What is a colonoscopy?
Colonoscopy is a diagnostic and potentially therapeutic procedure used to examine the colon with a camera-equipped flexible instrument, the colonoscope. The indications for this procedure are many, including evaluation of gastrointestinal bleeding, pain, diarrhea, inflammatory bowel diseaseand very commonly, to evaluate for colon polyps or colon cancer. We believe that colonoscopy is up to 90% effective in reducing deaths related to colon cancer (National Polyp Study, 1993). Colon cancer is currently the second leading cause of all cancer-related deaths in the U.S.
The procedure typically lasts 30 to 60 minutes. Polyps, which have the potential to become colon cancers, can be detected and removed during your exam, potentially eliminating the need for surgery and prolonging life.
Here are some pictures taken during colonoscopy of healthy colonic mucosa. The picture on the right is of a colon polyp being removed by snare polypectomy.
What preparation is required for a colonoscopy?
Please note that if your insurance information has changed since you were last seen at our practice, you must update your information in person at least 5 days prior to your procedure. This will prevent errors in billing and avoid charges that you might otherwise have to pay.
We require that your undergo one of a variety of bowel preps in Colorado Springs before the procedure to ensure that we can adequately visualize the inside of your colon. All of the following preps will give you diarrhea within ½ to 3 hours. We recommend that you stay at home and near a bathroom after starting the prep.
The preps available are listed here:
Colonscopy Main Form
Miralax/Dulcolax Divided Dose Prep
2 Day Miralax/Suprep
In addition, we ask that you stop these medications:
Please check with the doctor who prescribed them before stopping them!
7 days prior to your procedure:
- All aspirin and NSAID’s (Aleve, Motrin, Advil, Naprosyn, Vioxx)
- Anti-platelet medications (Plavix, Pletal, Ticlid, Aggrenox)
- Gingko Biloba, Ginger, Garlic
5 days prior to your procedure:
- All blood thinners (coumadin/warfarin)
2 days prior to your procedure:
- Iron supplements
12 hours prior to your procedure:
- Lovenox, Fragmin
If you are a diabetic, the following also apply:
- If you are insulin dependent: No insulin or may take ½ of normal insulin dose depending on AM blood sugar. May take ½ glass of juice if blood sugar is low.
- If you only take oral glucose medication: Do not take.
What happens before your procedure?
At either the Endoscopy Center of Colorado Springs, or at Penrose if your insurance requires you to have your procedure there, you will be registered as a patient, will be given a consent form to read and to sign, and will have the opportunity to ask the nurse and doctor questions. An IV catheter will be placed in an arm or hand vein. You will be instructed to arrive 1 hour before your scheduled procedure time in order to properly prepare for the procedure.
Your physician will go over the procedure again with you, and if all questions have been answered, will give you medications to achieve a conscious sedation. Most patients tolerate the procedure very well with little memory of the actual procedure. Our goal is to ensure you have a comfortable experience, and we will provide as much sedation as we can safely administer titrated to your individual needs.
What happens during the procedure?
The instrument will be inserted through the rectum and guided to the beginning of the colon. Your physician may instill water or air into the colon to help with visualization.
Areas of abnormal tissue will be biopsied, and photos of the areas will be obtained and reviewed with you.
Polyps are commonly seen during colonoscopy and your physician employs a variety of techniques to biopsy and remove these lesions during your exam. If a polypectomy is performed, your physician will go over this with you afterwards and remind you not to take aspirin or NSAIDs for several days afterward.
What happens after your procedure?
After your procedure, you will be monitored and allowed to recover from the sedation. This typically takes 30 minutes to one hour. Your abdomen may be a little sore for a while, and you may feel bloating or cramping right after the procedure because of air introduced into your colon during the test.
With rare exceptions, most patients can resume a normal diet immediately afterwards.
You will go home with a copy of your procedure report, and your referring physician will receive a copy in the mail usually within one week. You will be sedated for this exam (unless you specifically ask not to be) and will need to have a driver home. A taxi cab is not sufficient. If you do not have a driver to take you home, your appointment will be cancelled/rescheduled. You will not be allowed to drive or operate machinery for 8 hours after the procedure and we recommend that you not attempt to go back to work that day.
What are the possible complications of a colonoscopy?
Colonoscopy is generally safe and complications are rare when the test is performed by a Board-certified gastroenterologist.
Irritation may occur at the vein where medications were given, sometimes leaving a tender lump lasting for several weeks. Applying hot moist towels may help relieve discomfort.
There is a small risk that biopsies or removal of polyps will cause bleeding which could require transfusions. You should take no aspirin, arthritis pills (other than acetaminophen/Tylenol), or other blood thinners for a period of time after biopsies or polypectomy. Your physician will inform you when you can resume these types of medications.
Rarely, a tear in the wall of the colon could require hospitalization, emergency surgery, or even death. Also, there is a small possibility of a splenic tear or rupture.
Other rare risks include a reaction to the sedatives used or aggravation of heart or lung diseases.