What is a colonoscopy?
A colonoscopy is an endoscopic examination of the large intestine. It is a study that usually takes place in the endoscopy department of a hospital. The survey is conducted by an internist, usually a Gastroenterologist.
Indications
Examples of indications for colonoscopy are:
- Recurrent complaints of constipation after already previously been treated.
- Excessive rectal bleeding.
- Recurrent intestinal symptoms after having already been previously treated as abdominal pain, abnormal stools, abdominal cramps etc.
- Colorectal cancer screening: this cancer almost always develops from polyps. These are abnormal appendages of the intestinal wall. These polyps can be prematurely removed during a colonoscopy.
Preparation for colonoscopy
The exact preparation for a colonoscopy can vary by institution, but broadly it is almost the same everywhere.
Two days before the study
Two days before the investigation is to take the patient laxative medication as bisacodyl and magnesium sulphate. Patients with certain intestinal disorder sometimes given other medicines.
One day before the examination
The day before the colonoscopy, the patient should start drinking a very strong laxative drink, which are polyethylene glycol and electrolytes. Usually this means is branded Klean Prep offered. The Klean Prep has spread throughout the day, dissolved in cold water, to be drunk until the 'stool' only consists of water. It also allowed the patient that day certain foods and beverages not consume.
Day of the examination
The day of the trial itself should not eat the patient at all. In some instances there may still be a few hours before the examination some water to drink.
Gavage
In some patients, the preparation does not, or partly, and then there is sometimes succeeds chosen for the insertion of a gastric tube. This may be, for example, because the patient must vomiting of the Klean Prep. Many patients experience the use of the Klean Prep additionally as unpleasant because of the lemon-like flavor. But patients with congestive heart failure usually have a fluid restriction and can not tolerate much water. Then, there is selected for a stomach tube, so that less water needs to be taken. The insertion of a stomach tube is carried out by a nurse.
Performance
In the endoscopy room, in the endoscopy department where the research is necessary to accompany the patient on the examining table. The patient then receives from the endoscopy nurse administered a strong sedative, midazolam, via a venflon or via an intravenous injection. This is done because of the investigation would be painful. The doctor then brings the scoop colon through the anus into the rectum and then the doctor can examine the colon for any abnormalities inside. In addition, any necessary treatment can be carried out via the colon scoop, such as the removal of polyps.
Colonoscopy aftercare
After the examination, the patient is taken to the so-called recovery room. If the patient is again quite awake, he or she go and eat and drink again. In most countries it is illegal to operate a motor vehicle or machine within a few hours after a colonoscopy or operate because it had administered midazolam can not yet be fully developed.
Colonoscopy risks and complications
A colonoscopy is a safe procedure and complications are rare. Nevertheless, take into account the following potential complications:
- Perforation of the intestine: the risk to this is 0.2 to 0.4% after a regular colonoscopy and 0.3 to 1.0% after the removal of polyps. A large perforation, which is visible through the colonoscope, is an indication for emergency surgery. At smaller lesions, which can often go undetected, initial severe abdominal pain and distention of the abdomen are the first signs. Severe infection and peritonitis may follow.
- Bleeds: in about 0.1% of cases there will be bleeding occur which can prevent both immediate and delayed. Most bleeding stop spontaneously but in some cases, further treatment is necessary.
- Rupture of the spleen and bowel obstruction are very rare complications during a colonoscopy.
- In about 0.5% of the research are used for serious complications as a result of the medication during a colonoscopy.