What is a colonoscopy?
A colonoscopy is a procedure that allows your doctor to examine the lining of your colon for abnormalities. The doctor inserts a flexible tube about the size of a finger (called a colonoscope) into the anus and passes it through your colon to see if there are any problems such as inflammation or polyps (growths). Sometimes the doctor takes a tiny tissue sample, called a biopsy, by passing a small instrument through the colonoscope. The sample is then sent to the laboratory for analysis. Your doctor can also remove polyps using the same painless technique.
Why should I have a colonoscopy?
Colonoscopies reduce the chance of developing colon cancer by removing polyps, or growths, that can become cancerous. Polyps grow in the colon like warts; sometimes their cells change and become cancerous. Removing the polyps during a colonoscopy can prevent colon cancer from developing.
Who should have a colonoscopy?
The American Cancer Society and the American College of Gastroenterology recommend that all adults have this screening test beginning at age 50. If you are having unusual symptoms; have a family member with colon cancer; or if you are African American, your doctor may recommend that you have the test sooner.
Is the procedure painful or uncomfortable?
The biggest complaint about having a colonoscopy is the preparation beforehand, when you must drink a solution that clears the bowel of all solid matter (see below). During the actual procedure, you might feel some pressure, bloating or cramping, but it is not usually painful. You will be given moderate sedation through an intravenous line (IV) to make you relaxed, drowsy and comfortable, but you will not go to sleep. The procedure itself takes 30 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery.
What happens during the procedure?
During your procedure, you will lie on your left side with your knees slightly bent. Your doctor will give you medication through the intravenous (IV) line. You will be given oxygen through a nasal tube; a device will be placed on your finger to monitor your oxygen levels; and electrodes will be placed on your chest to monitor your heart. Once the procedure has started there may be periods of discomfort as the scope goes around bends in the bowel. Usually these will ease once the bend has passed. Your doctor may inflate the colon slightly with air, to get a better view. Occasionally, you may be asked to change your position to ease the scope's passage. A nurse will be at your side during the entire procedure-if you are experiencing greater than average discomfort, you can alert the nurse, and you will be given additional sedative or pain relief medication. When the procedure is finished, the scope is gently removed.
What happens after a colonoscopy?
You will be monitored for up to an hour after your procedure in the recovery room. When you are alert and awake, you can have a drink and get dressed. Your physician will explain how the exam went, and will tell you whether you had polyps removed or biopsies taken. You can then go home. You may have some cramping or bloating because of the air introduced into the colon during the procedure. This should disappear quickly when you pass gas. You will receive the results of any biopsies during a follow-up visit in the next several weeks.
What should I do to prepare for the procedure?
- You will not be able to drive the day of your procedure. A responsible adult must sign you out of the unit following your procedure, and accompany you home (by car, taxi or bus-as long as you are accompanied).
- Please have any required blood work done one to two weeks before your procedure (your provider will give you a lab slip). The blood work may be completed at any laboratory. There is a lab at the West River Center.
- Please check with your insurance company before the procedure is done to confirm your coverage.
- Bring a detailed list of your medications, including over-the-counter medications and supplements. List the dose (ex: 10 mgs) and when you take it (ex: once a day at bedtime).
- Follow the bowel preparation instructions you were given carefully. Your lower bowel must be completely empty of waste material to allow the physician to have a clear view.
What are the risks of a colonoscopy?
- Up to 2 percent of patients may experience minor bleeding after a colonoscopy, if they have had tissue samples taken and/or polyps are removed. Most of the time, the bleeding will stop on its own.
- Very rarely (only in about 1 out of every 1,000 colonoscopies), the scope can make a hole, called a perforation, in the wall of your colon. This may need more surgery or treatment with medication.
- Sometimes, the colonoscopy can miss a polyp. As many as 15 percent of small polyps and 5 percent of larger polyps may be missed.
- Rarely, a person develops an infection after a colonoscopy, which is treated with medication.
- Some people have an adverse reaction to the medicines used to relax you during the colonoscopy. Reactions may include a skin rash, nausea, vomiting, temporary difficulty in breathing, palpitations, low blood pressure, seizures, brain damage, or death.
Can I have a different screening test instead of a colonoscopy?
