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Understanding Colonoscopy

What is Colonoscopy?
Colonoscopy is a procedure in which your physician examines the colon lining, (large bowel), for abnormalities. This is done by inserting a flexible colon scope into the anus and advancing it slowly into the rectum and up to the cecum of your colon.

What kind of preparations are required?
The colon must be completely clean for the procedure to be accurate and complete. Your physician will give you detailed dietary instructions and restrictions prior to your colonoscopy procedure. During the preparation phase, you generally consume a large volume of a special cleansing solution combined with days of clear liquid diet. There are many types of bowel preparation kits, and your doctor may choose one for you appropriately. Be sure to follow your doctor's prep instructions carefully. If you do not, the procedure may result in unsatisfactory examination of your colon and the preparation process may need to be repeated again in the near future.

What about my current medications??
Most medications may be continued as usual, but certain products can interfere with the preparation or the examination itself. Alert your physician of you current medications, and any allergies to medications in the doctor’s office. You may also alert the nurse who will be confirming appointment days prior to your procedure at the Greenbelt Endoscopy Center. Aspirin products, arthritis medicines, anticoagulants (blood thinners), insulin, and iron products are examples of medications you need to avoid prior to your procedure. Inform your doctor if you use antibiotics prior to undergoing dental procedures, because you may need antibiotics prior to colonoscopy as well.

What can be expected during a colonoscopy procedure?
All Colonoscopy procedure performed at GEC will require sedation. You will be positioned on your side while the colon scope is advanced slowly through the large intestine up until the cecum area (where large intestine and small intestine intersect). The colon scope will then be slowly withdrawn, the lining of the colon is again carefully examined. The procedure takes anywhere from 15 to 40 minutes. Procedure times differ greatly depending on the amount of polyps found and biopsies taken during the examination. In some cases, passage of the colon scope up to the cecum section cannot be achieved due medical reasons. The physician will have to decide if the limited examination is sufficient or alternative methods may be necessary.

What if Colonoscopy shows something abnormal?
If your doctor thinks an area of the colon needs to be evaluated in greater detail, a forceps instrument is passed through the colon scope in order to obtain a biopsy (sample of the colon lining). A biopsy or specimen is then submitted to the pathology laboratory for further analysis. If polyps are found, they are generally removed and also sent for biopsy. In most cases, the procedures mentioned above will not cause additional pain. Note that in most cases biopsies can be done for many reasons, such as preventive measures. Biopsies usually do not indicate that cancer is suspected.

What are polyps and how are the removed?
Polyps are abnormal growths from the lining of the colon that vary in size from a tiny dot in millimeters and up to centimeters in length. The majority of polyps are benign (non-cancerous) but the doctor cannot always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.

Small polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscopy and severs the attachment of the polyp from the intestinal wall by means of an electrical current. There is a small risk that removing a polyp this way will cause bleeding or result in a burn to the wall of the colon. These cases may require emergency surgery in a hospital environment.

What happens after a Colonoscopy procedure?
Your physician will examine your condition after the procedure. You physician will also explain the results to you by this time. After your discharge is approved by your physician, a responsible person must sign you out from our facility. Even if you feel fully alert after the procedure, your judgment and reflexes may be impaired by sedation for the rest of the day, making it unsafe for you to drive or operate any machinery. Cramping or bloating may persist for some time after procedure. These conditions should disappear quickly with the passage of flatus. You should be able to eat after your discharge unless you were told otherwise by your physician. However, you doctor may also restrict your diet based on your procedure results.

What are some possible complications?
Colonoscopy are generally safe, but complications can occur during or after the procedure. For example, polypectomy and biopsy sites can occasionally cause bleeding after the procedure. However, this is usually minor and will stop on its own without any intervention. Also, perforation or tears may become an issue during the procedure. These complications will require surgery at the hospital but are usually non-life-threatening.

Although complications after a colonoscopy procedure are uncommon, it is important for you to recognize signs of any complication. Ask your physician about early signs of complications. If you suspect or notice any unusual activities after your procedure, contact your doctor right away for assistance.

Questions or concerns?
If you have any specific questions about your need for Colonoscopy procedure, possible alternatives, cost, billing methods, insurance coverage, or other inquiries, do not hesitate to contact your doctor’s office. Our gastroenterologists are highly trained specialists and welcome your questions. Alternatively, you may discuss your concerns with our nursing staff who will contact you before your scheduled procedure date.