Colonoscopy is a procedure where a flexible instrument – a so-called endoscopy instrument – is used to examine the anus, the large intestine and the section between the small and large intestines. The procedure provides scope not only for diagnostics, but taking samples, and when required, for smaller interventions (such as removal of polyps).
In the interest of reducing the possibility of pain to a minimum, we offer colonoscopy both under general anaesthetic and in a tranquillised state. Following examinations done under general anaesthetic or in a tranquillised state patients are retained in the surgery for an hour and discharge only when accompanied. Patients are forbidden to drive, or work on the same day.
Fresh samples only need to be taken before the interventions if the patient also suffers from other diseases, the physician will inform the patient of this at the consultation preceding the colonoscopy.
Assessment of the rectum and large intestine in their entirety, including the mucus membrane lining them, finding source of bleeding or constricted segment (polyp, malignant tumor, inflammation of the mucus membrane, ulcers, etc), but the examination allows biopsies and removal of entire polyps too.
Durig the examination the doctor is able to survey the entirety of the large intestine with an approx. 160 cm long, flexible instrument. The device, called a colonoscope, contains fibre-optic technology that relays light and images. The image is viewed on a tv screen. To enable the instrument to move, it needs room, so the doctor uses one of the channels of the colonoscope during the examination to pump air into the large intestine. If necessary, they are able to remove it too, or any residual fluids from the bowels. The device also has another, thinner channel that enables the doctor to take tiny tissue samples from areas that suggest the presence of disease with the aid of special clips, and also remove entire polyps from their base using loops heated up with electricity, a procedure that carries a relatively low risk of post-op bleeding. The tissue sample can be appropriately processed and then viewed under a microscope.
During the examination, you lie on your left side, with your legs pulled up in front. During the examination, the doctor may ask you to roll on your back, your right side, or, more rarely, on your stomach, with the help of an assistant. The device is lubricated then inserted carefully into the rectum. The examination may take 10-40 minutes.
During the examination you may experience the urge to defecate because of the device, bloating because of the air inserted, abdominal cramps, and pain because of the tension of abdominal membranes covering the intestines. In patients where operations in the abdominal cavity have resulted in imperfect healing and joins, this is more likely. In the interest of minimising discomfort and pain, we offer colonoscopies in a tranquillised state and under general anaesthetic.
When the examination is concluded, patients are immediately given a diagnostic report. If samples were also taken for a biopsy, results typically become available in 1-2 weeks.
If you are diabetic, you have to inform the doctor who conducts your examination, because during the preparation phase, your carbohydrate metabolism may get thrown off balance, which might necessitate the recalibration of your medications or insulin dosage.
If you are a heamophiliac, or take blood thinning medications, (such as Syncumar), you have to inform your doctor before the examination, because if they take a tissue sample, you may bleed profusely, which may get out of control!
If you suffer from cardiac inadequacy, you may need to take antibiotics before the examination – you should also inform your doctor of this.
During the examination, air will be introduced into your large intestine, so later on you may feel bloated, have cramps until the air passes out of your body. The air can also leave your body during the examination, this is natural,
If the doctor takes a tissue sample during the examination, you may see a small amount of blood in your next stool. This is usually normal. If bleeding persistst of becomes more profuse, you have to see a doctor!
Occasionally, after the removal of a polyp, you may be retained in the hospital for 1-2 days for observation.
If you receive a tranquilliser injection before the examination, you will need 1-2 hours after the colonoscopy to recover under observation. If you come to the examination by car, you should be driven home.
If you have severe abdominal cramps, increasing pain in your adbomen, or a temperature, consult a doctor.
It’s worth taking a few hours to relax after the examination, and drink plenty of fluid, so that the fluid your body lost because of the laxative may get replenished.
Injury of the large intestine, perforation of its wall, especially when the intestinal wall had worn thin due to a tumour or inflammation. This is a very rare but dangerous complication, and requires immediate surgical intervention.
After a biopsy sample has been taken, more or less bleeding is natural.
Perhaps the most common complaint is that after the preparation, the laxative, and the mechanical irritation of the examination, you may develop haemorrhoids, especially if you’d already had them at some point. These are normally mild, and can be well contained through conservative treatment.
Like all medications, the injection administered before the examination may trigger an allergic reaction.
If you have a disease that causes a significant narrowing of your large intestine, the laxative may trigger your intestines to get blocked (ileus), which may necessitate an emergency operation.
The examination (especially when the device needs to navigate the bends of the large intestine), may cause abdominal cramps. The introduction of air into the intestine may cause tension, which can be pretty uncomfortable. If you are tranquillised for your examination, you’ll remember practically nothing of the colonoscopy.
Normally clear and easy to understand. It details how long a section of the intestine has been surveyed (normally the entire large intestine), whether there is any inconsistency in the mucus membrane, inflammation, ulcer, tumor, or bleeding along this section, and whether samples have been taken or polyps removed.
Before a colonoscopy, a substance need to be applied to clean the intestines, so they may be seen clearly. Professional preparation is vital, as only appropriately cleaned intestines can be examined thoroughly.
On the 3 days preceding the examination, try to only eat easily digestible, fibre-free foods, such as soups, potato puree, grated apples, pasta, and dairy products.
Do not consume:
– vegetables (tomatoes, peppers, cucumbers), because their skins are retained in the body.
– cooked greens (spinach, sorrel), fruit-flavoured teas, because they may dye the intestinal wall.
– other foods that may cause bloating (swede, sprouts, cabbage, peas, beans).
– anything containing seeds (poppy seeds, grapes, raspberries, kiwi, etc.), because seeds are retained in the body.
– bread with seeds, muesli, cereal
– fruit rich in fibre (tangerines, oranges), because fibres are retained in the body.
One day before the examination do not consume solids, and watch your fluid intake. We recommend non-carbonated water, mild tea, clear fruit juice (but do not consume fruit and vegetable juices rich in fibre, or milky drinks)
12 hours before the examination, drink the first sachet of laxative that your doctor prescribed (such as a solution made using PICOPREP®). Drink the second solution made from a sachet of PICOPREP® 6hours before the examination. Leave at least 12, but no more than 24 hours between the examination and the first sachet of laxative. Do leave 6 hours between the second sachet and the examination.
Drink 1.5-2 litres of fluid after both doses of laxatives.
Use the laxatives following their guidelines or your doctor’s instructions. We’ll use the application of the laxative PICOPREP® as an example.
You need to prepare with 2 sachets of PICOPREP®. PICOPREP® has a pleasant orangey flavour, it is easy to take.
1. Our 150 ml (a glass) of cold water into a mug.
2. Dissolve the contents of the PICOPREP® sachet (white crystalline powder with an orangey aroma) in the water.
3. Keep stirring for 2-3 minutes to make sure the powder is fully dissolved. The solution may warm up – before drinking it, wait for it to cool down.
4. After drinking the solution, drink 250 ml(a mugful) of clear water every hour. This can be apple juice, tea, clear fruit juice, clear carbonated drink, broth, clear soup. The more you drink, the easier it will be to conduct the examination.
5. 6 hours after the first dose, prepare the second dose the same way you did the first.
6. Drink it, and don’t forget to keep drinking 250 ml(one mugful) of clear water every hour afterwards.
If you forgot to drink every hour, drink as soon as you remember. During the preparation phase, you should consume 3-4 litre of fluid in all.
When you have drunk your first dose of PICOPREP®, do not venture too far from a toilet, as it may start working in 1-3 hours in some cases.