Colonoscopy is a procedure to study the inside of the colon or large intestine. The physicians at Atlantic Digestive Specialists, who are all trained endoscopists, perform the procedure. Using a long, thin flexible tube called a colonoscope, your doctor will gently insert the tube into the anus, slowly advancing it into the rectum and colon. The scope has a lens and light on the tip, providing a light source to illuminate the bowel while projecting an image to a video screen. The scope has a water channel to wash off the lens, an air channel to inflate the colon, a suction channel to remove fluid, and a working channel to allow passage of instruments to obtain tissue samples, remove polyps, etc. The colonoscope is capable of viewing the entire colon for diagnostic purposes, screening for colon cancer, and performing therapeutic interventions. Tissue may be sampled or biopsied, small growths or polyps may be entirely removed, areas of persistent bleeding may be cauterized, strictured or narrowed areas may be dilated, just to name a few of the conditions that can be treated with the colonoscope.
Routine colonoscopy is offered for colon cancer screening for anyone over the age of 50. Certain other high-risk groups may undergo screening colonoscopy at an earlier age. High risk groups include people with a family history of colon cancer, prior history of polyps, a history of inflammatory bowel disease, to name a few. Colonoscopy is often recommended to investigate specific symptoms such as blood in the stool, diarrhea, anemia, or follow up on an abnormal X-ray. As noted above, many of the conditions that are identified can actually be treated with the scope.
The physicians at Atlantic Digestive Specialists perform colonoscopies in hospitals and surgery centers. To ensure your safety and comfort during the exam, an intravenous line is started and monitoring equipment is set up to monitor heart rate, blood pressure, and breathing. Sedation is administered through the intravenous line using a combination of medicine geared to providing a pleasant and safe experience. This is not general anesthesia. You may be conscious of your surroundings and experience mild cramps or bloating during the procedure. If necessary, more medication may be administered throughout the exam. Some people opt to have a colonoscopy with no sedation at all, but you must be willing to put up with a fair amount of discomfort. The exam usually lasts for 15-20 minutes but recovery from the sedation may take two to three times longer. There is minimal recovery following colonoscopy. Air is used to inflate the colon, so you will feel bloated and need to expel the air. This generally occurs before leaving the hospital. There may be some mild cramping. The bulk of the recovery is from the effects of the sedation, which can take up to 24 hours to completely clear. Plan for at least a two-hour hospital stay from start to finish. Because of the sedation, you cannot drive yourself home after the procedure or for the following 24 hours. It is expected that you will be able to return to full activities on the day following the exam.
Results may be available immediately following the colonoscopy, but if tissue is removed, it will take several days for a final report.
How do I Prepare for the Exam?
The bowel prep or clean out is the most important part of the exam and is the part that you have complete control over. Bowel preps are described in detail on the colonoscopy prep page. A good prep means a clean colon, and a clean colon means a more thorough and easier exam. Less time will be spent cleaning out the residual stool with the scope and less air will be needed. This all translates to a quicker, more comfortable exam with a speedier recovery.
Colonoscopy is an invasive procedure that carries some limited risks. There is a small chance of causing an injury to the colon such as bleeding or perforation. Rarely the prep may cause some electrolyte disturbances, and the sedatives may also cause some untoward reactions such as respiratory depression or allergic reaction.
CT scan is generally not a good way to examine the colon, nor is MRI, but the CT scan is useful for depicting the structures around the colon in the abdominal cavity. A new test currently under development is virtual colonoscopy, which does utilize a CT scanner to reconstruct the colon. This is currently available in some centers and studies are currently underway to determine its place in diagnosis of colonic diseases.
There are alternatives to having a colonoscopy, using other techniques to study the colon. Our colon cancer screening page describes these in detail.
If you would like to schedule a colonoscopy exam, please call our office, and we will be happy to assist you. At Atlantic Digestive Specialists you will benefit from the personal care and technologically advanced procedures performed by our leading, board-certified gastroenterologists. Contact us for more information on Colonoscopies.
6 Minute Educational Video: “What to Expect During a Colonoscopy”