Colonoscopy Procedure

A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, abdominal pain, or changes in bowel habits. Colonoscopies are also performed in individuals without symptoms to check for colorectal polyps or cancer. A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings, or children with a history of colorectal cancer or polyps.

What happens before a colonoscopy?

To have a successful colonoscopy, your bowel must be empty so that your doctor can clearly view the colon. It is very important that you read and follow all of the instructions given to you for your bowel preparation well in advance of the procedure. If your bowel is not empty, your colonoscopy will not be successful and may have to be repeated.

• To empty your bowel, you will drink a bowel prep solution. Here are some tips for handling possible nausea/ vomiting and for reducing skin irritation around the anus.
• To reduce nausea or vomiting. If you feel nauseated or vomit while taking the bowel preparation, wait 30 minutes before drinking more fluid and start with small sips of solution. Some activity (such as walking) or a few soda crackers may help decrease nausea you are feeling. If nausea persists, call your doctor.
• To prevent skin irritation. You may experience skin irritation around the anus due to the passage of liquid stools. To prevent and treat skin irritation, you should:
  1. Apply vaseline to the skin around the anus before drinking the bowel preparation medications. These products can be purchased at any drug store.
  2. Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
  3. Sit in a bathtub filled with warm water for 10 to 15 minutes after you finish passing a stool. After soaking, blot the skin dry with a soft cloth. Then apply vaseline to the anal area, and place a cotton ball just outside your anus to absorb leaking fluid.

What happens during a colonoscopy?

During a colonoscopy, an experienced doctor uses a colonoscope (a long, flexible instrument about 1/2 inch 1.27cm in diameter) to view the lining of the colon. The colonoscope is inserted into the rectum and advanced through the large intestine. If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (a biopsy) and polyps can be identified and entirely removed. In many cases, a colonoscopy allows accurate diagnosis and treatment of colorectal problems without the need for a major operation.

How much time is needed to perform a colonoscopy?

The procedure typically lasts from 30 minutes to 1 hour.

What should I expect after a colonoscopy?

• You may feel some cramping or a sensation of having gas, but this quickly passes.
• If a biopsy was taken or a polyp was removed, you may notice light rectal bleeding for one to two days after the procedure. If you have a large amount of rectal bleeding, high or persistent fevers, or severe abdominal pain within the next 2 weeks, go to your local emergency room and call the doctor who performed your exam.
• If polyps were removed or a biopsy was taken, the doctor performing your colonoscopy will tell you when it is safe to resume taking your blood thinners.

Note: To follow are other important questions to ask your doctor. Keep in mind that each doctor and/or his or her health care facility has their own unique set of instructions for their patients. Most doctors/healthcare facilities are in general agreement with the following answers. However, ALWAYS ask your doctor for his/her specific instructions.

Driving home. If sedation has been given, a responsible adult (a family member or friend) must drive you home.

Being alone when home. For safety reasons, you probably shouldn't be alone. Ask your doctor how long you should remain with family or friends.

Returning to normal diet and activities. Unless otherwise instructed, most patients can return to their normal diet immediately following the colonoscopy. Other typical advice is to avoid alcohol, driving, regular activities, and operating machinery for 24 hours following the procedure.