Colonoscopy

colonoscopy-procedureOverview:

Colonoscopy is an exam of the lower part of the gastrointestinal tract, which is called the colon or large bowel.  This safe procedure provides information that other tests may not be able to give.  It also offers an opportunity to treat certain conditions at the same time.  The procedure is done with conscious sedations and generally takes between 20 minutes and 1 hour.

Reasons for colonoscopy:

Colonoscopy is most commonly used to evaluate the following:

  • Screening exam for polyps or colon cancer
  • Rectal bleeding
  • A change in bowel habits
  • Iron deficiency anaemia
  • Family history of colon cancer
  • Unexplained abdominal or rectal pain
  • Abnormalities seen on A-ray or CT scan

 

What to expect:

Before the colonoscopy, the procedure as well as any specific information relevant to you will be explained in detailed.  You will have enough opportunity to ask any questions that you might have.

An IV line will be inserted in your arm or hand.  Your blood pressure, heart rate and oxygen saturation in your blood will be monitored during the procedure.  Sedation will be given through the IV line, which will help to keep you relaxed and pain free.  Some patients sleep through the procedure, while most others are awake, but comfortable and generally not aware.

The colonoscope is a flexible tube, approximately the diameter of the index finger.  The scope gently pumps air into the colon to inflate it to allow the doctor to see the entire lining.  You might feel bloating or cramping as the air opens the colon.  Please do not be embarrassed about passing this gas!  (it’s just air)

After the colonoscopy you will be observed until the sedative medication wears off.  You may experience some bloating or cramps.  Some people feel a little groggy from the sedation medication.  You should not drive or return to work that day.

 

Colonoscopy complications:

Colonoscopy is a very safe procedure and complications are very rare.

  • Bleeding can occur from biopsies or the removal of polyps.  This is usually minimal and can be controlled.
  • The colonoscopy can cause a hole or tear in the colon.  This complication is rare, but is a serious problem.  Someone who develops this complication might need to have an operation to close the hole on the colon.
  • It is possible to have side effects from the sedative medications.
  • Although colonoscopy is the best test to examine the colon, it is possible for even the most experienced and skilled endoscopist to miss or overlook an abnormal area in the colon.

 

Prep for Colonoscopy:

Four days before your appointment

Stop eating all seeds and nuts in breads, fruits, tomatoes, cucumbers, grapes, watermelon, etc., as they could plug the instrument during the procedure.

How to take Moviprep

  1. At 18:00, the day before your appointment:

Dissolve the first 2 sachets (A+B) of Moviprep in one litre of a clear drink (most people use water) and start drinking at the rate of one glass every 10 minutes. You may drink slower if you prefer.

  1. If you find Moviprep difficult to take, try chilling it and drinking with a straw or sipping slowly. You may also start the preparation earlier. This gives more time to consume the Moviprep and may avoid fullness and nausea.  You may also add Oros or any artificial cooldrink mixture.
  2. Diarrhoea-like bowel movements will start. It is normal for the bowel movements to initially become clear and later turn to a yellow colour.
  3. Drink at least 500mls of clear fluids after the Moviprep

Morning Appointments

The day before your appointment

  • You may have a light breakfast, before 9:00 a.m.
  • After breakfast and until the procedure is finished, you must remain on a diet of clear fluids. No solid foods. You may take as much clear fluids as you can.
  • At 6:00 p.m., take the 1st litre of Moviprep (sachet A+B), followed by at least 500mls of clear fluids.

The day of your appointment

  • Take the second litre of Moviprep (sachet A+B) at 05:00 the morning of the appointment followed by at least 500mls of clear fluids
  • Two (2) hours before your appointment time: stop taking any fluids.

Afternoon appointments

The day before your appointment

  • You may have breakfast and a light lunch at 13:00.
  •  After lunch and until the procedure is finished, you must remain on a diet of clear fluids. No solid foods. You may take as much clear fluids as you can.
  • At 6:00 p.m., take the 1st litre of Moviprep (sachet A+B), followed by 500mls of clear fluids

The day of your appointment

  • From 7:00 a.m. take the remaining Litre of Moviprep (sachet A+B), followed by 500mls of clear fluids
  • Two (2) hours before your appointment time: stop taking any fluids.

 

Examples of clear fluids

Clear fluids should be consumed as much as possible and the following is allowed:

  • Black coffee or black tea
  • Clear soup
  • Stock cubes dissolved in water
  • Jelly
  • Clear Juice
  • Sprite or Sprite Zero (no Coke, Fanta etc.)
  • Energy drinks like Energade or Powerade

 

After The Procedure

  • You will remain in the recovery room for close observation for approximately ½ hour.
  • A bloated feeling and flatulence can occur after the procedure if air was used to improve visibility. You can usually get rid of excess gas by sitting on the toilet with your head down.
  • You will be able to resume your normal diet after the procedure, unless you are instructed otherwise.
  • You cannot drive until the following morning and must arrange to have someone else drive you home after the procedure. If you choose to go by taxi or public transit, you must be accompanied by someone.
  • For safety reasons, the person who drives or accompanies you must meet you inside the clinic after the procedure. You cannot leave the clinic on your own.
  • Due to the sedation, you may feel disorientated or forgetful for a short time after the procedure. We recommend that you do not sign any legal or other important documents until the following day.

 

Precautions

Please carefully read and follow these instructions if you are on any of the medications listed below:

  • If you are on Aspirin (including Bufferin, Novasen), discontinue the medication 7 days prior to your procedure. It may be restarted the next day if no biopsy was done. Otherwise, restart 3 days after the procedure.
  • If you take Plavix (clopidogrel), discontinue the medication 7 (seven) days before your procedure and restart the next day (or 3 days in case of biopsy). You should confirm with your doctor that it is safe to be off this medication.
  • If you take iron supplementation, discontinue 5 days before the procedure.
  • If you are on anti-inflammatory medications (Indocid, Motrin, Advil, etc.), stop the day prior to the procedure. Celebrex is alright to take.