Colonoscopy

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See Also:
The Day of...
Gastroscopy
ERCP

External resources:
SAGES Colonscopy Info

What is Colonoscopy?
A colonoscopy allows the doctor to examine the inside of your colon and rectum. A long flexible tube (colonoscope) with a small camera is passed into your rectum and colon. On a video monitor, the doctor looks for any abnormal areas on the lining of your colon. Sometimes a small tissue sample will be taken. This is called a biopsy. If polyps (small growths) are found, they can be removed using tiny tools passed through the colonoscope. The samples will be sent to a lab where they will be checked for any signs of cancer as well as other diseases of the colon. 

Benefits of a Colonoscopy
A colonoscopy:

• is the most effective way to diagnose colon cancer, and
• can prevent colon cancer by finding and removing polyps before they turn into cancer.
• Can diagnose a variety of diseases of the colon, including inflammatory bowel disease. It cannot, however, diagnose irritable bowel syndrome. This is done based on your doctor's clinical assessment.
• is the most effective way to diagnose and often treat causes of gastrointestinal bleeding coming from the colon.

Risks of a Colonoscopy
For most people, a colonoscopy is a safe and straightforward procedure. However, the following rare complications are possible:

• A tender lump or redness might occur where the IV is placed in your arm. 
• Medications given may cause breathing or blood pressure problems, a rash, or fever. 
• Bleeding may occur after biopsies or removal of a polyp. In rare cases you may need to receive blood or require surgery. 
• A hole may occur in the colon. This occurs in approximately 1 in 2000 procedures. If this happens you may be given antibiotics, IV fluids or may require surgery. In very rare cases, people have died.

There is also a small chance that a polyp cancer may be missed depending on well the colon can be seen. Discuss the risks and benefits with the before you agree to have a colonoscopy. 

Before your colonoscopy

• Your colon must be empty so that the doctor can see the lining clearly. The clinic will tell you what laxative to take and diet to follow. Follow the instructions carefully.
• Please see The Day of Your Endoscopy page for more information about the day of your procedure.
• Continue to take your usual medications unless your doctor tells you otherwise. Be sure to have specific instructions from your surgeon if you take blood thinning medications such as warfarin/coumadin, plavix, Xarelto or Pradaxa.
• Follow your doctor’s exact instructions if you take medications for diabetes.
• Tell your doctor if you have an implanted device, such as pacemaker, defibrillator, heart valve, orthopedic implant (hip or knee), cochlear implant, spinal cord stimulator etc.
• If you need an interpreter, advise the facility. You may be asked to bring someone to interpret for you.

During your colonoscopy

• You will be given sedatives and pain medications through your IV.
• The doctor will gently pass a thin flexible tube (colonoscope) into your rectum through your anus.
• Your colon will be inflated with air so that the doctor can see it better.
• You may feel some pressure or a bloating sensation, but you should not feel much pain. If you are having pain, tell your doctor or nurse.
• If polyps are found, the doctor may remove them.
• Biopsies may be taken if any abnormal areas are found within your colon.
• The test will take approximately 20 – 30 minutes.

After your colonoscopy

• You will be taken into the recovery room. 
  
• A nurse will monitor your blood pressure, pulse, breathing and temperature.
• You will stay in this area for about 1 hour.
  
• Once you are able to drink fluids and feel less drowsy, the nurse will remove your IV. You will be allowed to go home with your escort.
• Your surgeon may speak with you after the procedure, or you may be provided with a written copy of your results.  A letter will also be sent to your family doctor outlining the results and recommendations. 
• Be sure you know what your follow-up plan is before you leave the hospital. This may include a follow-up visit to the surgeon's office, a scheduled phone call, or simply a routine visit to your family doctor.

When you go home
For the next 24 hours:

• do not drive, take sedatives, drink alcohol, or use power tools.
• do not sign legal papers or make other important decisions.
• You should have someone stay with you overnight if you live alone.
• You may feel bloated and have cramps from the air in your colon. This will eventually pass. Gradually increasing  your activity level will help.
• You may pass small amounts of blood in your stool (1-2 teaspoons or 5-10 ml). This is more likely if you have a biopsy or a polyp removed.
• You may not have a bowel movement for 1 to 2 days. Follow the dietary instructions given to you. Eat your normal diet when you feel you can.

Call the doctor who performed the colonoscopy if you have concerns or if you experience:

• fever (38° C or greater) or chills.
  
• dull abdominal pain or discomfort that lasts more than a few hours after the procedure or is increasing.
• new abdominal pain. 
  
• nausea or vomiting.
  
• persistent abdominal bloating.
  
• moderate amounts of blood in a bowel movement (more than 2-3 teaspoons or 10-15 ml).
• black stools.
  
• pain, redness or swelling of the intravenous site for more than 48 hours.
• If your doctor cannot be reached, go to the nearest emergency department.

Go to the emergency department immediately, if you experience:

• sharp, steady or worsening abdominal pain.
  
• passing large amounts of blood or clots (1/2 cup or 125 ml).
• difficulty breathing.