Colonoscopy Test- Types, Procedure, Preparation, Results & Risks Factors,

Overview

A colonoscopy is a medical procedure conducted by doctors to check for changes in the large intestine and rectum. The changes include swollen, irritated tissues, polyps, or cancer. During the procedure, a long flexible tube with a small video camera is inserted inside the rectum to allow the doctors to check the entire colon’s inside thoroughly.

Every year, thousands of people get a colonoscopy as a part of their routine medical examination. However, most people do not know the significance of getting the test while others aren’t sure of what to expect during the test. It is important to understand that a colonoscopy is a valuable screening tool. It is performed by trained medical practitioners in medical facilities . Here we discuss the aspects of a colonoscopy, what you can expect when getting one, and perhaps most importantly if it is painful

What is a Colonoscopy?

Colonoscopy is a medical procedure done by a trained medical expert in which the insides of the colon, or large intestine, is examined. It is done with the help of a colonoscope, which is a long flexible tube with a light & camera attached to one end. The camera sends its feed to a monitor where the colon is visualised .

The colonoscope is inserted into the patient’s body through the anus and extended along the rectum right up the entire large intestine or, in some cases, up to the last part of the small intestine.

Also Read About: Solitary Rectal Ulcer Syndrome

Why Should You Get a Colonoscopy?

Your doctor might recommend a colonoscopy for a variety of reasons. One of the most common reasons to get the procedure done is to screen for colon cancer. Patients who are above 50 years of age are more at risk of developing colon cancer and thus require proper screening.

You might also require a colonoscopy if you are exhibiting symptoms like abdominal pain, diarrhea, or blood in the stool. The procedure is an exploratory examination to determine the cause of such symptoms.

A third reason for the procedure could be that you have a family history of colon cancer or a personal history of polyps. That might place you at greater risk of developing cancer. A colonoscopy is both a screening test and a medical procedure to remove any polyps if present.

Your healthcare provider may recommend you get screened for colon and rectal cancer when you are 45 years, if you do not have underlying health issues or are at a higher risk of developing cancer. You are likely to develop colorectal cancer, if youa:

Are a male
Are African American
Have a family history of polyp or colorectal cancer
Have a personal medical history of inflammatory bowel disease, including ulcerative colitis and crohn’s disease
Are experiencing Lynch syndrome or other genetic disorder
Are overweight or smoke cigarettes

Sometimes, your doctor may recommend that you start getting screened for cancer at a younger age if you are at a higher risk of developing colorectal cancer. Also, if you are above 75 years you must talk to your doctor if screening is necessary. Several insurance companies often pay for a cancer screening test, find out about yours and plan accordingly.

Things You Must Know or Tell Your Doctor Before a colonoscopy?

Have an open and sincere conversation with your doctor about your medications, including prescriptions, over-the-counter medications, and supplements. By doing so, your doctor can make necessary changes to your medications, if required. However, if you have diabetes or require blood thinners, your doctor may alter the doses before the procedure.

Most hospitals only perform the procedure if you have a caretaker to take you home safely. For a successful colonoscopy, you must follow the doctor’s instructions, including the dietary restrictions before the procedure. In addition, your colon should be empty for your doctor to view the colon. It involves a process called bowel preparation.

How Should You Prepare for a Colonoscopy?

Your treating doctor may ask you to empty your colon a day before your colonoscopy is scheduled. Any residue might obstruct the field of view of the colonoscope. To empty the colon, you might be asked to do any of the following:

Eat a special diet: Your diet will be restricted to certain fluids on the day before the examination. You will not be allowed to drink any dairy products or have carbonated beverages. You might also be asked to avoid any liquids with red dye in it since it can be mistaken for blood during the procedure. Be sure to ask your doctor for the exact diet.
Take laxatives: Your doctor might recommend a laxative the night before and the morning of the procedure. The laxative can be either in liquid or tablet form.
Get an enema: An enema is an efficient way to empty out the lower part of the colon.
Adjust any medications: You must give your doctor a comprehensive list of all the medications you are taking. These might have to be adjusted and you should inform your doctor at least a week prior to your procedure.

What To Do For Easier Preparation Of Colonoscopy?

