A colonoscopy is an exam of the colon (also called the large intestine or bowel) with a slim, flexible, lighted tube called a colonoscope. Colonoscopy is the most direct and complete way to see the entire lining of the colon. A colonoscopy is a very well-tolerated procedure that could be lifesaving.
The colon is the last part of the intestines. Fibers and digested food are passed through to the colon, where the rest of the nutrients are absorbed and stools are formed. Stools are stored in the lower part of the colon, the sigmoid, and the rectum before being excreted through the anus.
A colonoscopy is a common and safe procedure. However, it has a few risks that you should learn about. Most commonly, patients experience abdominal pain or swelling in the lower abdomen (this is due to the air that is pumped into the intestine during the procedure and usually lasts until the body passes the extra air shortly after the procedure.
Other, more rare risks include:
- Bleeding inside the colon
- Damage to the colon (perforation) from the colonoscope
Be sure to talk with your caregiver if you are worried or have questions about the procedure.
Before the Procedure
The physician or nurse will need to know your medical and surgical history, including whether you are or could be pregnant. Your caregiver will also ask you about any medications you take (prescribed, over-the counter or other nutritional supplements) and any allergies you may have to medications or other substances. You should always carry a list of these items with you.
Depending on your condition and history, your physician may order additional tests for you. These may include blood, urine or stool tests.
If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen or naproxen. This helps avoid extra bleeding during the procedure. If you are taking daily aspirin for a medical condition, ask your physician if you need to stop taking it before the procedure. If you have been taking Coumadin (a blood thinner), you will have to stop taking it several days before the exam.
Follow your physician's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least two weeks before the procedure.
You should arrange to have someone be with you on the day of your procedure. If you are discharged after your colonoscopy, you will not be able to drive home due to the medications you are given during the procedure.
You will be instructed to follow a clear liquid diet the day before your procedure. Clear liquids are water, broth, apple or white grape juice, tea or coffee (no milk or cream), and soda. Gelatin in any color except red may also be eaten. You should not eat any solid food for 24 hours before the exam. Increase the amount of water you are drinking. Make sure you drink eight to ten eight-ounce cups of liquid, especially the day before your procedure.
Your bowel needs to be empty before your procedure so the scope will pass through your colon more easily and allow your physician to be able to see the colon and its lining more clearly. Your physician will give you written instructions on how to clear bowel movements from the colon. This will include taking certain medications (laxatives) to empty your bowel. These medicines will give you diarrhea (loose, watery stools), but will quickly clean out your bowel.
On the Day of Your Procedure
Do not take anything by mouth on the morning of your procedure, unless you have been instructed to do so by your physician or the nurse. This includes food, liquid, and medications. If you are instructed to take medicines, you may have them the morning of your procedure with a few small sips of water.
Bring with you any papers your physician has given you to sign as well as your list of medications and allergies.
Wear loose fitting, comfortable clothing.
You may need an enema, using warm water, the morning of your procedure.
An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
During the Procedure
You will be taken to the endoscopy room and then lay on a special bed or table. The nurse will place pads on your chest to monitor your heart rate and attach a clip to your finger to monitor your oxygen levels. You will be given medication through your IV to relax and sedate you. You will be asked to lie on your left side and raise one or both knees toward your chest. Your lower body will be covered with a sheet. The colonoscope is lubricated and gently placed into your anus. It is then passed through the rectum and into the colon. Air is put into the colon to help expand it. When the procedure is finished, the scope is slowly removed.
The procedure takes 30 to 45 minutes. If you are an outpatient, normally your stay will be two to three hours. This will include check-in, procedure and recovery.
After Your Procedure
You will be observed for about an hour. This is to make sure that the medicine given to you has worn off. You may continue to feel the same discomfort or symptoms that you had before the procedure. When you are alert and able to take food and fluids, you can change clothes and go home.
Air is used to inflate the colon during the test to help the physician see inside of your intestines better. This may make you feel bloated and gaseous after the test. This is normal and will go away within a few hours.
Your physician will tell you how soon you can eat and drink. You should start eating slowly after the test. Eat a light snack first and be sure to drink lots of fluids.
If polyps or other tissue is removed, you may notice a small amount of blood in your stools for a short time. You should not take aspirin or go on any long car trips for the next seven days.
Before the procedure, ask your physician when and how you will be informed of the results. Someone may call you, or you may need to call or make a follow-up appointment to get the results.
Call Your Physician If:
- You cannot make it to your appointment on time.
- You get sick (a cold or flu) or have a temperature over 101 degrees.
- You have constipation (dry, hard stools) and the medicines are not helping to empty your bowel.
- You do not return to your normal bowel habits.
- You have questions or concerns about your procedure.
Seek Care Immediately If:
- You are not able to eat or drink, or are urinating less or not at all.
- Your abdomen becomes tender and hard.
- Your signs and symptoms are getting worse.
- Your vomit has blood or bile in it.
- You have severe pain in your abdomen.
- You have a large amount of rectal bleeding (a small amount of blood from the rectum is not serious, especially if hemorrhoids are present).
- You feel too dizzy to stand up, short of breath, or faint.
Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments or procedures may be done to treat your condition. Your physician should also tell you about the risks and benefits of each treatment. You will be asked to sign a consent form that gives your physician and the hospital staff permission to do certain tests, treatments or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
For more information, contact one of our gastroenterologists.