WHAT IS A COLONOSCOPY?
A Colonoscopy is typically an outpatient procedure that allows your physician to examine the inside of the colon (large intestine or large bowel) and rectum. Your gastroenterologist may perform the procedure to diagnose and treat, when possible, certain diseases of the lower gastrointestinal (GI) tract, including the rectum and colon. During a colonoscopy, your physician uses a Colonoscope, also called an Endoscope, which is a long, flexible, tubular instrument that is about the width of an average pea, that transmits an image of the lining of the colon on a viewing monitor so the physician can examine it for any abnormalities. The Colonoscope is inserted through the rectum and advanced to the other end of the large intestine. (see diagram below).
A colonoscopy may be performed to screen for colon cancer and evaluate many problems, including:
- Long term, unexplained
- abdominal pain
- Anemia (low red blood cells)
- Blood in the stool
- Change in bowel habits
- Chronic Diarrhea
- Chronic Constipation
- Unexplained weight loss
- Polyps, including benign, pre-cancerous and cancerous
- Hemorrhoids that do not require surgical intervention
In order to have a successful view of the interior of the colon, it must be completely cleaned. To prepare for the test, your physician will prescribe dietary, medication and social behavior modifications.
You will be asked to stop any prescribed blood thinners five (5) days before your procedure. Acetaminophen (Tylenol) may be continued or used as a pain reliever. You will also be asked limit or eliminate high fiber foods for at least two (2) days before your procedure, including: salads, nuts or seeds of any kind, and any food with a peel or skin (examples include: popcorn, peanuts, fennel seeds, poppy seeds, sesame seeds, grapes, beans, tomatoes, green peas, corn, blueberries, raspberries, watermelon etc). Additionally, you will be required to adhere to a full "clear" liquid diet on the day before your procedure. We will cover the restrictions of a full "clear" liquid diet in the prep section of this site. There are several colonoscopy preparation medications that your doctor may prescribe, and each come with detailed instructions about the cleanse preparation. Whatever method of preparation is prescribed, you should follow the instructions given by your physician or their assistant, exactly as given, or the procedure could be unsuccessful and may have to be repeated. If your physician or his assistant has notified you that blood work is required, please complete at least 2 days prior to your procedure. You will also be advised to refrain from smoking, especially on the day of your procedure. The longer you refrain from smoking, the greater your chances are of avoiding anesthesia-related complications.
How long does a colonoscopy take?
A Colonoscopy can take anywhere from 15 minutes to an hour.
During the Procedure
If you have not already done so, you will have an opportunity to discuss this procedure with your physician or nurse. You will be asked if you are allergic to any medications. At this time, if applicable, also inform the nurse if there is a possibility of pregnancy. Prior to the procedure, you will be taken on a hospital bed into the endoscopy suite (procedure room) and connected to the vital monitoring devices to measure heart rhythm and blood pressure as well as oxygen in the blood. You will be asked to turn onto your left side and bend your knees slightly. Once you are comfortable, anesthesia (sedation) is administered through an intravenous line by the Anesthesiologist.
When you are properly relaxed, the colonoscope will be inserted into the rectum and advanced through your colon (large intestine) (see diagram). Once your physician has reached the Cecum (the tip of the colon or the last portion of the small intestine), a photo is taken of the Cecum and the colonoscope is slowly withdrawn while the lining of your bowel is carefully examined. During the withdrawal process, if the physician identifies any tissue that may be abnormal, a small amount of the tissue can be removed for microscopic analysis (this is called a biopsy) and abnormal growths, or polyps, can be identified and removed (this technique is referred to as a polypectomy). Biopsy and/or polypectomy specimens are sent to the laboratory for examination by a Pathologist. Results are typically available within 7-10 business days and you will be notified either by phone with the findings or by an email instructing you to visit the patient portal for a copy of your results.