What You Need to Know About a Colonscopy

Colorectal cancer is the second leading cause of cancer-related death in men and women in the U.S., and one in three people are not up to date on their screening.

A colonoscopy  is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.

Below are answers to the most frequently asked questions about this procedure:

Who should have a Colonoscopy?

The American Cancer Society currently recommends that men and women should be screened for colorectal cancer starting at age 45. Although there are other tests that can used to identify cancer, a colonoscopy is the only screening test that also can prevent cancer from developing.

Follow-up colonoscopies should be done every 1 to 3 years, depending on the person’s risk factors for colorectal cancer and the findings on the previous exam.

Patients with a family history of colon or related types of cancers should talk with their doctor about earlier screening recommendations.

What preparation is required?

The colon must be completely clean for the procedure to be accurate and complete. Your physician will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. Follow your doctor’s instructions carefully. If you do not, the procedure may have to be canceled and repeated later. 

What about my current medications?

Most medications may be continued as usual, but some medications can interfere with the preparation or examination. It is therefore best to inform your physician 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 physician prior to the examination.

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. Your doctor may give you medication through a vein to help you relax and better tolerate any discomfort from the procedure. You will be lying on your 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 physician will decide if the limited examination is sufficient or if other examinations are necessary.

What if the colonoscopy shows something abnormal?

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 lining can only sense stretching. Remember, biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. 

What are polyps and why are they removed?

Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. 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.

How are polyps removed?

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 in the wall of the colon which could require emergency surgery.

What happens after Colonoscopy?

After colonoscopy, your physician 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 up to 2 hours). You· will need someone to drive you home after the procedure. You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with the passage of flatus (gas). Generally, you should be able to eat 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 of colonoscopy is a perforation or tear through the bowel wall which could require surgery. Bleeding may occur from the site of 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. Localized 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 discomfort.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact the physician who performed the colonoscopy if you notice any of the following symptoms: severe abdominal pain, fever 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 physicians who have been specially trained and are experienced in these endoscopic procedures.

Starling Gastroenterologist, Dr. Barry Kemler is here to provide his expertise.
Don’t neglect to schedule this important screening that could save your life.
Schedule a consultation today.
Call (860) 224-6249