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What is Colonoscopy?

Colonoscopy is a procedure that enables your doctor to examine the lining of the colon (large bowel) for abnormalities, by inserting a flexible tube about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.


What preparation is required?

Bowel Preparation Instructions

The colon must be completely clean for the procedure to be accurate and complete. Your doctor will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. In general, preparation consists of either consumption of a large volume of a special cleansing solution or several days of clear liquids, laxatives and enemas prior to the examination.

Follow your doctor's instructions carefully. If you do not, the procedure may have to be cancelled and repeated later.


What about my current medications?

Most medications may be continued as usual, but some medications can interfere with the preparation or the examination. It is therefore best to inform your doctor of your current medications as well as any allergies to medications several days prior to the examination. Aspirin products, arthritis medications, anticoagulants (blood thinners), insulin, and iron products are examples of medications whose use should be discussed with your doctor prior to the examination. It is also essential that you alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to colonoscopy as well.


What can be expected during Colonoscopy?

Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating or cramping at times during the procedure. The anaesthetist will give you medication through a vein to help you relax and better tolerate any discomfort from the procedure. You will be lying on your left side or on your back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the lining is again carefully examined. The procedure usually takes 15 to 60 minutes. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The doctor will decide if the limited examination is sufficient or if other examinations are necessary.

If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining) or a small brush is introduced to collect cells (a cytology test). These specimens are submitted to the pathology laboratory for analysis. If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulating the bleeding vessels. If polyps are found, they are generally removed. None of these additional procedures produce pain since the colon can only sense stretching. Remember, biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.


How are polyps removed?

Polyps are abnormal growths on the lining of the colon that vary in size from a tiny dot to several centimetres. The majority of polyps are benign (non cancerous) but the doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis by the pathologist. Removal of colon polyps is an important means of preventing colorectal cancer.

Tiny polyps may be totally destroyed by fulguration (burning) but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electric current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon (perforation) which could require emergency surgery.


What happens after the Colonoscopy

PAfter the colonoscopy, your doctor will explain the results to you. If you have been given medications during the procedure, you will be observed until most of the effects of sedation have worn off (for ½ to 2 hours). You will need someone to drive you home after the procedure.
You must not drive.

You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with passage of flatus (gas). Generally, you should be able to eat and drink normally after leaving the endoscopy area but your doctor may restrict your diet and activities, especially after polypectomy.


What are the possible complications of Colonoscopy?

One possible complication is a perforation or tear through the bowel wall that could require surgery. Bleeding may occur from the site of a biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the colonoscope. Rarely, blood transfusions or surgery may be required. Other potential risks include a reaction to the sedatives used and complications from heart or lung disease. Localised irritation of the vein where medications were injected may cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve the discomfort. Although complications after colonoscopy are uncommon, it is important for you to recognise early signs of any possible complication. Please contact the doctor who performed the colonoscopy or your own doctor if you notice any of the following symptoms: severe abdominal pain, fevers and chills, or rectal bleeding of more than one-half cup. Bleeding can occur several days after polypectomy.


Colonoscopy and polypectomy are generally safe when performed by doctors who have been specially trained and experienced conducting these endoscopic procedures. If you have problems after discharge please telephone 9808 7111 GLEN IRIS PRIVATE.


To the patient

Because education is an important part of comprehensive medical care, you have been provided with this information to prepare for this procedure. If you have questions about your need for colonoscopy, alternative tests, the cost of the procedure, methods of billing, or insurance coverage, do not hesitate to speak to your doctor or your doctor's office staff. Endoscopists are highly skilled specialists who welcome your questions regarding their credentials and training. If you have any questions that have not been answered, please discuss them with your local doctor or the doctor performing the procedure before the examination begins.

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