What is Colonoscopy?
Colonoscopy is the digital examination of the colon and rectum internally with a device called a colonoscope. The colonoscope is a flexible fiberoptic tube approximately 6 feet in length and one-half inch in diameter.
Colonoscopy – Preparation
In order for the endoscopist to adequately see the internal lining of the colon, a mechanical bowel prep to cleanse the bowel of stool needs to be carried out the day prior to the procedure. Various preps may include Golytely, MiraLax, OSMO prep, Magnesium Citrate, and Dulcolax pills in various combinations. Your scheduler will give you very specific instructions and a prescription or a bowel prep kit for use the day before the procedure.
Colonoscopy – Exam
On the day of your colonoscopy you will be asked to report to the GI Lab an hour or so before the scheduled procedure to allow check in, changing of clothes, nursing assessment, and starting your IV. Once preparations are completed you will be placed on a stretcher and rolled into the colonoscopy suite where intravenous sedation will be administered to allow you to take a brief nap during the procedure, but still be breathing on your own and able to respond to discomfort. Once satisfactory sedation is achieved the lubricated colonoscope is gently inserted through the anal opening and passed through the rectum and the various parts of the colon all the way to the cecum in the right lower portion of the abdomen. The mucosa is then carefully inspected as the scope is pulled back. Any polyps encountered will be either removed or biopsied. Normally the procedure is accomplished in less than 40 minutes.
What are the Risks of Colonoscopy?
The recognized risks include a one in 1,000 chance of poking a hole in the colon (large intestine) during procedure, and up to 5% risk of serious bleeding up to 12 days out from the procedure if any tissue is biopsied or any polyps removed. Over sedation very rarely leads to suppression of breathing (there are drugs immediately available which will reverse each of the sedating agents which are used for colonoscopy).
Colonoscopy – Aftercare
Following the procedure it is fine for the patient to eat the foods of their choice, unless otherwise instructed by the colonoscopist. Because of the sedation no documents should be signed, motor vehicles operated, or sharp or dangerous objects used at any time during the day of the procedure. You will be asked to call your doctor if you begin passing blood per rectum, develop worsening abdominal pain, or develop a fever.
Colonoscopy – Results
The pathology report from biopsies obtained during colonoscopy are usually available within 48 hours and should be reported to you by an office nurse.