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Colonoscopy is an examination that allows your doctor to look inside your large intestine for a complete large bowel evaluation. The colonoscope is a flexible tube about the thickness of a finger with a camera at the tip. The colonoscopy is inserted from the anus and carefully maneuvered through the rectum into the colon. Colonoscopy helps your doctor evaluate symptoms of the lower digestive tract, to find out if your large intestine is healthy or diseased. If needed, treatment can also be performed through the colonoscope, such as removal of polyps (polypectomy).
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Please inform your doctor of your medications as some may need to be stopped prior to colonoscopy. You will receive instructions in advance to help you prepare for this test. You will have to stop taking any dietary fiber (fruits, vegetables, mushrooms) for one day before the test. You will be given a purgative medication to clean out your large intestine, so that clear views can be obtained. The preparation time before colonoscopy takes at least 4 hours. Therefore it is possible to perform colonoscopy on the same day if the medication is taken early in the morning. However, most patients prefer to take the medication at home and have the colonoscopy performed the next morning. A written copy of the instructions will also be provided to help you.
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Colonoscopy is done with you lying on your left side. An injection of a sedative is usually given to make you relaxed and go into light sleep. The lubricated colonoscope is then gently introduced into the anus and steered through the entire large intestine. The entire procedure takes between 15 to 30 minutes. In some cases, it may be necessary to take a sample of tissue (biopsy) for examination. When polyps are encountered, the doctor will remove them for examination.
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As colonoscopy only involves pushing a tube through the colon without making any cuts, the risks are very small for any problems. Care will be taken to minimize discomfort but patients may feel mild cramping, bloating or gas after the procedure which can last up to 24 hrs. Heavy bleeding may occur after removal of a polyp and sometimes require transfusion but rarely requires reinsertion of colonoscope to control the bleeding. The risk of heavy bleeding is less than 0.1%. There is a slight risk of bowel perforation (tearing a hole) and the risk is increased in patients with multiple previous abdominal operations that may have caused adhesions and scarring in the abdomen. The overall risk of perforation is also less than 0.1%.
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Alternative tests to colonoscopy include a barium enema or a CT colonography. Both are specialised forms of radiologic examination that outline the colon and allow a diagnosis to be made. CT colonography is commonly referred to as "virtual colonoscopy". However, both tests do not allow biopsy of any abnormal findings. Study of the stools and blood can also provide indirect information about a colon condition. These exams, however, do not allow direct viewing of the colon, removal of polyps, or tissue samples of abnormal findings. Hence, these tests are only employed when a colonoscopy fails or when patients refuse to undergo colonoscopy.
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