ENDOSCOPY

An endoscope is a long, thin fiber optic tube with a small camera at the end, that is passed into your body directly to observe an internal organ or tissue in detail through a natural opening such as your mouth. It can also be used to carry out other tasks take biopsy samples & minor surgery.

During an (A) Upper gastric endoscopy or OGD, an endoscope is easily passed through the mouth and throat and into the esophagus, allowing the doctor to view the esophagus, stomach, and upper part of the small intestine. It is done under sedation.
Similarly, endoscopes can be passed into the large intestine ( colon) through the rectum to examine this area of the intestine. This procedure is called sigmoidoscopy or (B) Colonoscopy depending on how far up the colon is examined.

Alternatively, they can be inserted into small incisions, for instance, in the knee or abdomen. Surgery completed through a small incision and assisted with special instruments, such as the endoscope, is called keyhole surgery/laparoscopy. Endoscopes have a wide range of use in many regions of the human body both for diagnosis & treatment.


LOWER GASTROINTESTINAL TRACT

Common Disorders that Require Colonoscopy

  • Investigate intestinal signs and symptoms. A colonoscopy can help your doctor explore possible causes of abdominal pain, rectal bleeding, chronic diarrhea, and other intestinal problems. A tissue sample (biopsy) may be collected to investigate further at the lab.
  • A colonoscopy is used to look for changes, such as swollen, irritated tissues, polyps, or screen for cancer, in the large intestine (colon) and rectum.
  • Treat an issue. Sometimes, a colonoscopy may be done for treatment purposes, such as placing a stent, removing an object from your colon, or clipping a polyp.

Risks to the Procedure

A colonoscopy poses few risks. Rarely, complications of a colonoscopy may include:

  • A reaction to the sedative used during the exam
  • Bleeding from the site where a tissue sample ( biopsy) was taken or a polyp or other abnormal tissue was removed
  • A tear in the colon or rectum wall ( perforation)

After discussing the risks of colonoscopy with you, your health provider will ask you to sign a consent form giving permission for the procedure.

How to Prepare for the Procedure

Before a colonoscopy, you’ll need to clean out (empty) your colon. Any residue in your colon may make it difficult to get a good view of your colon and rectum during the exam. To empty your colon, your doctor may ask you to:

  • Follow a special diet the day before the exam. Typically, you won’t be able to eat solid food the day before the exam. Drinks may be limited to clear liquids — plain water, tea, and coffee without milk or cream, broth, and carbonated beverages. Avoid red liquids, which can be mistaken for blood during the colonoscopy. You may not be able to eat or drink anything after midnight the night before the exam.
  • Take a laxative. Your doctor will usually recommend taking a prescription laxative, usually in a large volume in either pill or liquid form. In most instances, you will be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure.
  • Adjust your medications. Remind your doctor of your medications at least a week before the exam — especially if you have diabetes, high blood pressure, or heart problems or if you take medications or supplements that contain iron.

Also tell your doctor if you take aspirin or other medications that thin the blood, such as warfarin ( Coumadin, Jantoven); newer anticoagulants, such as dabigatran ( Pradaxa) or rivaroxaban ( Xarelto), used to reduce risk of blood clots or stroke; or heart medications that affect platelets, such as clopidogrel ( Plavix).

You may need to adjust your dosages or stop taking the medications temporarily.

During the Procedure

  • During a colonoscopy, you’ll wear a gown, but likely nothing else. Sedation or anesthesia is usually recommended. In most cases, the sedative is combined with pain medication given directly into your bloodstream ( intravenously) to lessen any discomfort.
  • 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, carbon dioxide, or water into your colon. The air or carbon dioxide inflates the colon, which provides a better view of the lining of the colon.
  • When the scope is moved or air is introduced, you may feel stomach cramping or the urge to have a bowel movement.
  • 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 Colonoscopy

After the exam, it takes about an hour to begin to recover from the sedative. 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.

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 1 to 2 weeks.

Results

Negative Result

  • A colonoscopy is considered negative if the doctor doesn’t find any abnormalities in the colon. Your doctor may recommend that you have a screening colonoscopy depending on your age at certain intervals or if at high risk.
  • If there was a residual stool in the colon that prevented a complete examination of your colon, your doctor may recommend a repeat colonoscopy. How soon will depend on the amount of stool and how much of your colon was able to be seen. Your doctor may recommend a different bowel preparation to ensure that your bowel is completely emptied before the next colonoscopy.

Positive Result

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.

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 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.

Biopsy Result

Your healthcare provider may take a tissue sample ( biopsy) during the procedure depending on what was visualized. This tissue is then examined under a microscope and investigated further by a pathologist at a lab to help identify the cause of your symptoms.

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FAQs

Colonoscopy is typically not painful because you are given sedation to help you relax and minimize discomfort. Most people don’t remember the procedure. Afterward, some may feel mild cramping, bloating, or gas, but these sensations usually go away within a few hours.

The biggest risk of a colonoscopy is a perforation (a small tear) in the colon, though this is very rare. Other potential risks include bleeding (especially if a biopsy is taken), infection, or an adverse reaction to the sedation. However, these complications are uncommon, and the procedure is generally very safe.

Common side effects include feeling bloated, cramping, or passing gas after the procedure. These usually go away in a few hours. Some people may also feel tired or groggy due to the sedation. Rarely, people may experience more serious issues like bleeding or infection, but these are uncommon.

While colonoscopy can be performed on people of many ages, individuals over 75 may face higher risks due to age-related health concerns. Older adults may have other health conditions, such as heart or lung disease, that can make the procedure riskier. Your doctor will evaluate your health to decide if it’s safe to go ahead with the procedure.

Colonoscopy may not be recommended for people with certain health conditions, such as severe heart or lung disease, uncontrolled bleeding disorders, or those who have had serious reactions to sedation in the past. If you have a condition that increases your risk of complications, your doctor will discuss alternative options with you.

It’s not typical to experience pain when using the bathroom after a colonoscopy, but mild discomfort, bloating, or gas may occur. This is usually due to the air used during the procedure. If you feel significant pain, have trouble passing stools, or notice heavy bleeding, contact your doctor.

Your doctor will provide specific instructions for a colon-cleansing prep, usually involving a clear-liquid diet and laxatives. You’ll know your colon is empty when your stool becomes clear or light yellow with no solid material. If your stool is still cloudy or contains solid pieces, you may need to repeat the prep to ensure a clear view during the procedure.

TESTIMONIALS


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