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Colonoscopy includes the following range of examinations:
- diagnostic colonoscopy,
- colonoscopy with the collection of biopsy specimens,
- colonoscopy with polyp removal,
- colonoscopy with the treatment of vascular lesions.
What is colonoscopy?
Colonoscopy is the examination of the large bowel with a flexible tube that is an index finger thick passed through the anus (fiber optic camera). The instrument is passed slowly through the anus along the whole large intestine. In some cases, the instrument can be passed to the distal part of the small bowel.
How to prepare for the examination?
Colonoscopy does not require a special diet. The day before the examination the patient can eat a light breakfast and dinner including clear soup. After that, the patient should drink a large quantity of liquids with special laxatives. As a result, the large colon will be normally purified which helps to perform the full and reliable examination.
It is vital to inform the doctor of any drugs that are taken by the patient, for example: aspirins and its derivatives, other non-steroid anti-inflammatory drugs, drugs that affects blood coagulability, insulin and iron preparation because some of them might have negative effect on the preparation and course of the examination.
Procedure of colonoscopy.
As a general rule, patients tolerate the examination which hardly ever causes strong complaints. Sometimes colonoscopy is accompanied by the feeling of burst, bloats as well as stomach cramps. The doctor can order to take painkillers and tranquilizers that might help to relax and endure any discomfort.
During the examination the patient is laying on the side whilst the doctor inserts the fiber optic camera into the large bowel. Taking the tube out of the large bowel, the doctor will assess the condition of the intestine and deviation from the proper condition. The examination usually lasts from 15 to 60 minutes. In some cases the doctor is not able to insert the fiber optic camera at the end of large bowel (where it connects with small bowel). When that happens, the specialist might order other additional examination or decide that the incomplete colonoscopy is sufficient.
What happens when the results of colonoscopy are not good?
In the case of lesions found within the large bowel that need more specific assessment, the doctor might use tiny forceps and take tissue samples (biopsy specimens) for farther histopathological analysis.
Not only is the collection of biopsy specimens carried out to diagnose cancer but also various diseases of large bowel.
If the examination is preformed to detect the origin of bleeding in the lower part of gastrointestinal truck, the doctor might control it with the use of some instruments inserted through the fiber optic camera. It is performed by the injection of special substances or by the use of coagulation (treatment with high temperature). Polyps of the large bowel can be found with the colonoscopy and in most cases they might be removed during this examination. All treatments mentioned above are painless.
Polyps of the large bowel and the removal of them.
Polyps are abnormal, usually benign growth of the tissue in the large bowel wall. They might reach the size from a few millimetres to a few centimetres. During the examination, the doctor is not able to define the malignancy of the polyps based just on their outward appearance. Therefore, each polyp should be removed and taken to the farther histopathological analysis. In most cases, the cancer of the large bowel develops from the polyp – that is why the polyp removal of the large bowel is significant element that prevent the development of cancer.
There are many techniques of the polyp removal, depending on the size of polyps. Small polyps might be put through the coagulation or they might be removed by the forceps used for the biopsy specimens. In the case of larger polyps, they are cut with metal cold snare for polypectomy that is inserted through the fiber optic camera and used the electric current. Polyp removal (polypectomy) is mainly painless.
What happens after colonoscopy?
After the procedure, the doctor acquaints the patient with the result of the examination. In the case of biopsy specimens and polyp removal, the patient should wait few days for the results of the histopathological examination. If the patient receives painkillers and tranquilizers during the colonoscopy, his/her reactions and reflex might be debilitated. The patient should not drive or operate any machines that are in motion after the examination till the end of the day when the procedure was taken. Moreover, very common aftereffect from the procedure is a bout of flatulence and stomach ache caused by air insufflation into the bowel during the procedure. The above complaints subside after breaking winds. Unless the doctor orders will change, the patient is allowed to drink and eat after the colonoscopy.
What are the complications of colonoscopy?
As a general rule, both colonoscopy and polypectomy are safe medical procedures. It is significant that they are performed by doctors with special training and experienced health professionals. One of the complications is the perforation or rapture of the large intestine which requires the operation. In the case of biopsy specimens or polypectomy, some bleeding might occur after the procedure, however, it is not profuse and it usually subsides by itself. Moreover, this symptom might be treated by the use of the fiber optic camera – it hardly ever requires inpatient treatment. The painkillers or tranquilizers might have allergenic effects that result in allergic reaction or exacerbation of heart disease or respiratory system.
Any complications of the colonoscopy are seldom, however, it is significant for the patient to diagnose the early symptoms by himself/herself. If the patient feels very intense pain of the stomach, is shivering and has fever or profuse bleeding from the anus after the examination, he/she should contact the specialist immediately.