Colonoscopy
Colonoscopy is an examination that allows direct visualization of the entire large intestine and also, if necessary, the final part of the small intestine (terminal ileum). It is used as a diagnostic test, it allows the extraction of biopsies and the performance of endoscopic therapy.
Summary
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- 1 How the exam is carried out
- 1 What it feels like during the exam
- 2 Reasons why the exam is carried out
- 3 Benefits
- 4 Normal values
- 5 Meaning of abnormal results
- 6 Complications
- 7 Sources
How the exam is carried out
Before the colonoscopy, the intestine must be completely cleaned of all debris. This is done one or two days before the exam with a medication prescribed by the doctor. Many patients are given intravenous sedation, or “twilight sleep,” to perform this procedure. The colonoscope is inserted into the rectum and advanced to the part of the colon where it joins the small intestine . During a complete bowel examination, the doctor removes polyps or takes biopsies as needed. The entire procedure normally takes less than an hour. After colonoscopy, the patient may feel slight discomfort that improves quickly as gas is expelled. Most patients can continue with their usual diet and activities the same day.
What it feels like during the exam
Pain medications and sedatives will give the patient relaxation and make them drowsy. Many people do not remember having a colonoscopy. Usually, a digital rectal examination is done before the exam to check for major obstructions. The patient may feel the urge to defecate when the rectal exam is being performed or as the colonoscope is being inserted. The person may also feel pressure as the colonoscope enters. You may also experience brief cramping and gas pain as air is introduced or the colonoscope is advanced. The passage of gases is necessary and is to be expected to happen. The discomfort can be reduced by breathing slowly and deeply, which also helps relax the abdominal muscles. Mild abdominal cramping and significant passing of gas may occur after the exam. The sedation should wear off within a few hours.
Reasons for taking the exam
Colonoscopy may be used for the following reasons:
- Abdominal pain, changes in bowel movements, or weight loss
- Abnormal changes (such as polyps) found on sigmoidoscopy or x-ray exams ( CT scan or opaque enema )
- Anemia due to low iron (usually when no other cause has been found)
- Blood in the stool or black or tarry stools
- Follow-up of a previous finding, such as polyps or colon cancer .
- Inflammatory bowel disease ( ulcerative colitis and Crohn’s disease )
- Screening for colorectal cancer
Benefits
Colonoscopy is more accurate than a radiological examination of the colon in detecting polyps or cancer in early stages. With colonoscopy, it is now possible to detect and remove most polyps without abdominal surgery. Removing polyps is an important step in colon cancer prevention.
Normal values
The normal result is to find healthy intestinal tissues.
Meaning of abnormal results
- Diverticulosis (abnormal pouches in the lining of the intestines, which increase with age)
- Inflammatory bowel disease
- Low digestive bleeding
- polyps
- Tumor
Additional conditions under which the exam may be performed are:
- Cytomegalovirus , gastroenteritis or colitis
- Colon cancer screening
- Colorectal polyps
- Ischemic colitis
- Pseudomembranous colitis
Complications
- Heavy or persistent bleeding from the biopsy site or polyp removal sites
- Hole or break in the wall of the colon (intestinal perforation) that requires surgical repair
- Fluid imbalance in the body due to enemas and laxatives given before the procedure
- Infection requiring antibiotic therapy (very rare)
- Nausea, vomiting, bloating, or rectal irritation caused by oral medications to cleanse the intestines
- Reaction to sedatives, causing breathing problems or low blood pressure.
