Colonoscopy is a safe endoscopic procedure that yields information that common radiological tests are not always able to offer. A colonoscopy has the advantage of being used for both diagnostic purposes and treatment of certain diseases that affect the colon and rectum.
Patients need to undergo colonoscopy often have many questions and concerns about the procedure. In this article, we’ll explain everything you need to know before undergoing a colonoscopy test.
What is colonoscopy?
A colonoscopy is a test aimed at allowing the doctor to look directly into the colon (large intestine). To do this, we use an endoscopic instrument called a colonoscope.
The colonoscope is a long, thin flexible tube with a length that can reach approximately 185 cm and a diameter ranging from 1.0 to 1.3 cm.
Colonoscopy is through the introduction of the colonoscope into the anus and progression thereof to the start end of the colon and small intestine.Colonoscopy
At the tip of the colonoscope is a small camera transmits images to a monitor, allowing the doctor to see and record what happens inside the large intestine. The last centimeters of the colonoscope are articulated and can rotate at various angles, to facilitate the visualization of the entire interior of the colon.
The colonoscope also allows the clinician to introduce a kind of clamp, that can be used to remove, completely or partially, suspicious lesions, such as polyps.
Sigmoidoscopy is a variation of the traditional colonoscopy, which is performed with a shorter device, which only goes to the end of the descending colon (segment in yellow in the illustration above). Rectosigmoidoscopy allows visualization of the rectum, sigmoid colon, and descending, which are the regions most frequently bowel tumor lesions present.
Reasons for colonoscopy
As colonoscopy allows direct visualization of the inside of the intestine, usually it indicated as a diagnostic tool for a variety of conditions of the intestinal tract. The most common reasons to indicate a colonoscopy are:
- Examination of screening for colon cancer.
- Research intestinal bleeding.
- Research by alterations in bowel habits such as persistent diarrhea.
- Research iron deficiency anemia.
- As a routine examination of people with intestinal polyps.
- Investigation of chronic abdominal pain without apparent cause.
- Confirmation of abnormal results on noninvasive tests like X-rays, CT or ultrasonography.
Preparation for Colonoscopy
Before the colonoscopy, the colon must be completely clean so that the doctor can see the lining of the colon without interference. Most patients considered more unpleasant than the exam itself preparation.
Your doctor should give you specific instructions on how to prepare for colonoscopy. It is common that you receive a kit with instructions on how to proceed. Certify to read the instructions with antecedence to contact your doctor in good time if a doubt arises.
The preparation starts with a free diet of solid foods for 1-3 days. To clean the colon, it is common to use a strong laxative to be taken the night before the test. Some doctors also suggest performing an enema to help clean. The aim is to cause severe diarrhea, so that no traces of faeces on the colon, colonoscopy able to hinder. Do not schedule anything away on the eve of the exam. You will be with a lot of diarrhea and need to go to the toilet frequently to evacuate.
It is important that you drink plenty of fluids the day before. The most suitable are:
– Fruit juice cast.
– Pure Coffee.
– common tea.
– Sports drinks such as Gatorade.
Avoid cola, milk or any liquid red coloring.
Should I stop using my regular medications before the Colonoscopy?
You should tell your doctor about all the medicines you take so he can see whether a drug should be suspended before the colonoscopy. Most drugs do not need to be interrupted before the test, however, some doses may need adjustment, as in the case of drugs for diabetes, due to decreased food intake before the procedure. It is also important to tell your doctor if medicines are used iron-based, as these may impede the visualization of the colon.
Drugs that act on coagulation are those that should receive more attention, as the doctor may choose to remove small samples of intestinal tissue during colonoscopy. Usually, aspirin, clopidogrel and anti-inflammatories, which are substances that increase the risk of bleeding by inhibiting the action of platelets, need not be interrupted before the colonoscopy. The biggest concern is in relation to anticoagulants such as heparin and warfarin. In these cases, the decision to terminate will be the physician who must assess the risks and benefits.