You may have to perform a few things to help you drink the solution easily. You should do the following:

Use a straw for drinking the solution
Refrigerate the solution before drinking
Add lemon or chew ginger candy before swallowing the solution
Splitting the dose may help as well

Remember to stay close to the bathroom during the bowel preparation period. Your colon is clean if your stool looks clear and yellowish like urine. You may also experience anal irritation during rapid liquid stools. The following are the ways to treat and prevent the same:

Apply over-the-counter medications such as Vaseline to the skin around the anus before the bowel preparation.
Use disposable wet wipes to wipe your anus after each bowel movement. Avoid using toilet paper. Wet wipes are readily available in stores.
Submerge yourself in the bathtub filled with warm water for 15 minutes after passing the stool. After soaking, use a soft cloth to dry your skin, apply ointment to the anal area, and place a cotton ball to absorb any leaking fluids.

How Colonoscopy Works?

The doctors use a long, thin, and flexible tube with a light and camera attached to one end. Your doctor inserts the tube into the rectum and moves toward the colon. With the help of the camera, the doctor gets a clear picture of your colon. If there is an abnormality, your doctor will remove it by inserting another instrument, and they will send the tissue for biopsy. You are sedated and given pain medications to make you comfortable during the procedure.

Who Can Do Your Colonoscopy?

A colonoscopy is performed by a doctor specializing in the digestive system, known as a gastroenterologist or a GI specialist. It can also be performed by surgeons, family practitioners, and nurses. An anesthesiologist may also be present during the test as well.

Do People Feel The Tube Inside?

In most cases, patients are entirely sedated for the entire colonoscopy. However, when awake, the procedure is complete, and they will not have the same memory. In countries other than the U.S, sedation is not mandatory. Discuss with your doctor the sedation options that are available for you.

What sedation drugs do doctors use?

There are various sedatives, ranging from mild sedation and anaesthesia. The doctors may administer any of the following sedatives before the procedure:

Midazolam
Propofol
Diazepam
Diphenhydramine
Promethazine
Meperidine
Fentanyl

Depending on age, gender, race, and drug use, the doctors opt for different doses and medications. If there are any concerns regarding the sedation option, you should talk to your doctors to gain more information.

Is There Any Side Effect of Sedatives?

Like all medications, even sedatives too have side effects. If you are concerned about the risks and side effects, you need to voice your concerns to your doctor and get more information. Headache, nausea, and drowsiness are the side effect of sedatives. Therefore, doctors recommend patients avoid driving or stay away from handling any machinery for at least 24 hours from the completion of the procedure.

What About Abdominal Pain After Colonoscopy?

After the completion of the colonoscopy, some patients experience mild abdominal cramping that is similar to gastritis. The pain may last for a day after the procedure. It is due to a small amount of air that may be used to open up the colon to get a better view. The air moves through the colon, making a patient feel bloated or gassy.

If there were abnormalities in the colon, your doctors might have performed a biopsy. After the biopsy, you may experience discomfort or minimal bleeding. If your pain worsens, there is increased bleeding, or the abdomen feels rigid and full, visit your healthcare provider immediately.

Are There Any Pain Prevention Options Other Than Sedatives?

Patients recovering from drug or alcohol addiction may prefer to opt out of sedative or opioid medications. If your colonoscopy is scheduled and you do not want any pain medication, the following are some alternatives:

Intravenous non-narcotic pain relief medication may be started before the procedure.
Opt for non-invasive screening methods, such as Cologuard
Check for CT scan screening to detect any abnormalities
Discuss with your doctor various other non-narcotic screening and detection tests for colorectal cancers

What Should You Expect During a Colonoscopy?

A colonoscopy is a complex medical procedure that involves many stages of preparation and recovery.

Before the Procedure

Before the colonoscopy, you will be started on IV fluids and will be connected to a heart monitor. If you are prescribed sedation, it is administered through the IV tube. The sedative is for you to relax and reduce any discomfort or pain during the colonoscopy. Patients usually experience mild cramping, bloating, or pressure, while most do not feel any pain.

During the Procedure

You will be in a hospital gown and wheeled into the procedure room. You will be asked to lie on your side with your knees drawn up. The colonoscope is inserted into the colon through the anus and air or carbon dioxide will also be pumped in to inflate the colon.

The light and the camera are switched on and the images begin to transmit to the monitor. The colonoscope will move along the entire length of the colon. Your doctor can also insert other instruments to collect samples if required. The entire procedure might take anywhere from 15 to 60 minutes.

After the procedure

The sedation will take about an hour to wear off. You will require someone to drive you home. If you continue to feel any bloating, you should try walking to help you release any gas or air still trapped in your colon.

