Colonoscopy

What is Colonoscopy ?

Colonoscopy is the endoscopic examination of the large bowel and the distal part of the small bowel via use of a long flexible tube with a fibre optic camera attached at the end and passed through anus. This procedure can help to identify varieties of bowel pathologies and doctor can take biopsy or remove polyp at the same time.

It is a gold standard test for diagnosis of Polyps and bowel cancers.

Why do we need colonoscopy?

A colonoscopy is indicated to screen for bowel cancer in certain situations such as a relative with diagnosis of bowel cancer, a family history of polyposis syndrome, a positive National Bowel Cancer Screening stool test or abnormal imaging like CT scan.

A colonoscopy may be recommended if you have rectal bleeding, or bowel symptoms such as a change in bowel habits, abdominal pain, bloating, or the passage of mucous or iron deficiency anaemia or unexplained weight loss.

What preparation are required for colonoscopy?

A colonoscopy procedure requires a clean bowel to properly inspect colon. If the bowel is not clean (poor prep), it increases the risk of missing pathologies, risk of complication and need for repeat procedure. Preparation includes:

• You need change in your diet for few days before – have low fibre diet and avoid seeds and grains.
• You need to drink bowel preparation – combination of laxatives to cause diarrhoea and clean your gut.
• Increase fluid intake
• Avoid food/liquid with colouring agents
• May need to stop or change some of your regular medications like blood thinner medications, Diabetes medications - as per you doctor’s instruction
• Arrange time off work and also arrage someone to drive you home after procedure as you should not drive, operate machinery or sign a legal document for 24 hrs after procedure due to the effect of anaesthetic medications.

How is the colonoscopy done?

Colonoscopy is usually done under sedation administered by your anaesthetist that helps you stay relaxed, comfortable and usually asleep throughout the procedure. Most people have little to no memory of the procedure. Your vitals like Heart rate, breathing and blood pressure are continuously monitored during procedure. Your doctor with pass colonoscope gently and carefully under vision to reach caecum or distal part of small bowel. The scope is than slowly pulled back while inspecting lining of bowels for any abnormalities like growth, inflammation. The fibre optic camera at the end of colonoscope helps to identify any pathology and also transmit the images to monitor. Your doctor make take biopsies if required or remove a growth (polyp) if detected. Rubber band ligation of haemorrhoid can be performed during colonoscopy to treat small haemorrhoids. Usually the procedure takes 20-40 minutes but it varies depending up on difficulty of procedure or additional procedure required like removal of multiple polyps.

What are the risk of colonoscopy ?

The colonoscopy is usually very safe procedure. You may feel bit bloated after procedure due to use of CO2 gas to distend colon. Usually it settles in 1-2 hrs. You may feel sometime feel some pain at anus or abdomen and may need simple analgesia. Small amount of blood per rectum may noticed for day or so.

Serious complications are very rare and includes perforation in bowel, major bleeding, injury to other organs like spleen and serious side effect to medications. This may require admission to hospital for observation, antibiotics, repeat colonoscopy to fix the problem or rarely surgery to fix hole in the bowel.