What is colonoscopy?
Colonoscopy is the direct visualization of the entire length of the colon using a flexible videoscopic tube that is inserted into the rectum. The endoscope is the width of a finger.
What are the indications for the procedure?
Colorectal cancer is the third leading cause of cancer deaths in the US and affects both men and women equally. It is estimated that there are approximately 150,000 new cases of colon cancer diagnosed annually. Colorectal cancer is highly preventable and colonoscopy can detect polyps (small growths on the colon) and be removed. This reduces the risk of developing colon cancer in the future.
Screening colonoscopy is recommended starting at the age of 50 even if there are no symptoms. Follow up colonoscopy is based on the results/findings at the time of colonoscopy.
Diagnostic Colonoscopy is performed when there is abdominal pain, rectal bleeding, anemia, diarrhea, change in bowel habits, a history of polyps and a family history of colon cancer or polyps or abnormal imaging studies. These are the most common reason for having a colonoscopy. Detecting polyps at an early stage can prevent cancer.
What preparation is required for colonoscopy?
You will be instructed to have a clear liquid diet the day before the procedure and to take specific laxatives. You will be given written directions/guidelines to follow. The colon must be completely clean for the procedure to be accurate and complete, so be sure to follow the instructions carefully. In general, it is ideal to stop aspirin-containing medications and blood thinners 4-7 days prior to your procedure to decrease the risk of bleeding. Because sedation is given, a designated driver is necessary to take the patient home after the procedure. If you are taking insulin or other diabetic medication, please let the scheduler know as adjustments may need to be made to reduce the risk of low blood sugar. Because sedation is given, a designated driver is necessary to take the patient home after the procedure.
How long will the procedure last?
The colonoscopy usually takes 30-45 minutes. Recovery time after the procedure is about 1 hour. You will be at the endoscopy center for about 3 hours.
Will the procedure be painful?
The majority of our patients do not feel or remember anything. If a prior experience was not pleasant, please let us know so we may communicate this to our physician. Sedation administered by an anesthesiologist may be necessary.
What will happen if a polyp is seen?
We try to remove all polyps at the time of colonoscopy. Biopsies and polyp removal rarely cause pain. Biopsies or tissue samples can be safely obtained for examination under the microscope. Biopsies are taken with pinch forceps that are passed through a channel in the endoscopy. Small, superficial pieces of the lining are obtained and sent to the pathologist for examination. Results are usually available within a week. Our office will review the results and a letter will be sent detailing the findings and when repeat colonoscopy will be due.
How often is colonoscopy required?
If pre-cancerous polyps are removed, a repeat exam in 1-5 years should be considered depending on the size, number and location of the polyp. This is determined at the time of review of the written pathology report.
What are the safety issues of colonoscopy?
Allergy or reaction to medications, bleeding after polyp removal and rare risks of perforation of the colon are the potential complications of colonoscopy. If polyps are removed you will be instructed to avoid aspirin products for 2 weeks to avoid risk of bleeding. In rare cases, when the scab comes off the polypectomy site, bleeding may occur. This often stops on its own or if necessary can be controlled with colonoscopic treatment.