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  Health Information Center  :  C  :  Colorectal Cancer

 Colonoscopy Procedure

 


What is a colonoscopy?
Colonoscopy is an outpatient procedure in which the rectum and the inside of the lower large intestine (colon) are examined.

Colonoscopies are commonly used to evaluate bowel disorders, rectal bleeding or polyps (usually benign growths) found on contrast x-rays. Colonoscopies are also performed to screen people over age 50 for colon and rectal cancer.

What happens during a colonoscopy?
During a colonoscopy, a physician uses a colonoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the colon. The colonoscope is inserted through the rectum and advanced to the large intestine.

If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (called a biopsy) and polyps can be identified and removed. In many cases, colonoscopy allows accurate diagnosis and treatment without the need for a major operation.

Before the procedure

Special conditions

  • Tell the physician if you are pregnant, have a lung or heart condition, or if you are allergic to any medications.
  • Tell the physician if you have an artificial heart valve or if you have ever been told you need to take antibiotics before a dental or surgical procedure. If you have any of these conditions, you may need to take antibiotics before the colonoscopy.

Medications

  • If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. Your primary physician will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
  • Tell your primary physician if you are taking blood-thinning medications such as Coumadin (warfarin), Persantine (dipyridamole) or Ticlid (ticlopidine hydrochloride). Your primary physician may prescribe an alternate method for thinning your blood before the procedure.
  • Within 1 week before the procedure, do NOT take aspirin, products containing aspirin or anti-inflammatory drugs (such as ibuprofen including Advil or Motrin; Naprosyn or Indocin).
  • Within 1 week before the procedure, do NOT take bulk-forming agents (such as Metamucil, Citrucel or Perdiem) or iron-containing preparations. These products may make it more difficult for the physician to see the inside of the colon.
  • Medications for high blood pressure, heart condition or thyroid disease may be taken with water the day of the procedure.

* Please note: Do not discontinue any medication without first consulting with your primary or referring physician.

Bowel preparation

  • The bowel must be clean in order for colonoscopy to be successful. It is very important that you read and follow the instructions given to you for your bowel preparation well in advance of the test.
  • You will need to purchase your prescription medications at least 5 days before the scheduled colonoscopy.

Transportation
You will need to bring a responsible adult to accompany you after the procedure. You should not drive or operate machinery for at least 8 hours. The medication given during the procedure may cause drowsiness, making it unsafe for you to drive or operate machinery.

On the day of the procedure
A physician will explain the procedure in detail, including possible complications and side effects. The physician will also answer any questions you may have.

During the procedure

  • The procedure is performed by a physician experienced in colonoscopy.
  • You are asked to wear a hospital gown and remove eyeglasses.
  • You are given a pain reliever and a sedative intravenously (in your vein). You will feel relaxed and drowsy.
  • You will lie on your left side, with your knees drawn up.
  • The colonoscope is inserted through the rectum and advanced to the large intestine.
  • A small amount of air is used to expand the colon so the physician can see the colon walls.
  • You may feel mild cramping during the procedure. Cramping can be reduced by taking slow, deep breaths.
  • The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
  • The procedure lasts from 30 minutes to 1 hour.

After the procedure

  • You will stay in a recovery room for about 30 minutes for observation.
  • You may feel some cramping or a sensation of having gas, but this usually passes quickly.
  • A responsible adult must accompany you home. Do not drive or operate machinery for at least 8 hours after the procedure.
  • You may resume your normal diet.
  • Avoid taking Coumadin (warfarin), Persantine (dipyridamole) or Ticlid (ticlopidine hydrochloride) for 2 weeks after the procedure to help decrease the risk of bleeding. Your physician may prescribe an alternate method for thinning your blood after the procedure.
  • If polyps were removed, avoid taking aspirin, products containing aspirin or anti-inflammatory drugs (such as ibuprofen including Advil, Naprosyn, Indocin or Motrin) for 2 weeks after the procedure to help decrease the risk of bleeding. You may take acetaminophen (such as Tylenol) if needed.
  • If a biopsy was taken, you may notice light rectal bleeding for 1 to 2 days after the procedure. This is normal.

If you have:
-- Rectal bleeding greater than 1 tsp. at any time within 2 weeks after the procedure;
-- Black stools at any time within 2 weeks after the procedure; OR -- Severe abdominal pain, fever  or chills; please call your health care provider.








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