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A colonoscopy lets your physician check the inside of your entire large intestine or colon

A colonoscopy is a visual examination of the entire large intestine (colon), using a lighted, flexible colonoscope. To be certain you are comfortable and relaxed, you will be sedated through an IV. In fact, most patients are asleep during the entire process and remember little to nothing about it.

The procedure is done using a long, flexible tube with a light and tiny camera on one end. The tube is inserted into your rectum and moved into your colon.

What conditions are diagnosed or treated through colonoscopy?

A colonoscopy may be used to check and, if needed, treat symptoms or conditions such as:

  • Early signs of cancer
  • Colon polyps
  • Tumors
  • Ulceration
  • Redness or swelling
  • Bleeding
  • Pouches, or diverticula along the colon wall
  • Narrowed areas of the colon
  • Any objects that might be in the colon

During a colonoscopy, your physician may remove tissue or abnormal growths for further exam. Your physician may be able to treat any problems that are found.

A colonoscopy is also used to screen for colorectal cancer. Screening means looking for cancer in people who don’t have any symptoms of the disease.

It may be used to find the cause of unexplained, long-term (chronic) diarrhea or bleeding in the gastrointestinal (GI) tract as well. It can also be used to check the colon after cancer treatment.

A colonoscopy may be used when other tests such as a barium enema, CT colonography, tests for blood in stool, stool DNA tests or sigmoidoscopy show the need for more testing.

Other reasons why you may need a colonoscopy

In addition to letting your physician see the inside of your colon, the tube can be used to:

  • Clean the lining of your colon with a water jet (irrigate)
  • Remove any liquid stool with a suction device
  • Inject air in your bowel to make it easier to see inside
  • Work inside your bowel with surgical tools

What are the risks of a colonoscopy?

Complications related to a colonoscopy may include, but are not limited to:

  • Continued bleeding after biopsy or polyp removal
  • Nausea, vomiting bloating or rectal irritation caused by the procedure or by the bowel cleansing that is done before
  • A hole punched through the intestinal wall; this is very rare.

You may have other risks, depending on your condition.

Be sure to discuss any concerns with your physician before the procedure.

Preparing for a colonoscopy

The colon must be completely clean of any stool and debris for adequate visualization of the colon.  You will receive instructions as to which laxative prep you will be requested to consume; this will clean out the colon.  You will be on a clear liquid diet the day prior to your procedure which consists of Jell-O, juices, broth, tea, coffee and popsicles.  The clear liquids should not contain anything red.

You must not eat or drink for a certain time before the procedure. This often means no food or drink after midnight or a restricted schedule with the laxative and water sips allowed until a couple hours before the colonoscopy. You may be given additional instructions about a special diet to follow for 1 or 2 days before the procedure. It is absolutely mandatory to follow your particular instructions carefully to avoid the procedure being canceled and to make sure of a safe, effective test.

If you take any diabetes medication or anticoagulant medicine you need to talk with you physician prior to the procedure.  If you take antibiotics prior for any dental procedures you need to inform your physician prior to the colonoscopy.

Important

  • If you take Coumadin (warfarin), Plavix or Aggrenox, call your physician at least seven days prior to the procedure.
  • You may take Tylenol, aspirin and ibuprofen.
  • Lovenox or Fragmin should not be used the day of the procedure.
  • Diabetics please consult your primary care physician on how to handle your medications and diet.
  • If you are under the care of a cardiologist, PLEASE CALL him/her before stopping any medications.
  • You may continue to take all other medications. 

What to expect during a colonoscopy

You may have a colonoscopy as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your physician’s practices.

Generally, the colonoscopy follows this process:

  • You will be asked to remove any jewelry or other objects that might get in the way during the procedure.
  • You may be asked to remove your clothing. If so, you will be given a gown to wear.
  • An IV will be inserted in your arm or hand, and a sedative or pain medicine will be injected into the IV.
  • You will be given oxygen to breathe in.
  • Your heart rate, blood pressure, respiratory rate, and oxygen level will be checked during the procedure.
  • You will be asked to lie on your left side with your knees pulled up towards your chest.
  • A lubricated tube will be put into your anus and moved into your rectum and colon. The colon will be insufflated with air during the exam, so you may experience mild pain, pressure or cramping during the procedure.
  • Depending on the type of anesthesia used, you may be completely asleep during the procedure. If awake, you may be asked to take slow, deep breaths while the tube is being inserted; this helps to relax your abdominal muscles and decrease the discomfort. You may also be asked to change your position to help the tube pass through.
  • Air may be injected into your bowel; this may make it easier to see the inside surfaces. A water jet may also be used to clean the lining of your colon, and a suction device may be used to remove any liquid stool.
  • Your physician will check your colon and may take photos. If a polyp is seen, it may be taken out, or it may be left there until another procedure is done.
  • After the procedure is over, the tube will be taken out.

The exam usually takes 30-45 minutes. The physician will take biopsies (removal of tissue) and/or remove polyps (abnormal tissue growth) if needed during the procedure.

Medication or heat may be sued to treat any bleeding found.

Biopsies may be taken for many reasons and do not necessarily mean cancer.

Before your colonoscopy

  • Your physician will explain the procedure to you; ask him or her any questions you have.
  • You may be asked to sign a consent form that gives permission for the procedure; read the form carefully and ask questions if anything isn’t clear.
  • Tell your physician if you are sensitive to or allergic to any medicines, latex, tape or anesthesia medicines (local and general).
  • Tell your provider about all the medicines you take including both over-the-counter and prescription medicines vitamins, herbs and other supplements.
  • Tell your physician if you have a history of bleeding disorders, and let him or her know if you are taking any blood-thinning medicines, aspirin, ibuprofen or other medicine that affect blood clotting. You may need to stop taking these before the procedure.
  • Tell your physician if you are pregnant or think you may be pregnant.

After a colonoscopy

After the procedure, you will be taken to the recovery room to be watched; your recovery process will depend on the type of sedative you had. Once your blood pressure, pulse and breathing are stable and you are awake and alert, you will be taken to your hospital room, or you may be discharged to your home.

You can usually eat whatever you feel you can tolerate after the procedure; some patients start with small, bland meals, and some do not.

You may pass gas and feel gas pains after the procedure; this is normal. Walking and moving about may help to ease any mild pain.

You should not drink alcohol for at least 24 hours, and you may be asked to drink extra fluids to make up for the water you lost as you got ready for the procedure.

Your physician may give you other instructions, depending on your situation.

Tell your physician if you have any of the following:

  • Fever or chills
  • Frequent bloody stools
  • Belly pain or swelling
  • Your belly feels hard
  • Not able to pass gas