Colonoscopy Q & A
Why is a Colonoscopy Performed?
1) As part of a routine screening for cancer
2) in patients with known polyps or previous polyp removal, In general, preparation consists of consumption of a special cleansing solution or several days of clear liquids, laxatives and enemas prior to the examination.
3) Before or after some surgeries,
4) to evaluate a change in bowel habits or bleeding or
5) to evaluate changes in the lining of the colon known as inflammatory disorders.
What Preparation is Required?
In general, preparation consists of consumption of a special cleansing solution or enemas prior to the examination. Your surgeon and his or her staff will provide you with instructions regarding the cleansing routine necessary for the colonoscopy.
Follow your surgeon’s instructions carefully. If you do not complete the preparation, it may be unsafe to perform the colonoscopy and the procedure may have to be rescheduled. If you are unable to take the preparation, contact our office at 440-953-5712.
Most medications can be continued as usual. Medication use such as aspirin, Vitamin E, non-steroidal anti-inflammatories, blood thinners and insulin should be discussed with your surgeon prior to the examination as well as any other medications you might be taking. It is essential that you alert your surgeon if you require antibiotics prior to undergoing dental procedures, since you may also require antibiotics prior to colonoscopy.
You will most likely be sedated during the procedure and an arrangement to have someone drive you home afterward is imperative. Sedatives will affect your judgment and reflexes for the rest of the day. You should not drive or operate machinery until the next day.
What if Colonoscopy Shows an Abnormality?
If your surgeon sees an area that needs more detailed evaluation, a biopsy may be obtained and submitted to a laboratory for analysis. A biopsy is performed by placing a special instrument through the colonoscope. Most polyps can be removed at the time of the colonoscopy. The majority of polyps are benign (non-cancerous), but your surgeon cannot always tell by the appearance alone. They can be removed by burning (fulgurating) or by a wire loop (snare).
What Happens After Colonoscopy?
Your surgeon will explain the results to you after your procedure or at your follow up visit. You may have some mild cramping or bloating from the air that was placed into the colon during the examination. This should quickly improve with the passage of the gas. You should be able to eat normally the same day and resume your normal activities after leaving the hospital. Do not drive or operate machinery until the next day, as the sedatives given will impair your reflexes.
If polyps were found during your procedure, you will need to have a repeat colonoscopy. Your surgeon will decide on the frequency of your colonoscopy exams.
What Complications Can Occur?
Colonoscopy complications include bleeding from the site of a biopsy or polypectomy and a tear (perforation) through the lining of the bowel wall. Other complications of the procedure include the possibility of missed polyps or other lesions. Serious complications happen less than 1 time in 5,000 procedures.
Should a perforation occur, it may be necessary for your surgeon to perform abdominal surgery to repair the intestinal tear. Blood transfusions are rarely required. A reaction to the sedatives can occur. Irritation to the vein that medications were given is uncommon, but may cause a tender lump lasting a few weeks. Warm, moist towels will help relieve this discomfort.
It is important to contact your surgeon if you notice symptoms of severe abdominal pain, fevers, chills or rectal bleeding of more than one-half cup. Bleeding can occur up to several days after a biopsy.
Patrick D. Huck, M.D., F.A.C.S.