Colonoscopy

Colonoscopy

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    A , Internal Medicine, answered
    Let's not sugarcoat reality: Most people would rather go through a tax audit than have a colonoscopy. But there is also no doubt that this screening test saves lives -- lots of them. During a colonoscopy, a doctor inserts a flexible tube with a camera into the rectum (it is not a self-test, and even Dr. Oz and myself do not do this one on ourselves)  and looks for signs of colon or rectal cancer. That's enough to make most people squeamish, but preparing for the procedure isn't much fun either, since you need to fast and the colon clean out is really special.

    Trust me, it's all worthwhile. A large, 20-year study found that colonoscopies cut the risk for dying of colon cancer by more than 50%. Yet about 40% of adults don't get screened on schedule, which usually means having a colonoscopy at least every 10 years after you turn 50. I had one when I hit the half-century mark and I'm sure glad I did. The doctor detected and removed a little nubbin on the lining of my colon called a polyp, which could have turned into a cancerous tumor.  A bit of hassle for peace of mind? I'll take that tradeoff any day.
  • 2 Answers
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    The United States Prevention Task Force (USPTF) advises against routine colonoscopies in anyone over the age of 85. People between the ages of 76 to 85 may consider a colonoscopy.

    No one over 85 should be having a colonoscopy, and in this 10-year interval prior to that, you should be making sure that this is an appropriate test for you. I think that these guidelines are important, but we have to really individualize these guidelines as well.
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    After a colonoscopy, you will be monitored in the recovery room until most of the effects of the medication have worn off. You may feel some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with the passage of gas.

    Diet - Generally, you should be able to eat normally after the colonoscopy. If your doctor recommends diet modifications, you will be instructed regarding this. If you feel nauseous or are having persistent pain, you should inform the recovery room nurse or call your doctor. If you feel the onset of nausea when you start to eat, it is best to stop eating; usually the nausea will pass, and you will be able to resume eating several hours later. Sometimes this nausea or upset stomach is due to the medications given during the colonoscopy.

    Biopsy Results - It will take about one week to receive the results of your biopsy. If you have not received the results from your doctor's office after 1 week, contact your physician.

    Activity - You should not drive a vehicle or perform strenuous activities on the afternoon or evening following colonoscopy. Unless you have had a polypectomy, you should be able to resume all normal activities the day after your colonoscopy. If you have any doubts about resuming an activity, call your doctor.

    Medications - You should resume your usual medications on the evening following your colonoscopy. It is especially important that you resume taking your cardiac and blood pressure medications. However, if you have diabetes and are taking insulin, do not resume your full insulin dose until you are tolerating a regular diet. If you have any questions regarding your insulin dosage, please call your internist or general practitioner. Unless prescribed by a physician, avoid aspirin, Motrin, Advil or similar analgesics for 2 to 3 days. In general, when you resume your diet, you should also resume your prescribed medications. For other blood thinners such as Plavix and Coumadin, your physician should give you specific instructions.
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    Alternatives to colonoscopy include other tests that examine the whole colon such as barium enema or computed tomographic (CT) colonography (virtual colonoscopy). Less frequently used are the fecal occult blood test cards and sigmoidoscopy (examination of the left side of the colon). With this method, yearly tests are done to screen your stool for blood. If these tests are negative, a flexible sigmoidoscopy is done every 3-5 years. If the stool blood tests are positive or there are polyps on sigmoidoscopy, a full colon examination is necessary.
  • 7 Answers
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    A colonoscopy itself usually takes about 30 minutes, but may take longer if a polyp is found and removed. Before the colonoscopy begins, you will be given a sedating medicine (usually through your vein) to make you feel comfortable and sleepy during the procedure. You will probably be awake, but you may not be aware of what is going on and may not remember the procedure afterward. Most people will be fully awake by the time they get home from the test.
    During the procedure, you will be asked to lie on your side with your knees flexed and a drape will cover you. Your blood pressure, heart rate, and breathing rate will be monitored during and after the test.
    Your doctor should do a digital rectal exam (inserting a gloved, lubricated finger into the rectum), before inserting the colonoscope. The colonoscope is lubricated so it can be easily inserted into the rectum. Once in the rectum, the colonoscope is passed all the way to the beginning of the colon, called the cecum. You may feel an urge to have a bowel movement when the colonoscope is inserted or pushed further up the colon. To ease any discomfort it may help to breathe deeply and slowly through your mouth. The colonoscope will deliver air into the colon so that it is easier for the doctor to see the lining of the colon and use the instruments to perform the test. Suction will be used to remove any blood or liquid stools.
    The doctor will look at the inner walls of the colon as he or she slowly withdraws the colonoscope. If a small polyp is found, the doctor may remove it. Some small polyps may eventually become cancerous. For this reason, they are usually removed. This is usually done by passing a wire loop through the colonoscope to cut the polyp from the wall of the colon with an electrical current. The polyp can then be sent to a lab to be checked under a microscope to see if it has any areas that have changed into cancer.
    If your doctor sees a larger polyp or tumor or anything else abnormal, a biopsy may be done. For this procedure, a small piece of tissue is taken out through the colonoscope. The tissue is looked at under a microscope to determine if it is a cancer, a benign (non-cancerous) growth, or a result of inflammation.
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    A , Cardiology (Cardiovascular Disease), answered

    In order for the colon to be viewed unobstructed by stool, patients prepare in advance for the colonoscopy. This bowel prep procedure is the part of the process that often makes people uneasy. The preferred method varies widely from physician to physician but the idea is the same; clean the colon clear so that no polyp or cancer is missed. An inadequately cleansed colon can jeopardize the effectiveness of the test.

    The best way to clear the colon is to forgo solid food entirely (liquids only) and induce diarrhea to expel what solids are left inside the colon. There are a few methods for bowel cleansing; drinking a copious amount of a salty solution, or pills and water - both cause high-volume diarrhea in a few hours. Your doctor will give you specific instructions so read them carefully a few days in advance. Expect to spend the day near the toilet.

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    A Gastroenterology, answered on behalf of
    You can eat in the recovery room after a colonoscopy as long as your abdomen feels comfortable and you have passed air. Upon discharge from the GI lab, you can eat whatever you want!
  • 3 Answers
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    A Gastroenterology, answered on behalf of
    What happens if a polyp is found during a colonoscopy?
    Watch Trupti Shinde, MD, of Citrus Memorial Hospital, explain how recommendations for future colonoscopies differ based on the type and number of polyps found.
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    Will I Feel Pain or Discomfort After Colonoscopy?
    After a colonoscopy you will feel little pain or discomfort. In this video, Eric Changchien, MD, a colorectal surgeon at Riverside Community Hospital, says that the preparation for the procedure may be more difficult than the procedure itself.
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    A Gastroenterology, answered on behalf of
    The problem with other types of tests, such as the virtual colonoscopy, is that the preparation is the same for these procedures as for colonoscopy, and if polyps are found, then colonoscopy still needs to be done for removal. In addition, the detection rate remains less than optimal with these tests. Blood tests can certainly detect anemia, or a low blood count, which is an indication for colonoscopy. However, no specific blood test has been shown to be sensitive enough to detect colon polyps or cancer.