What is a colonoscopy?
A colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum.
Why is a colonoscopy performed?
A colonoscopy is commonly used to evaluate lower gastrointestinal symptoms such as:
- Abdominal discomfort/pain
- Change in bowel habit
- Unexplained weight loss
- Evaluation of lower GI bleeding/anemia
- Diagnosis and management of Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative
- Follow up for diverticular bleeding and diverticulitis
- Abnormality found on X-ray or CT scan.
Colonoscopies are also performed in individuals without symptoms to check for colorectal polyps or cancer.
A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings or children with a history of colorectal cancer or polyps.
What happens before a colonoscopy?
To have a successful colonoscopy, your bowel must be clean so that your physician can clearly view the lining of your colon. Any residue left in the colon may obscure the doctor’s view of your colon and rectum during the exam. The bowel movement coming out should look like the fluids you are drinking–clear without many particles. You know you are done when the bowel movement coming out is yellow, light liquid and clear, like urine. Prior to leaving home, the bowel movement may be clear, yellow or green tinged but should not have solid matter.
To do this, it is very important to read and follow all of the written instructions given to you at least one week before your exam. If you did not receive detailed written instructions, call Digestive Disease Medicine at 315-624-7000.
If your bowel is not clean, your colonoscopy will not be successful and may have to be repeated.
If you normally take prescribed medication including high blood pressure medication in the morning, You must continue to take medication for blood pressure, heart, and respiratory/breathing problems (including inhalers) as you usually do. For instance, if you normally take it in the morning, take it on the day of your procedure with a sip of water at least four hours before your exam. However, do not take any diabetic medication the evening prior or the morning of the procedure.
If you are on medication that affects bleeding (Coumadin,Plavix,Xarelto,Pradaxa,Eliquis), you will receive special instruction concerning your anticoagulants. You do not need to stop taking your Aspirin 81mg (Baby Aspirin) prior to your exam. If you are taking Aspirin 325mg, usually you will be instructed to lower the dose to 81mg one week prior to your exam.
You must discontinue the use of Phentermine (Acidex-P, Supreza or any diet medications) for two weeks prior to your procedure.
You must discontinue the use of fiber supplements and iron for one week prior to your exam. Do not eat quinoa, popcorn ,nuts or seeds for one week prior to your exam.
Bring a copy of any advanced directives with you. (ex. Health care proxy, living will, DNR)
You do not need to bring your Cpap machine with you.
Do not use marijuana after midnight on the evening prior to your exam until your procedure is done.
Do not use cocaine for 2 weeks prior to your exam.
What happens during your admission?
After you sign in at the registration desk, you will be called from the waiting room for an interview with a nurse. The nurse will ask you questions concerning your medical history, allergies, medications, bowel prep results and NPO status among other questions. You will also sign a consent for your procedure which gives your GI doctor permission to perform your exam. Discharge instructions will also be reviewed with you at this time.
After your interview, you will be brought to the admitting area where you will get changed for your procedure. Baseline vital signs will be taken. An intravenous catheter will be inserted into your arm/hand by a nurse for administration of IV fluids/medications.
An Anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA) will be continually present for your care while you are a patient at MVEC. Before your procedure, an anesthesiologist will perform a brief physical assessment. You will be asked about underlying medical conditions, your medical history, and the medications you are taking. It is important to inform your anesthesiologist if you have a history of allergic reaction to specific medications. All of this information will assist your anesthesiologist in planning and administering the safest anesthetic possible.
Anesthesia at MVEC is provided by anesthesiologists, Dr Michelle Johnston and Dr Mark Sumner and by the nurse anesthetist group, Tricore Anesthesia.
What happens during a colonoscopy?
After you are taken to the procedure room, monitors will be attached to your body to allow your health care team to continuously monitor your breathing, blood pressure and heart rate.You will be asked to turn onto your left side. A nasal cannula will be placed to administer oxygen while you are sedated.
Your nurse anesthetist (CRNA) will administer your sedation into your IV line and monitor you throughout your procedure.
Once you are asleep, your physician will insert a flexible tube (colonoscope) into your rectum and advance it through your entire colon. A tiny video camera at the tip of the colonoscope allows the doctor to view the inside of your colon on an external high definition video monitor.
MVEC uses CO2 (carbon dioxide) rather than room air for distention of the colon during colonoscopy exams. The use of CO2 has proven to reduce the retention of gas, bloating, and abdominal discomfort following a colonoscopy.
If necessary, polyps or other types of abnormal tissue can be removed through the colonoscope during the procedure. Tissue samples (biopsies) can be taken as well.
Biopsies are taken for many reasons and do not necessarily imply cancer.
A colonoscopy typically takes 20-45 minutes to perform.
What are polyps and why are they removed?
Polyps are abnormal growths from the lining of the colon that vary in size from a tiny dot to several inches. The majority of colon polyps are benign but some can be precancerous. Some polyps can develop into colon cancer over time. In general, the larger the polyp, the greater chance of cancer.
The doctor cannot always tell a benign polyp from a malignant (cancerous) one by its outer appearance alone. For this reason, polyps that are removed are sent for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.
What happens after a colonoscopy?
After the procedure, you will be taken to the recovery room. The recovery period is usually 30 minutes before you can be discharged home. Before you are discharged, your GI doctor will explain the results of your procedure to you.
You will be able to resume your usual diet/medications unless instructed otherwise.
A responsible adult must drive/accompany you home.
You may feel alert after your procedure, but your judgement and reflexes may be impaired for the remainder of the day, making it unsafe to drive or operate machinery. You should also plan not to work, schedule meetings/appointments or make legal decisions on the day of your procedure.
What are the possible complications of a colonoscopy?
Colonoscopies and polypectomies are generally safe when performed by physicians who have been trained and are experienced in endoscopy procedures. Complications can occur but are rare. Your physician will inform you of potential complications prior to your exam. Although complications after a colonoscopy are uncommon, it is important for you to recognize early signs of any possible complications. Contact your doctor if you notice any of the following: severe abdominal pain, severe nausea/ vomiting, fever, chills or rectal bleeding more than a tablespoon. Bleeding can occur several days after polypectomy.