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.