What is a colonoscopy?
A colonoscopy is a medical procedure that allows a gastroenterologist, a colorectal surgeon, or an endoscopist to evaluate the inside of the large intestine (Colon) and the rectum by using a colonoscope. This long, flexible tube is fitted with a camera and a light source. Colonoscopy is used to diagnose diseases like polyps, inflamed tissue, ulcerations, and cancer. Colonoscopy can also be used as a tool for the treatment of polyps by removing them, and for sampling of tissues for biopsy.
Types of colonoscopy procedures
Each type of colonoscopy procedure has its own intention and indications. They are, namely
- Screening colonoscopy is a technique that is usually carried out on individuals without symptoms. This is most commonly done at the age of 45 or above to know if the individual is at average risk of colorectal cancer. The objective is to diagnose pre-cancerous polyps, or early-stage cancer, even before the cancer appears. If the individual shows normal results, then the colonoscopy procedure is repeated every 10 years for people with even an average risk.
- Diagnostic colonoscopy is a technique that is done on patients who exhibit symptoms like bleeding, a change in bowel habits, pain in the stomach, and sudden weight loss, or as a follow-up procedure if other diagnostic tests give a positive stool or blood test. The main objective of diagnostic colonoscopy is to detect diseases like colon cancer, inflammatory bowel disease, or any other serious conditions.
- Surveillance colonoscopy is a technique that is conducted on patients with a history of colon polyps, colon cancer, and pre-existing genetic problems due to personal or family history. The main objective is to observe the colon at regular stages to diagnose polyps or cancer early.
Colonoscopy, as a technique, is considered the gold standard for colorectal cancer identification and prevention because it allows for direct visualization, biopsy, and removal of diseased tissue all in one procedure.
| Procedure Name | Colonoscopy |
|---|---|
| Type of Surgery | Non-surgical procedure |
| Type of Anesthesia | Moderate sedation/Conscious sedition |
| Procedure Duration | 30-60 minutes |
| Recovery Duration | 24 hours |
Colonoscopy: Pre-Op & Post-Op Care
Colonoscopy, like any other surgical procedure, involves pre-operative care, followed by a well-monitored intra-operative care, and an attentive post-operative care. The success of the colonoscopy procedure depends on the meticulous precision of bowel cleansing that takes place in pre-operative care, as inadequate preparation may then prompt a rescheduling of the entire procedure
Pre-operative care: Preparation before the procedure
The pre-operative stage in colonoscopy can last for several days, and typically is focused on emptying the contents of the colon to provide a clear view for the endoscopist. Changes in diet involve having a low-fiber diet by avoiding whole grains, seeds, nuts, corn, and raw vegetables 3-7 days before the colonoscopy procedure. The day before the surgery, a liquid-only diet should be started, such as plain water, tea, coffee, broth, clear juices like apple or grape, and sports drinks. 2-3 hours before the procedure, all drinking and eating activities should be strictly avoided.
Adjusting the dosage/ stopping the intake of medicines for the duration of the colonoscopy procedure is also vital to the success, which involves stopping the intake of non-steroidal anti-inflammatory drugs like ibuprofen and naproxen, 7 days before the procedure. Followed by discontinuing blood-thinning drugs like warfarin and rivaroxaban. A day before the procedure, and on the day of the procedure, diabetic patients have to adjust the dosage of their insulin. A healthcare provider should be consulted in all instances.
Bowel cleaning involves the prescription of a strong laxative like polyethylene glycol or sodium phosphate, which is advised to be taken on the day before or on the day of the procedure. This preparation causes diarrhea, and the objective is to pass a liquid that is clear and yellowish. The patient should contact the concerned doctor immediately.
Intra-operative care: Colonoscopy procedure
On the day of colonoscopy, the focus is usually on thorough examination and the comfort of the patient. An intravenous needle is placed in a vein of the hand or arm to continue administering the medicine.
Moderate sedition is given with a combination of sedatives, like midazolam. The patient becomes drowsy and may respond to talking, but will not actually remember the procedure. In another method, a qualified anesthesia professional administers propofol to induce a deep state of sleep. Vital signs are then observed through the monitor until the procedure is completed.
The colonoscopy procedure involves the patient being asked to lie down on their side with their knees drawn towards the chest. Followed by the doctor inserting the colonoscope through the anus into the colon. The colon is inflated with air or carbon dioxide for better visibility, with the camera transmitting images to the monitor. If any polyps are detected, they are removed through the instruments sent through the tube, and then are sent to the lab for testing. If any abnormal tissue is identified, then a sample is taken and sent for biopsy. After this, the scope is then slowly withdrawn, with the remaining gas suctioned out to reduce post-operative bloating. This procedure takes about 30-60 minutes.
Post-operative care: Colonoscopy procedure
Immediately after the procedure, the patients are moved to the recovery area for monitoring, which is done for about 30-60 minutes, as the sedition slowly goes away. Common symptoms include cramping in the stomach, bloating from the gas that was used during the procedure, and walking reduces these symptoms. The doctor then discusses the initial findings with the patient or the family of the patient, and as a result, the biopsies become available in a few days or a week.
Recovery at home involves rest for at least 24 hours. Diet should gradually include small, bland meals, with plenty of fluids. Bowel movements might be delayed, and if polyps are removed, there might be some bleeding, which usually resolves in a few days.
Adjusting the dosage/ stopping the intake of medicines for the duration of the colonoscopy procedure is also vital to the success, which involves stopping the intake of non-steroidal anti-inflammatory drugs like ibuprofen and naproxen, 7 days before the procedure. Followed by discontinuing blood-thinning drugs like warfarin and rivaroxaban. A day before the procedure, and on the day of the procedure, diabetic patients have to adjust the dosage of their insulin.
Benefits of Colonoscopy at Yashoda Hospitals
- Colon cancer diagnosis and prevention
- Polyps removal
- Diagnosis of unexplained symptoms like stomach pain, chronic diarrhea, rectal bleeding, and sudden weight loss
- Diagnosis of Inflammatory Bowel Disease
- Identification of ulcers, diverticulosis, and narrowing of the intestine
- Treating internal blockages
- Removing foreign objects
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