Colonoscopy, or Lower Gastrointestinal Endoscopy, is the examination of the large bowel with a flexible video endoscope. This procedure may be performed for gastrointestinal emergencies on hospitalized patients, but more commonly it is used as a screening or diagnostic procedure in the outpatient setting. However, the indications for which a Colonoscopy is performed are numerous and include:
• Evaluation of anemia
• Evaluation of rectal or gastrointestinal bleeding
• Evaluation of stool positive for occult blood
• Evaluation of diarrhea or constipation
• Evaluation of abdominal pain.
• Evaluation of change in bowel habits
• Evaluation of weight loss
Most commonly today the procedure is done on asymptomatic patients as a screening test for polyps and colon cancer. Currently, the standard of care is for everyone, men and women alike, to undergo a colonoscopy beginning at age fifty and to have this procedure performed every ten years. (The recommended age to begin screening may be earlier than fifty if there is a first-degree family relative with colon polyps or cancer.) Should precancerous or adenomatous polyps be found on the colonoscopy, your doctor will discuss with you when a repeat colonoscopy is recommended.
You will be given detailed instructions on how to prepare for the Colonoscopy by your doctor’s office. You will need to be on a clear liquid diet the day before the procedure and take a powerful oral laxative on the evening before the colonoscopy. Additionally, you will have nothing to eat or drink after midnight prior to the day the colonoscopy is performed.
For outpatient colonoscopy, your time at the Endoscopy Center is similar to that outlined below in the section on Upper Endoscopy. Please refer to that section for details. A colonoscopy typically lasts fifteen to twenty minutes unless some therapeutic intervention is needed. Once the procedure is completed, you will be then taken to the recovery room where you will spend approximately 30 minutes before discharge home. Overall, you will spend approximately one and a half to two hours in the Endoscopy Center.
The colonoscopy procedure may be both diagnostic and therapeutic. That is, should polyps or growths from the lining of the colon be seen, they will be removed. This is technically feasible in the vast majority of cases. Biopsies to aid in the diagnosis of various conditions may also be taken. Additionally, if a source of bleeding is identified, treatment with epinephrine injection and/or electro-cauterization may be performed to control the bleeding site.
Colonoscopy is overall quite safe. Potential risks and complications include bleeding (particularly secondary to polyp removal), missing a polyp or other lesion, and perforation which would require surgical intervention (either direct surgical repair of the perforation or creation of a temporary colostomy which would be reversed or taken down at a later date). Infection and an allergic or medication reaction are rare occurrences.
At the conclusion of the procedure, you will be given a written report and representative photographs. Your doctor may also discuss the procedure findings with you in the recovery area. If indicated, you will be asked to schedule a follow-up appointment with your doctor at his or her office to further discuss the results of the procedure and treatment plan
Many people have fears and have heard horror stories about Colonoscopy. However, the vast majority of patients find the procedure to be quite underwhelming. All of us attempt to make the patient as comfortable as possible for colonoscopy. Thus, there should be no reason why fear should preclude one from undergoing this important and potentially life-saving procedure.