Do not be alarmed if you find some blood in your stool after a colonoscopy. This is normal and might last a few days. If you experience abdominal pain or develop a fever, then please consult with your doctor.

What Results Can You Expect from the Colonoscopy?

A negative result is when your doctor does not find any abnormalities during the colonoscopy. In such a case, your doctor will recommend that you get your next colonoscopy after ten years. However, if you are at risk for cancer, you will be asked to repeat the procedure in five years. In case the doctor was unable to get a clear picture of your colon due to any obstruction, then you will need to repeat the process within a year.

A positive result is when your doctor finds any abnormalities or polyps in your colon. If you have polyps, then it would have been removed and sent to a laboratory for further examination. Most polyps are not cancerous but can be pre-indications of cancer cell growth. You might require more rigorous screening depending on the size and number of polyps.

What are the Risks of Getting a Colonoscopy?

The risks involved in colonoscopy are very minimal. Even so, you might experience an adverse reaction to the sedative used or experience bleeding if a polyp is extracted. In very rare cases, the wall of the colon can be perforated.

Do talk to your doctor about any concerns you might have with the procedure and make sure you understand all the risks involved.

How is virtual colonoscopy different from colonoscopy?

Virtual colonoscopy provides certain benefits over the traditional colonoscopy procedure. Here are the differences between both these procedures:

	Virtual Colonoscopy	Colonoscopy
Procedure	Performed using a CT scan (3D images) of the abdomen and pelvis	Performed using a tiny camera inserted into the colon through the rectum
Recommended frequency between tests	5 years	10 years
Pros	Less invasiveMore thorough and comprehensive Lesser chances of developing complications	Effective removal of polypsMinimal discomfort through medication
Cons	Radiation exposure	Complications can occur during procedure

virtual colonoscopy vs. colonoscopy?

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At What Age To Have A Colonoscopy?

You can get a colonoscopy at any age; however, if you have a family or personal history of increased risk of colorectal cancer, you need to get screened regularly. Irrespective of the risk factor, the Preventive Services Task Force suggests that adults between 50-70 age should undergo colonoscopy at least once in 10 years. It helps in detecting colorectal cancer.

The American Cancer Society (ACS) also recommend that people begin regular screening at an early age of 45 years and continue till they reach 75 years if they have an average risk of developing colorectal cancer. Colonoscopy for 76-85 year-olds depends upon various factors, including preference, health, and life expectancy. The ACS also recommends that it is not required for individuals above 85-year-old to get screened for cancer.

What happens if there are abnormalities?

If there is an abnormality, such as polyps, the doctor will remove them and send them to the lab for further testing. The tests determine if the polyp is benign or cancerous. If polyps are grown in the inner wall of the colon, it is considered benign. The doctor may recommend regular check-ups if there are abnormalities and the frequency of these check-ups depends on the size, numbers, and other risk factors.

FAQs

Is a colonoscopy painful?

A colonoscopy is performed under a mild sedative that prevents patients from feeling any pain. At most, you might experience bloating or cramps.

When should I get a colonoscopy?

People above the age of fifty are asked to get a colonoscopy every ten years. If you have a history of colon cancer, then you will need to get screened earlier and more regularly. You might also need the procedure if you have any symptoms of gastrointestinal discomfort.

How many days will I need to take off from work?

The colonoscopy is completed within a day, and you will need only a single day off. However, you might need extra time off if you continue to feel the effects of the sedation or develop a fever.

How long will it take to recover from a colonoscopy?

The normal recovery time for any colonoscopy is around 1 day.

How do you poop after a colonoscopy?

To prepare for the procedure, patients are expected to completely empty their bowels. Hence, patients recovering from a colonoscopy procedure may not be required to poop for a couple of days.

Is a colonoscopy a serious procedure?

Colonoscopy do not pose any major risks to the patients, and discomfort can be reduced through medication.

How many hours does it take to recover from a colonoscopy?

After the colonoscopy, the patient needs at least 24 hours of rest to heal completely.

Does it hurt to poop after a colonoscopy?

After the colonoscopy, you may experience minor discomfort, including gas, bloating, and mild cramping. The doctor may advise you to walk around and pass gas to help with the discomfort. After the procedure, you may notice small amounts of blood in the first bowel movement – it is normal. But, if the bleeding continues, you must consult your doctor immediately.