Colonoscopy is a process in which a colonoscope, a long flexible tubular tool with a light source, is inserted via the anus to check the lining of the colon or large intestine for any abnormalities.

It is performed as a Day Surgery procedure and takes roughly 20-30 minutes. The procedure is performed under moderate sedation, which means the patient will be given drugs into their veins to make them feel comfortable, painless, and drowsy.

Air is blasted into the colon during the scopy to help us see more clearly, which may cause mild abdominal discomfort but soon go away. As the scope is progressively withdrawn, we will evaluate the colon and do any necessary operations (such as biopsy or polypectomy) based on what we observe.

Most common reasons to recommend colonoscopy:

• Abdominal pain or discomfort
• Blood in stools or bleeding per rectum
• Change in bowel habits
  • Constipation
  • Diarrhea
• Loss of appetite
• Loss of weight
• Occult blood in stools or FOBT positive (Fecal occult blood test) or FIT (Fecal immunochemical test) positive
• Screening for colon cancer
  • Age 50 and above
  • Family history of colon cancer
  • Family history of bowel cancer
  • Family history of other high-risk cancers
• Surveillance after cancer surgery
• Surveillance of colon polyps

Things to do before colonoscopy:

• Avoid high fiber diet for three days before the scope
• Fasting overnight
• Laxatives the night before
  • Detail instruction will be shared with the patient, including how to take the prescribed laxatives.
  • These laxatives cause diarrhea, which cleans out the entire bowel.
  • Because a dirty colon is difficult to diagnose and minor lesions can be missed, it is critical that the patient follows these guidelines.
  • We will teach the patient how to determine if the bowel preparation is sufficient for a thorough examination during the colonoscopy.
• Please advise us ahead of time if the patient has any unique medical conditions (such as diabetes, hypertension, heart valves, or blood thinner drugs), since this will necessitate further instructions.

Road to recovery after colonoscopy:

• Close monitoring on the patient status in the recovery room right after undergoing the procedure
• After waking up, patients can go back to their regular diet
• Patients may experience cramps or bloating at first, but this will subside as they begin passing gas
• Specific drugs must be temporarily withheld if certain procedures were performed during the scope – as we will explain at discharge
• If a biopsy or polypectomy was performed, the histology of the procedure must be determined at the next clinic visit
• We would advise patients to arrange for a family member or a driver to transport them home because the sedative medication used during the operation makes it dangerous to drive or operate machinery for roughly 8-12 hours after the surgery

Possible complications:

• Abdominal cramps
• Bleeding, especially when polypectomy or biopsy is done
• Perforation of colon
  • The chances of the aforementioned two issues occurring are tiny – about one in 1000 to one in 1500 – but if they do, the patient may need emergency surgery, which can be fatal.
  • However, in the hands of a skilled colonoscopist, the technique is generally safe.

Incomplete scopy:

• Due to anatomical causes and/or insufficient bowel preparation, it may be technically difficult to perform the scope in roughly 3% of patients.
• In such cases, we may need to arrange for alternate imaging modalities, such as CT colonography, or we may need to repeat the scope on a different day, which we will recommend based on the patient’s needs.

Follow-up:

• We will offer images of the colon lining taken during the scopy.
• At the following clinic visit, we will present the histology report and explain/proceed with the next steps.
• We will recommend follow-up scopes at predetermined intervals based on the findings.