There are alternative tests available for those unable or unwilling to have a colonoscopy (however, these tests do not allow your doctor to look directly at the colon or to remove polyps or take biopsies):
- A "virtual colonoscopy" with a CT scan image of the colon (rarely used for screening)
- An x-ray using a barium enema (less sensitive than a colonoscopy).
Please ask your doctor for further information about these tests.
What's the difference between Golytely, Nulytely, and Colyte?
There is no real difference. They are all similar liquid solutions that you drink to cleanse the bowel before your procedure.
Why do I have to drink so much?
The large amount of solution gently cleanses the bowel over a period of several hours. Do not just sip the solution-it is important to drink eight ounces every 15 minutes. The fluid does not absorb into your body (it carries no calories), nor will the frequent evacuation cause you to become dehydrated.
Should I drink other liquids beside the prep liquid?
Yes, you should continue to drink clear fluids (at least four to six large glasses) until four hours before your scheduled procedure in order to stay well hydrated. Avoid alcohol and carbonated drinks and try sports drinks with electrolytes, such as Gatorade.
What do you mean by "clear fluids"?
Clear fluids are any liquids you can see through, such as water, apple juice, clear chicken broth, herbal tea (no milk) or Gatorade.
Why must I avoid red liquids?
The red color can remain in the colon and could be mistaken for blood.
How can I make this taste better?
You may flavor the solution with 1 to 2 tablespoons of pre-sweetened powder such as Kool-Aid or Crystal Lite. Many people find that drinking the solution quickly at an ice cold temperature is helpful. Drinking through a straw, sucking a hard candy afterwards or rinsing your mouth with mouthwash are other suggestions.
The solution is making me nauseous. What should I do?
It is important that you continue drinking, so the large volume of fluid can empty your bowel. Without a clean bowel, the doctor will not be able to see the inside of your colon. If you do vomit, wait 30 minutes, and begin drinking the solution again. Resting, breathing deeply and walking around for 30 minutes may also help relieve these symptoms. You may also try drinking six ounces at a time, rather than eight ounces. If your nausea or vomiting does not improve, call us, and make sure to have the phone number of an open pharmacy on hand in case we need to call in a prescription.
I am drinking the solution but have not gone to the bathroom yet. What should I do?
Keep drinking eight ounces every 15 minutes. Most people have a bowel movement after an hour; some patients may take up to two or more hours.
I am drinking the solution and having loose, watery stools. Do I still need to drink the full amount?
Yes, you may have solid stool higher in the colon that needs to be eliminated.
I already have diarrhea. Do I still have to take the laxative?
Yes, just follow your doctor's instructions. Your colon is approximately six feet long, and the entire length must be emptied for your physician to examine it properly.
I see yellow color in the toilet bowl and a few flecks. What do I do?
If you drank the prescribed amount of solution and your last bowel movements were clear enough that you could see the bottom of the toilet, you should be all set. A few flecks of material will not interfere with the examination. The yellow color is simply bile that normally colors the feces.
What can I do for my sore bottom?
Avoid rubbing the area during cleaning. Instead, gently pat with a wet washcloth. Apply a generous amount of Vaseline, Preparation H, or Desitin. You may also use unscented baby wipes or Tucks Pads.
Can I drink alcoholic beverages?
Alcoholic beverages can cause dehydration, and are best avoided before your procedure. In addition, some wines may thin your blood.
Can I have gum or candy on the day of my procedure?
No. Please do not chew gum, eat candy or suck on hard candy the day of your procedure.
It's the morning of my test and I am still passing stool. What do I do?
Try giving yourself a tap water enema until you run clear. If this does not work, call our office.
I am menstruating. Can I still have the colonoscopy?
Yes, the procedure can still be performed while you have your period. If possible, we ask that you do not use a tampon.
Do I need a prescription for the laxatives?
Golytely, Nulytely, and Colyte all require a prescription, but it depends on your doctor's instructions.
I am on a fluid-restricted diet due to heart disease. Is it safe to drink all this liquid?
The prep solution is formulated to flush through your intestinal tract without being absorbed into your blood stream. It is considered the safest prep for patients with a history of congestive heart failure.
I am on a fluid-restricted diet due to kidney failure. Is it safe to drink all this liquid?
The prep solution is formulated to flush through your intestinal tract without being absorbed into your blood stream. It is considered the safest prep for patients with a history of kidney failure.