Colonoscopy is the examination of the entire lining of the colon and rectum using a long, flexible lighted instrument. Colonoscopy is used as a screening tool for diseases of the colon and rectum, for the safe removal of colon polyps and to perform biopsies. Colonoscopies are done in the outpatient setting with the patient under IV sedation.
For people with no risk factors for colorectal cancer, a screening colonoscopy is recommended at age 50. Those individuals with a family history of colon cancer or otherwise at high risk may need a screening colonoscopy earlier. Please check with your physician regarding the timing of your first colonoscopy.
Additional indications for a colonoscopy include unexplained rectal bleeding, as a follow-up to a positive test showing blood in the stool, iron-deficiency anemia, new onset of constipation or diarrhea, abdominal pain, unexplained weight loss, and to monitor or diagnose inflammatory bowel disease.
Colorectal cancer is the second most common cause of cancer-related death in the United States. It is one of the few cancers that can be prevented or stopped in the early stages if proper screening measures are followed. Nearly all colon and rectal cancers begin as benign polyps that take years to degenerate into cancer. If benign polyps are found and removed by colonoscopy, colon cancer can be prevented.
Preparation
While the bowel preparation can be uncomfortable, it is a very important aspect of the procedure. If the bowel preparation is inadequate, it will obscure visualization and make it dangerous to advance the scope through the colon. In these cases, the colonoscopy cannot be completed and must be rescheduled – making it necessary to repeat the bowel prep. Additionally, poor bowel prep may not allow for detection of small or flat adenomas, defeating the purpose of the exam.
Risks
Complications from colonoscopy are exceedingly rare, but they can occur. The risks of the procedure include missed polyps, bleeding, perforation (tear) of the colon, risks associated with anesthesia and medical complications.
The day of the exam
Complete colonoscopies are done with IV sedation to make the patient comfortable. If a polyp is found during the exam, it may be removed and sent for pathology. In instances where removal of a polyp would be unsafe, a biopsy will be performed.
After the colonoscopy is complete, your physician will speak with you and your family regarding the results of the exam. If a biopsy is taken or a polyp is removed, it will be necessary to wait for the final pathology results before the next appropriate step can be planned.
After the exam
After you have recovered from the IV anesthesia, unless instructed otherwise, you may resume your regular diet. Full recovery from IV sedation can take up to 24 hours. Do not plan on returning to work or driving the day of the exam.
Call your physician if you experience fever, abdominal pain, nausea, vomiting or any other symptoms that seem out of the ordinary after your colonoscopy.
Follow-up exams
Based on the findings from your colonoscopy, your doctor will instruct you regarding the timing of your next colonoscopy.