Colonoscopy |
Colonoscopy and Colonoscopic Polypectomy |
During
the procedure, you will be sedated and may remain groggy
for up to two hours afterwards. For this reason, we ask
that you plan to have someone accompany you to the office
to drive your home.Some Answers to Questions About Colonoscopy:It has been decided after careful medical assessment that colonoscopy is necessary for further evaluation and treatment of your condition. This information has been prepared to help you understand the procedure. Questions Answered:What should I expect during the procedure? What happens after the colonoscopy? Are there any complications of colonoscopy and polypectomy? What is Colonoscopy?
A colonoscope is a long flexible tube that is about the thickness of a finger. It is inserted through the rectum into the large intestine (colon) and allows the physician to carefully examine the lining of the colon. Abnormalities suspected by X-ray can be confirmed and studied in detail. Abnormalities which are too small to be seen on X-ray may also be identified. If the doctor sees a suspicious area or needs to evaluate an area of inflammation in greater detail, he can pass an instrument through the colonoscope and take a sample of tissue (a "biopsy") for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. A small brush can be introduced as well to collect cells from an abnormal area for examination in the laboratory (a form of "pap test" or "cytology"). What is polypectomy?During the course of the examination a polyp may be found. Polyps are abnormal growths of tissue, which vary in size from a tiny dot to several inches. If your doctor feels that removal of the polyp is indicated he will pass a wire loop (snare) through the colonoscope and sever the attachment of the polyp to the intestinal wall by means of an electrical current. If additional polyps are detected, they may be removed as well. You should feel no pain during removal of the polyp. Polyps are usually removed because they can cause rectal bleeding or may contain cancer. Although the majority of polyps are benign (noncancerous), a small percentage may contain an area of cancer in them or may develop into cancer . Removal of colon polyps, therefore, is an important means of prevention and cure of colon cancer, which is a leading form of cancer in the United States. What preparation is required?For the best possible examination, the colon must be completely empty of waste material, so only clear liquids should be taken for one to two days before the procedure. Discontinue the use of aspirin products and iron tablets for one week before the examination. Laxatives or enemas are taken before the colonoscopy. Your doctor will give you detailed instructions in the cleansing routine that he prefers and can advise you on the specific liquids that are allowed. Be sure to let your doctor know if you are allergic to any drugs. A companion must accompany you to the office because you will be given a medication to help you relax. It will make you drowsy so you will need someone to take you home. You will not be allowed to drive after the procedure. Even though you may not reel tired, your judgment and reflexes may not be normal. Please bring your X-rays with you, they may be very important for comparison and localization of abnormalities. What should I expect during the procedures?Your doctor will give you medication through a vein to make you relaxed and sleepy. While you are lying in a comfortable position the colonoscopy is inserted into the rectum and gradually advanced through the colon while the lining is examined thoroughly. The colonoscope is then slowly withdrawn while the intestine is again carefully examined. The procedure is usually well tolerated and rarely causes pain. Many patients even fall asleep during the examination. There may be some discomfort during the colonoscopy but it is usually mild. In rare cases, passage of the colonoscope through the entire colon cannot be achieved. A limited examination may be sufficient if the area of suspected abnormality was well visualized. What happens after the colonoscopy?You will be kept in the endoscopic area until most of the effects of the medication have worn off. You may feel bloated and "gassy" right after the procedure because of the air that was introduced to see the colon. As soon as the procedure has been completed, you may resume your usual diet, unless other instructions are given. If a polyp has been removed your doctor recommends you stay on clear liquid diet for 24 hours before returning to your regular diet. It is generally advisable to avoid heavy lifting and exercise for several days after polypectomy. Are there any complications of colonoscopy and polypectomy?Colonoscopy and polypectomy are safe and are associated with minimal risk when performed by physicians who have been specially trained and are experienced in these endoscopic procedures. One major possible complication is perforation, in which a tear through the wall may allow leakage of intestinal fluids. It may be managed with antibiotics and intravenous fluids, although surgery is usually required. Bleeding may occur from the site of biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of electric current) through the colonoscope. Rarely, transfusions or surgery may be required. Localized irritation of the vein can occur at the site of medication injection. A tender lump develops which may remain for several weeks to several months but goes away eventually. Other risks include drug reactions and complications from unrelated diseases such as heart attacks or stroke. Death is extremely rare but remains a remote possibility. Why is colonoscopy necessary?Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by X-ray can be confirmed and studied in detail. Even when X-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found by colonoscopy. It is useful for the diagnosis and follow-up of patients with inflammatory bowel diseases as well. Colonoscopy's greatest impact is probably in its contribution to the control of colon cancer by polyp removal. Before colonoscopy became available, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant. Now, most polyps can be removed easily and safely with-out surgery. Periodic colonoscopy is a valuable tool for follow-up of patients with previous polyps, colon cancer and family history of colon cancer. Colonoscopy is a safe and extremely worthwhile procedure, which is very well tolerated. Your doctor's decision to perform this procedure was based upon his assessment of your particular problem. If you have any questions about your need for colonoscopy do not hesitate to discuss them with your doctor who will also be happy to discuss the cost of the procedure, method of billing, and insurance coverage with you. Both of you share a common goal -your good health -and it can only be achieved through mutual trust, respect, and understanding. |
