Colonoscopy is a medical procedure conducted to examine the rectum and colon throughout their entire lengths to identify issues such as inflammation, leakage, or polyps. In most cases, the procedure also examines the distal part of the small intestine. During the procedure, a flexible tube with a small camera is inserted through the anus. This examination is routinely performed at the Pediatric Gastroenterology and Nutrition Institute, with over 400 tests conducted annually for various indications. All endoscopic procedures in children are carried out with deep sedation by experienced pediatric anesthesiologists, ensuring that the child not only does not experience discomfort but also doesn't remember the procedure.
Sigmoidoscopy is a similar but much shorter test that examines only the rectum and the end of the large intestine, called the sigmoid colon.
Preparation for the Procedure:
To conduct a successful test, it's important to empty the bowels before the examination. Detailed instructions will be provided on how to perform this bowel preparation. Despite the discomfort associated with bowel cleansing, it's crucial to follow the instructions diligently as an unprepared bowel can affect the test's success and increase the likelihood of complications.
Part of the preparation might involve dietary restrictions. In any case, the patient should fast from solid food for at least six hours before the procedure (often longer periods are required, depending on bowel cleansing protocols). Clear fluids (any beverage that you can see through, such as tea with sugar, apple juice, strained clear soup, clear juices, and non-red jelly) can be consumed until two hours before the test. Inform the doctor if the patient has any chronic conditions (asthma, diabetes, bleeding disorders, etc.), takes medications, has sensitivities to drugs, or has had any previous adverse reactions to anesthesia. In such cases, a letter from the treating physician detailing the medical condition and relevant documents or blood tests should be brought. This is to ensure the procedure is conducted under the safest conditions. If, for any reason, the patient cannot make it to the appointment, contact the Gastroenterology Institute at 02-6555116 to reschedule.
The Procedure:
The procedure is performed at the Gastroenterology Institute (4th floor) and takes approximately 30 minutes. Efforts are made to minimize waiting times, understanding the challenges of fasting and waiting, especially for children. However, unforeseen medical and technical issues may arise in the hospital environment, causing delays in the procedure schedule. If this occurs, your understanding is appreciated.
Arrive approximately half an hour before the scheduled time for registration and preparation. Our waiting room is well-equipped and child-friendly. Sometimes, a staff member will provide the child with guidance before sedation. Before the procedure, the patient and accompanying caregivers will be asked to sign a consent form for the procedure and sedation. The performing doctor and the anesthesiologist will explain the procedure and what to expect. Feel free to ask any questions before signing the form to ensure a clear understanding of the reasons for the test, the alternatives, and the risks.
The child will receive general sedation and won't experience any pain during the examination. Sedation is usually initiated with a mask and later through an intravenous line to ensure the child doesn't feel pain during the procedure. In most cases, sedation is light enough that the child continues to breathe on their own and maintain vital reflexes. After the child is asleep, the accompanying caregivers will wait outside the examination room until the procedure is completed.
During the procedure, a flexible and soft tube is inserted into the rectum and gradually moved through the large intestine until it reaches the connection with the small intestine. In most cases, the doctor will take a biopsy (a small tissue sample from the intestine's lining) to be examined in the lab. If any polyps are found, they will be removed using advanced instruments through the tube. The doctor might also take pictures of abnormal areas for documentation in the procedure report. While a small amount of air is introduced into the intestine during the procedure to improve visibility, discomfort might be experienced in the abdomen afterward. This will be relieved by passing gas, and there is no cause for concern. If the patient experiences severe abdominal pain, vomiting, fever, weakness, black or bloody stools, or breathing difficulties after the procedure, they should seek immediate medical attention.
After the Procedure:
We use short-acting sedative agents, and after the procedure, the patient will be transferred to a recovery area until the sedation wears off, usually within a few minutes. Before discharge, the performing doctor will explain the findings and provide a copy of the procedure report and discharge instructions. The patient may be offered clear fluids and can resume a regular diet at home unless otherwise instructed by the doctor. Generally, the patient can leave the hospital about an hour to an hour and a half after the procedure. Even if the patient has a driving license, it's recommended to have someone else drive them home, as driving after sedation is not advisable.
Test Results:
Before being discharged, ensure you have a contact number to receive the biopsy results. In non-urgent cases, the results will be available within two to three weeks. You can contact the Gastroenterology Institute at 02-6555116 to receive the results via fax. To discuss the results, schedule an appointment with the referring doctor, and remember to bring the printed test results with you.