What is a Colonoscopy?
A colonoscopy enables your doctor to examine the lining of the large intestine for abnormalities. The procedure is generally safe when performed by specially trained and experienced doctors, as are the physicians at Gastroenterology Associates, LLP.
Open access colonoscopy is a service that allows healthy, age-appropriate patients to easily schedule a screening colonoscopy, usually without a pre-procedure visit. If you are in good health, an open access colonoscopy will likely prove to be a very efficient use of your time.
During a colonoscopy, a flexible tube as thick as a finger called a colonoscope is inserted into the anus and slowly advanced into the rectum and colon. You will lie on your side or back while your doctor slowly advances a colonoscope to examine the lining. Your doctor will examine the lining again as he or she slowly withdraws the colonoscope.
A colonoscopy is usually well tolerated and rarely causes much pain, though you might feel pressure, bloating or cramping during or after the procedure because of the air introduced into the colon during the examination. This should disappear quickly when you pass gas. You should be able to eat after the examination, but your doctor might restrict your diet and activities, especially after a polypectomy.
Your doctor may administer a sedative to help you relax and better tolerate any discomfort. If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day.
The procedure usually takes 15 minutes to an hour, although you should plan on two to three hours for waiting, preparation and recovery. After the procedure, your physician will explain the results of the examination to you, although you'll probably have to wait for the results of any biopsies performed.
In some cases, the doctor cannot pass the colonoscope through the entire colon to where it meets the small intestine. Although another examination might be needed, your doctor might decide that the limited examination is sufficient.
If your doctor thinks an area needs further evaluation, he or she might pass an instrument through the colonoscope to obtain a biopsy (a sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn't suspect cancer.
Your doctor might also find polyps during colonoscopy, and he or she will most likely remove them during the examination. Polyps are abnormal growths in the colon lining that are usually benign (non-cancerous). They vary in size from a tiny dot to several inches. Because cancer begins in polyps, removing them is an important means of preventing colorectal cancer.
Polyps are removed with either biopsy instruments or by passing an electrical current through small wire loops called “snares,” a procedure that should be pain free.
Polyps known as "hyperplastic" might not require removal, but benign polyps known as "adenomas" are potentially pre-cancerous. Your doctor can't always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so he or she might send removed polyps for further analysis.
Colonoscopies and polypectomies are generally safe procedures when performed by specially trained and experienced doctors. Possible complications include:
- A perforation or tear through the bowel wall could occur, which then may require surgery
- Minor bleeding at the site of a biopsy or polypectomy, which may stop on its own or be controlled through the colonoscope, both rarely requiring follow-up treatment
- A reaction to the sedatives
- Complications from heart or lung disease
If a colonoscopy is being performed to identify sites of bleeding, your doctor might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Both of these procedures are usually pain free.
Although complications after a colonoscopy are uncommon, it's important to recognize early signs of possible complications. Contact your doctor if you notice any of the following symptoms:
- Severe abdominal pain
- Fever and chills
- Rectal bleeding of more than one-half cup (bleeding can occur several days after the procedure)
Your doctor will tell you what dietary restrictions to follow and what cleansing routine to use. In general, the preparation consists of either consuming a large volume of a special cleansing solution or clear liquids and special oral laxatives. The colon must be completely clean for the procedure to be accurate and complete, so be sure to follow your doctor's instructions carefully.
Most medications can be continued as usual, but some can interfere with the preparation or the examination. Inform your doctor about medications you're taking, particularly:
- Aspirin products
- Arthritis medications
- Anticoagulants (blood thinners)
- Iron products
Be sure to mention any allergies you have to medications. You should also alert your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics before a colonoscopy as well.
What can I eat or drink while I’m drinking the cleansing solution?
Do not eat or drink anything else while you are drinking the solution.
Can I drink alcoholic beverages?
Do not drink any alcoholic beverages prior to your procedure, since they can cause dehydration.
Is there any way to make the cleansing solution taste better? Can I chew gum or suck on candy?
You can try rinsing your mouth with water or mouthwash. Gum or hard candy cannot be used.
Why do I have to avoid red liquids?
The red coloring can persist in the colon and potentially look like blood.
Can I brush my teeth?
Yes, feel free to brush your teeth.
Can I wear my dentures?
Yes, you may wear your dentures. However, you may be asked to remove them prior to the procedure.
I was given a split dose prep. Why can't I drink it all at once?
Simply put, splitting the prep does a better job at cleaning out the colon, specifically the right side of the colon. The better the clean out, the better the results. Studies show that when the colon is clean, more polyps are detected and more cancers prevented. We really do understand how inconvenient a split prep may be (we have to do it ourselves!!), but it gives us the best chance at finding polyps and preventing colon cancer.
I feel like vomiting and I don’t think that I can drink all of the cleansing solution. What do I do?
It is important that you drink all of the cleansing solution if possible. Without a clean bowel, the doctor will not be able to see the inside of your colon to complete the examination. If you experience nausea, wait 15 minutes and resume drinking slowly. If you vomit, wait 45 minutes and begin drinking the solution again. You can also try sipping the solution through a straw.
I drank a lot of the cleansing solution and I have not gone to the bathroom yet. What should I do?
Continue to drink all of the cleansing solution if possible. Most people have a bowel movement after an hour, though some patients may take two hours or longer.
I am drinking the cleansing solution and now have loose watery stools. Do I still need to drink the rest of the cleansing solution?
Yes, continue to drink all of the cleansing solution if possible. You may have solid stool higher in the colon that still needs to be eliminated.
I already have diarrhea before drinking the cleansing solution. Do I still have to drink it?
Yes, drink all of the cleansing solution if possible. Your entire colon is approximately six feet long, and it must be emptied for your physician to see the clearly.
I see yellow color in the toilet bowl and a few flecks. What do I do?
If you have finished drinking the entire cleansing solution, or if your last bowel movements were clear enough that you were able to see the bottom of the toilet, you should be fine.
My bottom is so sore. What can I do?
Avoid rubbing when cleaning the area. Instead, gently pat with a wet washcloth or moist baby wipes. You may also apply Vaseline.
Why do I have to stop taking aspirin, anti-inflammatory medications and blood thinners prior to the procedure?
Some prescription and over-the-counter medications can reduce the body’s ability to form blood clots. Taking them prior to a colonoscopy procedure may increase the risk of bleeding if a polyp needs to be removed. The decision to stop any medication is always based on an estimate of the risk of having a significant medical problem during the short time that you are off of them compared to the risk of bleeding complications from the procedure.
Please speak with your physician if you are taking:
- Aspirin/ecotrin for a specific medical problem
What can I take for headaches and pain relief?
You may take Tylenol.
Can I have the colonoscopy done if I am having my period?
Yes, the procedure can still be performed. If you are having your period, we ask that you use a tampon if possible.