procedure. In general, the colon preparation consists of drinking a solution that will make you move your bowels until only clear liquid remains. Preparations we commonly use are HalfLytely, GoLytely and Fleet PhosphoSoda.
Most medications can be continued as usual. Medications that should be discussed ahead of time with your physician are: blood thinners and insulin.
You will most likely be sedated during the procedure and will need to have a responsible adult to accompany you home. If you do not have a responsible adult to accompany you home you will not be able to receive sedation for the procedure. The sedative will affect your judgment and reflexes for the remainder of the day. You should not plan to drink any alcohol, work or operate and machinery for the remainder of the day.
What can be expected during the colonoscopy?
Most patients tolerate the procedure very well, but often there is a feeling of pressure, gassiness, bloating or cramping at various times during the procedure. You will receive medication through an intravenous catheter that is placed in a vein in your arm, this medication will help you relax and better tolerate any discomfort that you may experience. You will be positioned on your left side for the examination; the procedure generally lasts from 15 to 60 minutes, with the average time for a colonoscopy being about 20 minutes.
What if there is an abnormality seen?
If the physician sees an area that needs to be more closely evaluated, a biopsy may be taken and sent to pathology for a microscopic examination. A special instrument, called a biopsy forcep, is passed through the colonoscopy to take a sample of tissue from the lining of the colon. Polyps are generally removed also using a biopsy forcep or a snare. The majority of polyps removed are benign (non-cancerous), but your physician cannot be certain by appearance alone. If a biopsy is taken and/or a polyp is removed this does not necessarily mean you have cancer, removing polyps are an important way of preventing colorectal cancer.
What can I expect after my colonoscopy?
Your physician will give you a copy of your report before you leave the facility. Your individualized discharge instructions and procedure report will be reviewed prior to your discharge home. You may feel some mild cramping or bloating from the air that is put into your colon during the procedure. This feeling should pass quickly with the passage of the air out of your colon. You should be able to return to a normal diet that day. If you have received medication for your procedure you will be observed until most of the effects of the sedation have worn off. You will need someone to drive you home after the procedure. If any biopsies are taken or polyps removed your physician will contact you within a week with the results of the pathology.
Can complications occur?
Colonoscopies are safe when they are performed by physicians who have had specialized training and are experienced in these endoscopic procedures. Complications are rare, but can occur. These complications can include bleeding from the site of a biopsy or polypectomy, a perforation or tear in the lining of the colon. If this occurs surgery may be needed to repair this tear. You may have a reaction to the medication used to sedate you, if this occurs medication is available to reverse these effects. Irritation to the vein where the intravenous is inserted may occur. This type of reaction is not common, but if it does occur a tender bump may occur and remain for a few weeks. Warm, moist compresses can help relieve any discomfort.
Prepare for Your Visit
Fleet Phospho-Soda Bowel Preparation
GoLytely, NuLytely, CoLyte Bowel Preparation