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Colonoscopy

A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, abdominal pain, or changes in bowel habits. Colonoscopies are also performed in individuals without symptoms to check for colorectal polyps or cancer.

A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings, or children with a history of colorectal cancer or polyps.

Hospital Stay: Hospital Stay: 1 day
Duration: Duration: 30 mins
Cost Estimate: Cost Estimate: 115 USD - 121 USD These are indicative prices in Indian Hospitals

A colonoscopy may be advised if you have symptoms such as bleeding from the anus, pains in the lower abdomen, persistent diarrhoea, or other symptoms thought to be coming from the colon. The sort of conditions which can be confirmed include:

  • Ulcerative colitis (which causes inflammation of the colon).
  • Crohn’s disease (which also causes inflammation of the colon).
  • Diverticula (pouches which form in the lining of the colon).
  • Polyps of the colon.
  • Cancer of the colon.

Various other conditions may also be detected. Also, a colonoscopy is often normal. However, a normal result may help to rule out certain possible causes of your symptoms.

Preparation:

You should get instructions from the hospital department before your test. The sort of instructions given include:

  • The colon needs to be empty so that the operator can get a clear view. You will be instructed on how to take a special diet for a few days before the test. You will also be given some laxatives to take.
  • You will need somebody to accompany you home, as you will be drowsy with the sedative.

Colonoscopy is usually done as an outpatient or day case. It is a routine test which is commonly done. You will usually be given a sedative to help you to relax. This is usually given by an injection into a vein in the back of your hand. The sedative can make you drowsy but it does not ‘put you to sleep’. It is not a general anaesthetic.

You lie on your side on a couch. The operator will gently push the end of the colonoscope into your anus and up into the colon. The operator can look down the colonoscope and inspect the lining of the colon. Also, modern colonoscopes transmit pictures through a camera attachment on to a TV monitor for the operator to look at.

Air is passed down a channel in the colonoscope into the colon to make the inside lining easier to see. This may cause you to feel as if you want to go to the toilet (although there will be no faeces to pass). The air may also make you feel bloated, cause some mild ‘wind pains’, and may cause you to pass wind. This is normal and there is no need to be embarrassed, as the operator will expect this to happen.

The operator may take biopsies (small samples) of some parts of the inside lining of the colon – depending on why the test is done. This is painless. The biopsy samples are sent to the laboratory for testing, and to be looked at under the microscope. Also, it is possible to remove polyps, which may be found, with an instrument attached to a colonoscope. (Polyps are small lumps of tissue which hang from the inside lining of the colon.) At the end of the procedure the colonoscope is gently pulled out.

A colonoscopy usually takes about 20-30 minutes. However, you should allow at least two hours for the whole appointment to prepare, give time for the sedative to work, for the colonoscopy itself, and to recover. A colonoscopy does not usually hurt, but it can be a little uncomfortable, particularly when the colonoscope is first passed into the anus.

Complications of colonoscopy:

Most colonoscopies are done without any problem. The sedative may cause you to feel tired or sleepy for several hours afterwards. You may pass a small amount of blood from your anus if a biopsy was taken, or if a polyp was removed. You may also get leakage of liquid accompanied by gas for up to 24 hours after taking the last dose of laxatives: you should arrange your work/social activities following a colonoscopy with this in mind.

Occasionally, the colonoscope may cause damage to the colon. This may cause bleeding, infection and, rarely, perforation. If any of the following occur within 48 hours after a colonoscopy, consult a doctor immediately:

  • Abdominal pain. (In particular if it becomes gradually worse, and is different or more intense to any ‘usual’ pains that you may have.)
  • Fever (raised temperature).
  • Passing a lot of blood from your anus.

Colonoscopy lets a doctor closely look at the inside of the entire colon and rectum. The doctor is looking for polyps which could be early signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope. The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly.

The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s done.

Your doctor decides how often you need this test, usually once every 10 years, unless you are at a higher risk for developing colon cancer. It’s important that you talk with your doctor to understand your risk for colon cancer, the guidelines you should follow for testing, and whether you need to start having the tests at age 50 or earlier.

Most people don’t find these exams painful, although some people have more discomfort than others. Patients are given medicine to make them sleep through a colonoscopy, so they don’t feel anything.

During both of these tests, air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. The air pressure may cause some discomfort and cramping.

As with most medical tests, complications are possible with both of these tests. Some can be serious – for instance, bleeding and puncture of the colon – but they’re very uncommon. Make sure you understand how these tests work, how you can expect to feel during and after the test, and how to watch for possible problems that could come up afterward.

Colonoscopy is almost always done by a doctor, usually a gastroenterologist (a doctor whose specialty is the digestive tract) or a surgeon.

Colonoscopy is done in a private area; it may be a hospital outpatient department, a clinic, an ambulatory surgery center, or a doctor’s office. The patient’s privacy is very important. If you have concerns, talk with the doctor about where and how the procedure will be done.

Many people consider the bowel preparation (often called the bowel prep) the worst part of these tests. For the doctor to see your insides clearly and get good pictures, your bowels need to be as cleaned out as possible. You probably will be told to avoid certain foods and medicines and might be put on a clear liquid diet for one or more days before these exams. You will take very strong laxatives and you might also need enemas to clean out your colon. If you can choose a day for your exam, pick one that will make it easy for you to be at home the day or evening before the test, when you do the preparation.

You will get instructions from your doctor’s office ahead of time. Read them carefully since you will probably need to buy special supplies (like clear liquids, soups, and gelatin) and get laxatives or enemas. If any of the instructions are not clear or you do not understand them, call the doctor’s office and go over them step-by-step with the nurse. This is your chance to discuss any concerns about the bowel prep you might have.

Preparing for colonoscopy makes you to go the bathroom a lot! As soon as you take the laxatives, you’ll need to stay close to a bathroom. They usually start working pretty quickly. They might still be working the next morning when you go for your colonoscopy appointment. Don’t be embarrassed to ask for a bathroom when you get there. People have to ask this all the time and the staff is used to it.

Most people feel OK after a colonoscopy. You could feel a bit woozy from the drugs (anesthesia). You’ll be watched as you wake up. You might have some gas because of the air that was pumped into the bowel, which can cause cramping and discomfort. Because of the medicines given for the test, you will need someone to take you home. Because colonoscopy is usually done with drugs that make you sleepy, most people miss work the day of the test.

If a small polyp is found, your doctor will probably remove it during the test. Over time some polyps could become cancer. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy (by-op-see) will be done. For the biopsy, part or all of the polyp or abnormal area is taken out through the colonoscope. It’s sent to a lab for a doctor to look at under a microscope and check for cancer or pre-cancer cells.

Colorectal cancer screening helps people stay well and saves lives. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer or finding it early, when it’s easier to treat. There are 2 basic types of screening tests:

  • Tests that mainly find cancer: These involve testing the stool (feces) for signs that cancer may be present. These tests are easier, but they are also less likely to detect polyps.
  • Tests that can find both colorectal polyps and cancer: These tests look at the structure of the colon itself to find any abnormal areas. Colonoscopy and sigmoidoscopy fall in this group, along with double-contrast barium enema and CT colonography (virtual colonoscopy). These tests are preferred if they are available and you are willing to have them.

Removing polyps can help prevent colorectal cancer from ever starting. And cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive 5 years later. And many will live a normal life span.

But all too often people don’t get any of these screening tests. Then the cancer can grow and spread without being noticed. Early on, colorectal cancer doesn’t usually cause any changes that are noticed (symptoms). In most cases, by the time people do have symptoms the cancer is advanced and very hard to treat.

Regular screening is the most reliable way to find these cancers in the early stages.

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