Colonoscopy

Colonoscopy is the visual examination of the lining of the colon. The colon is about 5-6 feet long. The purpose of the exam is to identify any abnormalities by inserting a flexible fiberoptic tube into the anus. The tube, which is about the thickness of your finger, is slowly passed through the length of the colon to the cecum.

The results obtained from the colonoscopy may help explain the cause of symptoms such as rectal bleeding, pain, or diarrhea. A screening colonoscopy is recommended for anyone age 50 or older.

How Do I prepare for the examination?

The colon must be thoroughly clean in order for the exam to be accurate and complete. Please follow the enclosed preparation instructions.

What should I expect during the examination?

While lying on your left side with your knees bent, the physician will perform a finger exam of the anus and rectum. The colonoscopy is done by inserting a long flexible lighted tube into the rectum and beyond. In many cases, the instrument can be inserted throughout the entire extent of the large intestine, permitting a complete examination. The patient during the course or the examination usually experiences abdominal cramps. However, you will be sedated with medications, which will help the cramps. Be sure and tell us if you are allergic to any medications.

What is a polyp?

A polyp is a growth that is attached to the inside of the colon. Most of these growths are benign but their removal is strongly recommended so that the polyp may be examined under the microscope, permitting an exact diagnosis to be made. In addition, benign polyps at times may become malignant with the passage of time. Therefore, we believe they should be removed. At times, a polyp is discovered unexpectedly during the course of a colonoscopy examination, which is being done for other reasons. We recommend that all patients give us permission ahead of time to remove polyps if they are discovered.

What happens if a polyp is discovered?

If a polyp is discovered, a thin snare wire is passed through the colonoscope and the polyp is encircled. The snare is tightened and an electric current is passed through the wire, which cuts off the polyp. The polyp is then brought out of the colon and sent to the pathologist for further examination.

Are there any possible complications?

The possible complications of colonoscopy and polypectomy (polyp removal) include perforation (rupture) of the colon, hemorrhage from the colon and side effects due to the medications (sedatives) which are given. In very rare circumstances, death could result from a complication.

Please notify the physician if you are taking any blood thinners (coumadin, aggrenox, plavix). Please review all of your medications with the office as well as any medication allergies.

What can I expect after the exam?

You can expect to feel bloating for about 30-60 minutes after the exam. This sensation will be relieved as gas is passed. You may feel sleepy for several hours after the exam from the medications given prior to the exam. Do not plan to return to work, drive or sign any legal documents for the remainder of the day.

If the physician removes polyps or takes a tissue biopsy during your examination, our office will contact you in 5-7 business days with the pathology results.

 

PREPARATION FOR COLONOSCOPY

PRIOR TO PROCEDURE YOU WILL NEED TO PURCHASE

• The Prep that has been prescribed to you
• 2 Dulcolax (Bisacodyl) tablets (over the counter – no prescription required)
• One Reglan (Metoclopramide) or zofran optional (prescription enclosed)
• Be sure to let the nurse know if you are on Coumadin, Warfarin or Pradaxa as soon as possible.
• Five days prior to your procedure: Stop oral iron supplements; please avoid sesame seeds and nuts.

Diabetic medication adjustment:

The day before your procedure:

• Follow directions as directed per your prep.
• Take 1/2 (half) of your pm insulin dose and no oral diabetic medications.

The Day of your procedure:

• Do not take any diabetic medications until after the procedure.

DAY BEFORE EXAM

• Add water to “fill line” of Nulytely/Colyte container. Mix until powder is dissolved and refrigerate.
• You will be on a clear liquid diet all day, no solid foods or milk products.
  
  Clear liquid diet: coffee, tea, soft drinks, Jell-o, clear broth, popsicles, clear fruit juice, Gatorade, water, lemonade, Snapple, powdered fruit drinks. Avoid red and purple liquids.

  *It is important to stay well hydrated while prepping for the examination. Force fluids all day prior to and after starting the prep.

• At 2pm: take 2 Dulcolax tablets
• At 4:30pm have an early supper of clear liquids. You may have clear liquids until midnight.
• At 5pm take Reglan (optional) the prep may cause nausea and sometimes vomiting. Reglan taken in advance of the prep should reduce nausea and vomiting.
• At 5:30pm drink 8 ounces of Nulytely/Colyte. Drink 8 ounces every 15 minutes. When you have finished drinking half of the container you may stop if your stool is clear. If your stool is not clear, continue drinking 8oz every 15 minutes. Some patients may drink half of the container before they begin having diarrhea, continue drinking the prep and clear liquids.
• If you experience nausea and bloating, slow down drinking the prep, space interval to 20-25 minutes.
• Do not plan to go out anywhere after you have started drinking the prep. The prep will cause diarrhea to cleanse your bowel for the procedure.
• You may wish to use baby wipes rather than toilet tissue to protect your rectum from irritation.
• NOTHING TO EAT OR DRINK AFTER MidNIGHT.

DAY OF EXAMINATION

• Please take all regularly scheduled medications with a small amount of water.
• If you use an inhaler, bring it with you to the exam.
• YOU WILL BE SEDATED FOR THIS PROCEDURE AND WILL REQUIRE AN ADULT(18 YEARS OR OLDER) TO DRIVE YOU HOME. YOUR DRIVER WILL BE REQUIRED TO STAY AT THE FACILITY DURING YOUR PROCEDURE. The facility at which you are scheduled has the right to delay or cancel your procedure in the event that you do not have an adult with you when you arrive for your appointment.
• Do not plan to drive, go to work, sign any legal documents or participate in any activities that require concentration during the remainder of the day.
• Please arrive for your procedure at the scheduled arrival time. If you are unable to keep your appointment, please call our office as soon as possible to reschedule. We reserve the right to charge for missed appointments or appointments cancelled less than 72 hours in advance.

If you have any questions, please call our office.