COLONOSCOPY

What is Colonoscopy and what does it stand for ?

Colonoscopy is the method best exploring in real time the endo-luminal aspects of the anal, rectal, sigmoid and descending/ ascending /transverse colon, as well as the cecum and the ileal-cecal valve. The routine examination may also include the last ileum loop. Like the endoscopy of the superior digestive tube, the colonoscopy has both diagnosis and therapeutic purpose of biopsies, intra-cavity coloring, excision of polyps, hemostasis of bleeding regions, incisions of the mucosa, dilation of stenosis, insertion of stents within critical obstructions with intestinal occlusion, etc. As all other endoscopic assessments, colonoscopy has a higher diagnostic efficiency rate, of more than 95%. Moreover the development of screening (prevention) of colonic cancer boosted this investigation, especially for those procedures which require ambulatory care.

Prior to the procedure the physician will give a detailed explanation of the using method. It is a very detailed exploring procedure for the large intestine from the rectum to the small intestine with the help of a flexible and thin tube (about 10mm) called colonoscope equipped with a camera and a source of light, which sends the images taken from the intestine to a monitor where they can be visualized and recorded to a DVD.

What is the use of colonoscopy ?

With the help of thee colonoscopy, lesions of the colon (large intestine) will be discovered. Usually this procedure is made in the following clinical situations:
• presence of blood in dejections;
• intestinal transit disorders (constipation, diarrhea, especially alternation of these);
• abdominal pains due to unknown cause, especially on persons over 45 years old;
• history of colon or digestive tube cancer in the family;
• history of colonic polyps in the family;
• some abnormal laboratory analysis from uncertain cause;
• tumor markers of above normal value (CEA, CA 19-9);
• screening (on patients without symptoms, in order to prevent or discover a possible colonic cancer respectively colonic polyps). In many Occidental states screening colonoscopy after age 40-45 has made current practice due to extensive statistical studies which concluded that this is the best prevention method of colonic cancer-by identifying and resection of colonic polyps that gives birth to cancer.

How long does the procedure take ?

A proper exploration takes about 15-20 minutes, but this can vary due to individually conformation of the colon or presence of past surgical interventions of the abdomen. During this examination sampling of biopsies is possible, if there are lesions that require it. This can be realized only if approved by the patient or person responsible for him/her if the patient is sedated.

Total time needed for the entire procedure is about 60 minutes, including consulting and sedating, as well as explaining the results.

Is it a painful procedure ?

This is the most frequently asked question and this is a normal situation. It must be said that in most cases (8 out of 10) the procedure is not painful, within anesthesia conditions; it just inflicts an amount of discomfort depending on the colon’s anatomy, prior surgical events as well as individual tolerance towards pain.

In significant pain situations, the physician can administrate supplementary medication.

Who performs the procedure ?

The physician that performs the colonoscopy is especially trained for this type of procedures, and has a license issued by medical authorities.

Is the biopsy painful ? Or is it safe ?

NO, the biopsy is not painful, the intestine has no such receptors.

YES, it is safe. Even in a tumor or polyp eventuality the biopsy sampling does not extend the risk of spreading the cancer cells-when they exists. It is very important to know there is no additional risk of spreading the cancer cells when cancer is found and biopsy sampling is done. Plus it is not a must that samples from a lesion would mean that lesion is cancer. Sampling of biopsies is done in order to send them to the Pathological Anatomic Laboratory and examining them on a microscope, for establishing the nature of the lesion.

What does anesthesia imply ?

Anesthesia implies vein injection of a sedative substance, which determines an effect of calming down; another effect is somnolence, making the exploration much easier to tolerate, especially on patients with high anxiety; there is also a small amount of pain suppresser. As you will have a somnolence state and slight movement instability after the procedure, due to sedatives, we strongly recommend you will come with accompanying.

The sedative dose is adjusted depending on individual tolerance and necessary, beginning with small doses.

Can you drive after sedation ?

Driving is strictly forbidden after sedation, at least six hours. It is not recommended to make important decisions or sign papers.

Is a consultation necessary prior to colonoscopy ?

It is preferred that indication for this procedure is made by a physician.

This procedure can be done on patient request, after consulting with the physician that performs it.

How do I prepare for this procedure ?

Preparation begins the day before exploration. It implies not eating for 20 – 24 hours. It also implies ingestion of a solution which has the purpose of cleaning the intestine of dejections, in order to create proper visibility, optimizing the course of the exploration.

The time table for the preparation is individualized depending on the hour you should start the colonoscopy procedure therefore it’s best if you take a printed form of preparing ; it could be sent to you by e-mail, fax or you can download it from this site.

After your last meal you have to wait at least three or four hours before you begin ingesting (drinking) the Fortrans solution (commercial name). Medium quantity of necessary solution is four liters, depending on the appointment hour, or your constipation suffering etc. For easier ingestion you can combine the solution with clear liquids, such as juice (without pulp), soup, tea, light coffee.

You have to consult your physician about previous health problems, especially if you have a cardiac or lung disease, if you are pregnant or allergic to any drugs. It is recommended that you tell the physician which drugs you currently use, or take them with you to show them if you can’t enumerate them.

Can I use my medicines in the day of the colonoscopy ?

It is very important to take your usual drugs in the day you do the colonoscopy, also is important to talk to the physician about your other treatments, before the procedure begins.

What should I do if I am diabetic ?

If you are diabetic it is best if you solicit to do the procedure as early in the morning as possible as you can take your insulin doze after the colonoscopy when you can eat.