Colonoscopy (lower endoscopy) is a diagnostic procedure that allows the physician to examine the entire length of the large intestine. Colonoscopy can assist in identifying problems with the colon, such as early signs of cancer, polyps, inflammation, ulcers, and bleeding.
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During the procedure, a thin, flexible, lighted tube, called a colonoscope, is placed into the rectum and colon. In addition to allowing visualization of the internal colon, the colonoscope enables the physician to irrigate, suction, inject air, and access the intestine with surgical instruments. During a colonoscopy, the physician may remove tissue and/or polyps for further examination and possibly treat any problems that are discovered.
Other related procedures that may be used to assess problems of the colon include abdominal x-ray, computed tomography (CT scan) of the abdomen, abdominal ultrasound, barium enema, and sigmoidoscopy.
Before a colonoscopy, you will need to “prep” or clean out your colon so the doctor can see with the colonoscope. Residue left in the colon may obscure the view of your colon and rectum.
Your doctor will give you special instructions which will include:
During a colonoscopy, you'll wear a gown. Sedation is given by the anesthesia team to keep you comfortable and you are monitored throughout the procedure
You'll begin the exam lying on your side on the exam table, usually with your knees drawn toward your chest. The doctor will insert a colonoscope into your rectum.
The scope — which is long enough to reach the entire length of your colon — contains a light and a tube (channel) that allows the doctor to pump air or carbon dioxide into your colon. The air or carbon dioxide inflates the colon, which provides a better view of the lining of the colon.
The colonoscope also contains a tiny video camera at its tip. The camera sends images to an external monitor so that the doctor can study the inside of your colon.
The doctor can also insert instruments through the channel to take tissue samples (biopsies) or remove polyps or other areas of abnormal tissue.
A colonoscopy typically takes about 30 to 60 minutes.
After the exam, it takes a short time to recover from the anesthetic. You'll need someone to take you home because it can take up to a day for the full effects of the sedative to wear off. Don't drive or make important decisions or go back to work for the rest of the day.
If your doctor removed a polyp during your colonoscopy, you may be advised to eat a special diet temporarily.
You may feel bloated or pass gas for a few hours after the exam, as you clear the air from your colon. Walking may help relieve any discomfort.
You may also notice a small amount of blood with your first bowel movement after the exam. Usually, this isn't cause for alarm. Consult your doctor if you continue to pass blood or blood clots or if you have persistent abdominal pain or a fever. While unlikely, this may occur immediately or in the first few days after the procedure, but may be delayed for up to one to two weeks.
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A colonoscopy is considered negative if the doctor doesn't find any abnormalities in the colon.
Your doctor may recommend that you have another colonoscopy:
A colonoscopy is considered positive if the doctor finds any polyps or abnormal tissue in the colon.
Most polyps aren't cancerous, but some can be precancerous. Polyps removed during colonoscopy are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous.
It takes on average 5-7 days for your doctor to receive the pathology report on the polyps/specimens removed during the colonoscopy.
Depending on the size and number of polyps, you may need to follow a more rigorous surveillance schedule in the future to look for more polyps.
If your doctor finds one or two polyps less than 0.4 inch (1 centimeter) in diameter, he or she may recommend a repeat colonoscopy in five years, depending on your other risk factors for colon cancer.
Your doctor will recommend another colonoscopy sooner if you have:
If you have a polyp or other abnormal tissue that couldn't be removed during the colonoscopy, your doctor may recommend a repeat exam with a gastroenterologist who has special expertise in removing large polyps, or surgery.
Colorectal cancer is the third most common cause of cancer in men and women in the US and the second leading cause of cancer death in the US when men and women are combined. Colorectal cancer is one of the most preventable cancers in those who undergo screening. So why should you have a colonoscopy?