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A colonoscopy is the visual examination of the large intestine (colon) using a flexible fiberoptic or video endoscope. The colon begins in the right-lower abdomen and then moves up and around the abdomen, ending in the rectum. The colon is 5 to 6 feet long and has a number of functions including withdrawing water from the liquid stool that enters it so that a solid stool is produced.
Reasons for a Colonoscopy
In the colon, many types of problems can occur. The medical history, physical exam, laboratory tests and x-rays can provide useful information in making the diagnosis. The best examination of the colon can be made through directly viewing the colon by colonoscopy. Colonoscopy is used for:
- Diagnosing cancer
- Polyps - fleshy tumors which usually are the forerunners of colon cancer
- Colitis - chronic inflammation of the colon
- Diverticulosis and Diverticulitis - pockets along the intestinal wall that develop over time
- Bleeding lesions
- Abnormal barium x-ray exam
- Chronic diarrhea, constipation, or a change in bowel habits
To receive the full benefits of the exam, the colon must be clean and free of stool. The patient is instructed on how to do this. This process involves drinking a solution which flushes the colon clean or taking laxatives and enemas. Usually before the day of the exam, the patient only drinks clear liquids and eats no food. The physician advises the patient regarding the use of regular medications during that time.
Colonoscopy is usually performed on an outpatient basis. The patient is mildly sedated, the endoscope is inserted through the anus and moved gently through the bends in the colon. If a polyp is encountered, a thin wire snare is used to lasso it. Electrocautery (electrical heat) is then applied to painlessly remove it. Other tests including a biopsy can be made by obtaining small tissue specimens for microscopic analysis. The procedure takes 15 to 30 minutes and is seldom remembered by the sedated patient. A recovery area is available to monitor vital signs until the patient is fully awake. Mild cramping or abdominal pressure following the exam is normal and within an hour this usually ceases.
After the procedure, the physician and nurse will notate any significant findings of the exam and inform the patient or family. If a biopsy has been performed or a polyp removed, the results of these will not be for 14 days. The nurse and/or the physician will review all results of the procedure at the post operative appointment approximately two weeks after the procedure.
Benefits of the Procedure
A colonoscopy is performed to identify or correct a problem in the colon. The test enables a diagnosis to be made and a specific treatment to be given. If a polyp is found during the exam, it can be removed at that time, eliminating the need for a major operation later. If a bleeding site is identified, treatment can be administered to stop the bleeding.
Barium enemas or other types of x-ray exams are alternative tests which outline the colon and allow a diagnosis to be made. Study of the stools and blood can provide indirect information about a colon condition. These exams, however, do not allow direct viewing of the colon, removal of polyps, or the completion of biopsies.
Side Effects and Risks
Bloating and distension usually occur for about an hour after the exam until the air is expelled. Serious risks are uncommon. One such risk is excessive bleeding, especially with the removal of a large polyp. Due to mild sedation, the patient should not drive or operate machinery following the exam. For this reason, someone should be available to drive the patient home.