Does it hurt colonoscopy?
Our gut seems one of those empty party balloons. Its interior is hollow, but the walls are “stuck” in one another. For the colonoscope can come and view the walls of the large intestine at all angles necessary cause inflation thereof. So while the colonoscope is introduced, it will at the same time placing air (carbon dioxide, actually) inward, taking off as well, walls and allowing its progression.
The colonoscopy causes discomfort due to the air used to inflate the colon. The patient usually feel cramping, which may be stronger or weaker depending on each case. As the patient often feels like air is injected eliminate flatulence inward bowel during the examination. Do not be ashamed of it or try to prevent the escape of these gases. In fact, the removal of air helps the doctor to have any idea how much you tolerate the blow, allowing him to control it so that the test is less uncomfortable.
Some people believe that colonoscopy is a very uncomfortable exam while others tolerate without problems. That is very particular, but also depends on the skill of the physician.
Sedation during colonoscopy
Colonoscopy can be performed without sedation, with mild sedation or deep sedation. When deep sedation is desired, generally it called an anesthesiologist to accompany the exam.
The level of sedation is determined according to the level of anxiety of the patient, their ability to collaborate during the test and the conditions of their clinical status. Obese patients with heart or lung disease, such as bad tolerate more aggressive sedation. Ideally, always take the exam with minimal sedation necessary for the patient to feel good and allow the proper performance of colonoscopy. In general, patients are sleepy, but remain awake.
Before the test, ask your doctor how you plan to make your sedation.
How is colonoscopy performed?
At the time of examination you will be placed aside and stay with their vital signs monitored. A nurse will identify a vein to administer the serum and drugs. Will start the test when you are relaxed and properly sedated.
The doctor will insert the colonoscope through the anus, slowly progressing through the rectum and then the colon, as will inject carbon dioxide to inflate the bowel. During the exam, your doctor may ask you to make small movements with the body, to facilitate the passage of the colonoscope.
If during the procedure the doctor identifies polyps, they can be removed by colonoscopy. Similarly, suspicious lesions can be biopsied for better evaluation by a pathologist for signs of cancer. The result of the evaluation of the removed material usually takes a few days to be released.
The test takes 20-60 minutes. If cleaning the colon is unsatisfactory, the doctor may choose to discontinue the examination, reprogramándolo for another date.
The sedative takes time to completely disappear. Patients may have to stay in the clinic for 1-2 hours after the end of the colonoscopy. Full recovery of sedation is only scheduled for the following day. Therefore, the patient should always be accompanied by examination, because someone will have to help him return home. The patient should not work, drive vehicles or operate heavy machinery during this day.
After arriving home, the patient can have a snack or dinner, if you wish. If the doctor has removed one or more polyps may give you a special diet for the next few days. In cases where polyps are removed or suspicious lesions biopsy is performed, it is normal for a small amount of blood to appear in the first stool. However, large amounts of blood and / or persistent bleeding in the stool is not normal and should be reported to the doctor.
Elimination of flatulence and colic can occur for one or two hours after the procedure. If you are still full of gas to get home, walking helps remove them.
Risks of colonoscopy
A colonoscopy is a very safe test. However, like any medical procedure, there is always risk of problems. The complication rate is 0.2% and the risk of death is 0.007%. Complications are more common when you need to remove one or more polyps. Still, the risk is very low.
bleeding from biopsy or polyp removal can occur, but are usually minimal and can be easily controlled. Another, more rare potential complication is perforation of the colon.
You may have side effects of drugs used for sedation.
The transmission of disease by the colonoscope is very rare and theoretically could only occur if the colonoscope was not properly sterilized after each test. There are no reports of transmission of HIV through colonoscopy.
You should contact your doctor immediately if after the test has any of the following symptoms:
– Severe abdominal pain (not just gas cramps).
– Great distension of the abdomen.
– Bleeding in stools or persistent high volume.