Colonoscopy is both a diagnostic and therapeutic procedure. During a colonoscopy, the colon (large intestine) is examined through the anus. The procedure allows for the entire length of the colon, about 80-120 cm, to be scanned, including the connection with the small intestine, and also enables the examination of the final part of the colon (the terminal ileum - known as ileoscopy).
A flexible tube with a camera at its tip called an endoscope, is inserted into the lower digestive tract during the examination. The goal of colonoscopy is to visualize the lining of the large intestine and diagnose conditions such as cancer, colitis (inflammation of the large intestine), polyps (abnormal growths in the colon), and diverticula or diverticulosis (small pouches in the colon). Colonoscopy can also be used to investigate symptoms such as diarrhea, bleeding, and unexplained anemia. In some cases, colonoscopy is used to evaluate abnormalities seen in other imaging tests, such as CT scans.
During a colonoscopy, the doctor can assess the condition of the colon and identify processes within the colon itself, such as polyps, inflamed areas, and more. Complex procedures can be performed through the endoscope, such as polyp removal, cauterization of bleeding lesions, and more. Additionally, samples from the lining of the colon (biopsies) can be taken during the examination to diagnose inflammatory processes or growths.
Recently, there has been a significant advancement in the scope of procedures that can be performed using the endoscope, including the resection of large portions of the colon. This allows for endoscopic treatment of conditions that previously required surgical resection. The procedure is recommended as a screening test for all individuals over the age of 50, even without any symptoms or complaints.
Before the colonoscopy, thorough preparation is required to clean the colon, which is done at home in the days preceding the examination.
How should one deal with the medications that the patient takes regularly?
Most medications do not interfere, and there is no need to change their dosage or stop taking them. Usually, patients are asked to discontinue blood-thinning medications such as aspirin, Plavix, Coumadin, anti-inflammatory drugs, and iron supplements.
The procedure is carried out at the Gastro Institute of Shaare Zedek in a relaxed and tranquil atmosphere. Heart rate, blood pressure, and blood oxygen levels are monitored throughout the examination. A colonoscopy typically takes between 20 to 60 minutes, and after the procedure, the patient rests in the recovery room for one to two hours before being discharged.
What happens if the colonoscopy reveals abnormal findings?
One of the main advantages of colonoscopy over other types of large intestine examinations is its ability to sample abnormal areas for further evaluation. Sometimes the examining physician may take biopsies from areas that appear normal to the naked eye. If the reason for the colonoscopy is internal bleeding, your doctor may decide to cauterize or clip bleeding lesions using specialized instruments to stop the bleeding. These treatments rarely cause any discomfort. If a polyp is found, it will be removed and sent to the pathology laboratory for microscopic evaluation.
What is the procedure when a polyp is found?
One of the most common uses of colonoscopy is to prevent colorectal cancer. By detecting a polyp (a benign growth before becoming cancerous), most cases of cancer can be prevented by removing the polyp early. Polyps can vary in size from a poppy seed to several centimeters and are usually not noticeable. Some polyps can turn into cancer, and for this reason, they are usually removed during colonoscopy. In most cases, the examining physician cannot predict which polyp will become cancerous, so the tendency is to remove all of them or at least take a sample for examination under a microscope.
What happens after a colonoscopy?
The doctor will explain the examination's results, but you may need to wait for the biopsy results for a few days. The procedure is performed under sedation or anesthesia, making it easy and almost unnoticeable. You will be discharged with the accompaniment of a friend or family member. Even if you feel alert after the procedure, your judgment and reflexes may still be impaired, so you should not drive for 12 hours following the examination. Some patients may experience contractions or bloating due to the use of air to visualize the colon's lining, but this sensation should subside once you start passing gas. Although the patient should be able to eat shortly after the procedure, the physician performing it may limit your diet and activity, especially if a procedure like a polyp removal was done.
What are the complications or risks of colonoscopy?
Colonoscopy is a procedure with a very high safety profile and is performed by specially trained and experienced physicians. Like any invasive medical procedure, unexpected events can occur. There is a small risk of reacting to one of the medications given during the examination, but most side effects are readily manageable. A rare complication is tearing or perforation of the colon's lining during the examination or polyp removal. This is a relatively rare and problematic complication that may require surgery to repair the tear. Another risk is bleeding, usually at the site of polyp removal or biopsy. In most cases, bleeding can be controlled without treatment or during the procedure.
Although complications after colonoscopy are uncommon, it is essential to be aware of early warning signs that something is not right. You should not hesitate to contact your doctor if you experience unusual abdominal pain, fever, or significant bleeding from the anus after the procedure.
For additional questions and answers about colonoscopy or any concerns, you can contact the following phone number: 02-6666116 or the ER.