Colonoscopy

Colonoscopy Procedure

A colonoscopy is virtually painless and most patients are asleep for the entire procedure. The procedure itself, allows a physician to get a look inside the large intestine (colon). Generally, the physician performing the procedure is a Gastroenterologist, which is a specialist in gastrointestinal diseases that has received precise training in colonoscopy. A colonoscopy is the best and most commonly used procedure to look for early signs of cancer in the colon and rectum. In addition to looking for early signs of cancer, a colonoscopy may be recommended for reasons such as:

• Determining the type and extent of inflammatory bowel disease (ulcerative colitis and Crohn's disease)
• Blood in the stool, abdominal pain, changes in bowel habits
• Obtaining tissue for biopsy
• If you are age 50 years or older*

Most colonoscopies are done on an outpatient basis with minimal inconvenience and discomfort.

*People age 50 or older should schedule a colonoscopy every 10 years or sooner. If you have additional risk factors, your health care provider may recommend the procedure more frequently.

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Preparing for a Colonoscopy

A thoroughly clean colon is mandatory to ensure the physician performing the colonoscopy can see each part of the colon. If the colon is not completely emptied, and the physician cannot see the colon properly, it could lead to a longer procedure and potentially inaccurate exam.

The process of cleaning out the colon may be referred to as the bowel preparation or bowel prep process. As part of the bowel preparation process, a bowel purgative will likely be used to clean the colon. The purpose of the purgative is to quickly eliminate solid waste from the digestive tract, which is a similar effect as having diarrhea. The purgative process should produce a clean colon for the physician to examine.

Many bowel preparation choices are available. Different bowel purgatives clean the colon using different methods and the various options should be discussed with your physician or health care provider.

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Preparation Options

• PEG (Polyethylene Glycol) lavage: Regimen includes 2 to 4 liters of nonabsorbable liquids that work by a "plunger effect" to push out waste matter. Certain PEG lavage regimens may require use of laxatives and fluids in addition to the nonabsorbable solution.
• Sodium phosphate solution: Regimen involves 2 to 3 glasses of a salt solution with additional fluids. The goal of the solution is to draw water into the colon and flush out waste matter.
• Sodium phosphate tablets: Regimen consists of a series of tablets, taken with any clear liquid. Water will be drawn into the colon and will flush out the waste matter.

Health care providers’ instructions may differ depending on the type of purgative used, the time of the colonoscopy procedure, and a specific patient’s history. The bowel preparation process often requires certain dietary restrictions 1-3 days prior to the colonoscopy. Instructions on this should be provided by the physician or health care provider. A patient’s complete understanding of the bowel preparation instructions and purgative process is essential to the success of the colonoscopy.

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Colonoscopy Checklist

• Talk to your physician about the different bowel preparation options and select the one that will provide you with the safest, effective, and tolerable preparation.
• Complete the bowel preparation process exactly as your physician or health care provider instructs you. This is the best way to ensure you have a clean colon which will result in the most effective colonoscopy.
• Keep yourself extremely well hydrated by liberally drinking fluids before, during and after the colonoscopy procedure. Your body will lose fluid during the purgative process and it is very important to replace these lost fluids.
• Make arrangements for a friend or family member to drive you home. Due to the sedation used during the colonoscopy procedure, you will not be able to provide your own transportation.

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