What is Colonoscopy?
Colonoscopy is a diagnostic examination that uses a colonoscope to visualize the colon and small intestine along with an installed camera through the anus. This procedure is usually compared with sigmoidoscopy but is only similar but not the same. Colonoscopy is done in concurrence with a fecal occult blood test (examines feces for presence of blood invisible by the naked eye). This procedure is contraindicated to patients suspected or diagnosed with ulcerative colitis or Crohn’s disease for this can only worsen perforation of the bowel. Pregnant women are not recommended for this procedure. Those with heart diseases, acute peritonitis and blood problems are not cleared for this diagnostic exam and procedure.
People are recommended to undergo colonoscopy at the age of 50. This is highly essential and vital to people who have a family history of colorectal cancer and other inflammatory bowel disease. The family doctor will usually suggest this to their patients when data has been attained from them for those with familial diseases. This procedure is indicated to patients who are suspected or diagnosed to have bowel growths such as polyps. This can be a sign of cancer which the doctor needs to take sample of for biopsy. This polyp can be removed during the procedure and is a good way to prevent cancer. When the doctor sees abnormal tissues in the bowel system as the colonoscope is being inserted into the colon, the doctor can take samples for testing.
This procedure needs consent from the patient in order to continue and start preparation. First thing to do as one has consented for the procedure is to prepare his or her bowel. Usually the doctor shall order to completely empty ones bowel by starting with a clear liquid diet 1 to 3 days prior to the examination. Drinking colored drinks such as red or purple in color is not allowed. Increasing the oral fluid intake can facilitate also cleansing of the bowel.
The night before colonoscopy, the patient is ordered to take a laxative or an enema to completely cleanse the bowel. The enema is not readily suggested especially to those suspected of dehydration for this can only worsen the condition. The elderly are also not recommended to undergo enema for its complication of dehydration. Taking laxative is very much better for it can only loosen stool and induce bowel movements. Abuse to this can only make one constipated or dependent on laxatives. The elderly should be advised that this only done for the procedure and not a maintaining medication for constipation.
Colonoscopy is indicated to patients who experience the following:
- Abdominal pain and changes in the bowel movement
- Unexplained weight loss
- Abnormal imaging test results such as in CT scans, barium enema or sigmoidoscopy
- Unexplained anemia
- Blood in the stool or black tarry stools
- Inflammatory bowel disease
- Screening for cancer (colorectal)
Before the procedure is done, complete explanation of the purpose, indication and risks should be done. It is the patient’s right to know what he or she is up to and why this has to be done. Informing the patient that he will feel discomfort after the procedure and that he or she is to be given a sedative and pain medication during the procedure to feel relaxed and comfortable. Explain to patient that discomfort would truly be felt. As this is obtained, consent is a must. Bowel preparation is done when everything is set for colonoscopy.
When all is set, the patient is to lie on the exam table and lie on his left side. Induction of a sedative is done to keep patient relaxed. It depends on the patient on what is inducted. The doctor shall insert colonoscope into the patients anus which is with a built in camera that will also serve as a guidw. Slowly the scope is inserted into the colon. Full examination is then made available as it the images are presented on a computer screen. With this, the patient’s insides are checked until to the opening of the small intestine. Once the doctor identifies the problem, he shall remove the polyp or tissue for biopsy. And when there was nothing identified, the doctor shall reexamine and adjust the scope for better viewing.
The recovery period after the delicate procedure is done would take about 30 to 60 minutes. Usually the patient after a colonoscopy would experience cramping or bloating after the first hour of procedure. Fortunately, the patient can attain full recovery in a day or next. Medical practitioners would educate the patients to report for the following side effects immediately after they experience them:
- Severe, intractable abdominal pain
- High fever
- Black tarry stools or bloody stools
- Dizziness and weakness
A week before the procedure, one is advised to follow the recommended diet:
- Avoid taking aspirin (induces bleeding)
- Stop taking iron pills (for it can make stools black and tarry)
- Taking of barium swallow is not recommended for it can discolor the bowel system as well as the stools.
- Taking of anticoagulants can induce bleeding, one is advised to stop taking them
One should follow the recommended diet for patients in preparation of colonoscopy. Here are some of the clear liquids suggested to patients:
- Tea and clean coffee
- Sports drinks
- Fruit juices
The proposed cost for colonoscopy depends on the institution that one has applied for the procedure. Usually, the cost of the colonoscopy would range from $2,000 to $3,500 in the US. Those who have insurance would only pay for $1,000 for the colonoscopy.
Risks are present and are the following:
- GI (gastrointestinal perforation) is said to be life-endangering and needs immediate major surgery repair.
- Appendicitis is said to be associated to colonoscopy but in rare cases.
- Bleeding is a risk after the procedure especially when there is involvement of cauterization or removal by burning when the colonoscope is inserted.
- The use of anesthesia during the procedure can result to complications such as sudden drop of blood pressure and oxygen saturation. Pulmonary embolism or deep vein thrombosis can result too as one is prone to the development of blood clots.
- Because of the bowel preparation needed for colonoscopy, one may experience severe dehydration after taking laxatives or induction of enema. These preparations are indeed essential but can provide risks for electrolyte imbalance and loss. With this preparation, inflaming the bowel is likely as well as diarrhea and bowel obstruction.
- Burning some parts of the bowel is a risk and form of complication when there is need of the removal of a polyp found from the imaging tests or during the examination. This is called postpolypectomy syndrome which is a very rare complication that arises along with fever and abdominal pain.
Since there are potential risks with this procedure, guidelines for screening colonoscopy to patients are done in order to avoid complications. It has been stated that the elderly patients (over 75) are not recommended for this procedure. This is indeed a good way to avoid untoward results to patients and can promote optimum health rather than provide problems.