Colonoscopy

Colonoscopy is a procedure where a thin flexible tube, with a light and camera at the end, is inserted into the rectum and guided through the colon. This allows the lining off the colon to be examined in detail, take biopsies and perform therapeutic measures where necessary. 

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Who would benefit from a Colonoscopy?

  • Anyone over the age of 45 yrs (some organizations recommend 50 yrs) for Colorectal Cancer Screening. Screening may be even earlier if you have a family history of Colon Cancer.
  • Rectal bleeding
  • Change in bowel habits
  • Abdominal pain
  • Chronic diarrhea
  • Unintentional weight loss
  • Unexplained anemia

What preparation is required for this procedure?

Diet: Consume a low residue (low fibre) diet 2 days prior to procedure.  Do not eat beans, vegetables, corn, potato skin, nuts or seeds. These foods may stick to the folds of the colon, both interfering with adequate colon preparation and potentially getting sucked into the colonoscope during the procedure, clogging the instrument.

You may eat a light breakfast the day prior to procedure. No solid food is to be consumed after 12 noon the day before the procedure. Drink a lot of clear fluids the throughout the day prior to procedure. At least 10 glasses. Continue to drink clear liquids up to 2 hrs before the test. This includes water, broth, coconut water, apple juice etc. Do not drink alcohol. Do not drink red or purple juices. 

Bowel preparation with Peglyte should be taken at 6pm (2 litres) the evening prior to the procedure and 3am (2 litres) the morning of procedure unless otherwise stated. Some patients report it is easier to drink the solution once chilled and using a straw. 

Stay near a toilet as this will induce diarrhea. You may also have some mild bowel cramps until the stool has cleared the colon. 

Your stool should be clear or yellow liquid if you are adequately prepped. 

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The adequacy of the preparation has a direct impact on the quality of your procedure. Kindly follow all instructions given and contact our office if you have any queries or concerns. The procedure may need to be cancelled or repeated earlier than needed if the bowels are inadequately prepared.

Medication: It is important for your doctor to know what medication you are taking. Please bring a list of your medication with you to your consultation appointment. Necessary medication (such as Aspirin, if taken for known heart conditions, such as heart attack) can be taken with clear fluids (water, apple juice, coconut water) up to 4-6 hrs prior to procedure. If you are diabetic, do not take oral diabetic medication on the morning of the procedure as your blood sugar may drop too low due to reduced oral intake. If you are on blood thinners (such as Coumadin, Rivaroxaban, Apixaban, Dabigatran), this will need to be discussed with the physician to determine the appropriate timing to stop taking them, once safe to do so. Blood thinners will need to be stopped anywhere from 1-5 days depending on the indication for it and level of your kidney function. Stop iron tablets for 1 week prior to the procedure as these may alter visualization for your procedure. If you have any concerns about your medications, please contact your physician. 

Procedure:

A Colonoscopy is typically done in an endoscopy suite. FOSA has a recently furnished suite with state of the art equipment to facilitate this procedure under optimal conditions.  Your heart rate, blood pressure, respiratory rate, and oxygen level will be monitored throughout your procedure. You will have a pulse oximeter placed on your finger that measures oxygen saturation and pulse, and a blood pressure cuff will be placed on your arm.

You will then be positioned so that you lie on your left side. The procedure is done under conscious sedation, where intravenous medication is given to make you comfortable. The procedure may take about 30-40 minutes, depending on how well the bowel is prepped and what is found during the investigation. Once you are comfortable the scope is gently placed into the rectum and advanced to the other end of the large bowel (cecum). A detailed evaluation of the mucosal lining is done and an appropriate assessment made. 

During the procedure: 

  • Biopsies may be taken from the mucosa, if indicated. 
  • In the event of bleeding lesions, such as ulcers, therapeutic measures can be undertaken at the same time to treat the area. 
  • If a polyp (pre-cancerous) lesion is found these can be removed at the same time

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What to expect after the procedure?

After the procedure you will remain in the office for approximately 30 minutes until you are alert. However, ensure you make arrangements for someone to take you home on that day as you will not be able to drive or take public transportation on your own after receiving sedation. It is advised to take that day off work to allow the medication to completely wear out of your system. It is safe to return to work the day following the procedure. 

Air and water is used to open up the GI tract and so you may experience some bloating immediately after the procedure. This will be typically be passed out as flatulence. It is recommended therefore that you have comfortable clothing to put on after the procedure that won’t restrict your abdominal area. 

Often times, a biopsy may be taken of the mucosal lining. This will be sent to a pathologist for further evaluation. The results of this will typically be available a few weeks after submission. Your doctor will advise you of the results thereafter. 

You will be able to resume your regular diet after the procedure. 

A colonoscopy is a relatively quick procedure and is generally well tolerated. Please feel free to contact our office at FOSA if you are experiencing lower GI symptoms and need evaluation.