Colonoscopy – Cyprus Central Hospital

Colonoscopy

Colonoscopy is an endoscopic procedure that examines the large intestine and rectum. During colonoscopy, if necessary, polyps in the large intestine can be removed or tissue samples can be taken for examination in the laboratory. Colonoscopy, which is carried out by breeding, can be performed for both diagnostic and therapeutic purposes. It is examined with a flexible tube with light and camera at the intestine tip.

What is the reason for having a colonoscopy?

For Diagnostic Purpose:  Colonoscopy can be performed to diagnose problems in the intestine.

  • Do not go away with abdominal pain
  • Rectal bleeding
  • Chronic constipation
  • Unexplained anemia, i.e. anemia or iron deficiency
  • Chronic diarrhea
  • Colonoscopy should be performed in symptoms such as unexplained weight loss.

Bowel cancer screening:  Colonoscopy should be performed for early diagnosis of colon cancer and rectal cancer, even if there are no complaints. Colonoscopy is recommended every 5 years over the age of 50. For people with a family history of colon or rectal cancer, the frequency of colonoscopy may vary.

Polyp control:  People who have previously had bowel polyp problems may need to undergo a colonoscopy check periodically. Detecting intestinal polyps early and removing them during colonoscopy is one of the most important ways to prevent bowel cancer.

Which doctor should be visited for colonoscopy?

Colonoscopy can be performed for diagnosis as well as for therapeutic purposes. Colonoscopy, which examines the colon, large intestine and rectum, can be performed by gastroenterology and general surgery doctors. Doctors experienced in colonoscopy can prevent complications. At the same time, it is necessary to choose the centers where emergency intervention can be made against possible risks such as colon perforation.

What are the risks of colonoscopy?

Colonoscopy is a safe procedure. However, from time to time, negative situations may occur during or after the procedure.

  • Bleeding
  • inflammation
  • Outward hernia of the large intestine wall called diverticulum
  • Severe abdominal pain,
  • Negative response to tranquilizers used during the procedure
  • Tearing in the colon or rectum wall (perforation)
  • It can cause problems in people with heart or blood vessel disease.

What should be done before a colonoscopy?

To the gastroenterology doctor who will perform the procedure before colonoscopy;

  • Pregnancy
  • Lung diseases
  • Heart diseases
  • Diabetes
  • Information on the drugs used or drug allergy should be provided.

In order for colonoscopy to be successful, the intestines must be empty, that is, cleaned. Different methods can be applied for this. The intestines are not properly cleaned; It may cause the structures called lesions or polyp to be overlooked during the colonoscopy process, prolonged colonoscopy (which may bring prolonged colonoscopy risks), and repeated colonoscopy.

Preparing for a colonoscopy: There may be some diet or fluid restrictions before the colonoscopy. However, whether or not this type of diet can be applied may vary depending on the patient. After evaluating the patient’s condition, the doctor decides whether a diet is necessary for a colonoscopy.

The purpose of the colonoscopy diet is based on avoiding high fiber plant foods that leave pulp. Since consuming fibrous foods will leave too much pulp, there may be problems with colon cleansing.

Colonoscopy a few days ago:  Foods such as whole-grain foods, nuts, seeds, dried fruits, nuts or nuts, pasta, peas, beans should be avoided. Attention should be paid to low fiber nutrition. Until the day before the colonoscopy; Red or white meat, fish can be consumed except egg, yogurt, cheese, offal.

The day before the colonoscopy : Solid foods should not be consumed. Instead, water, tea, juice can be consumed. Yogurt can be consumed once or twice a day before the colonoscopy. It is important to avoid red fluids that can be mixed with blood during a colonoscopy. Nothing should be eaten after midnight before the colonoscopy.

After 18:00 in the evening, the medicines recommended by the doctor should be taken to clean the intestine.

On the day of the colonoscopy: No  solid or liquid food should be consumed. Since sedative anesthesia will be used during colonoscopy, smoking and tobacco products should be avoided.

Colonoscopy preparation drugs: There are different drugs and methods for colonoscopy that help clean the intestines. The doctor who will perform the colonoscopy will perform the drug and dosage adjustment according to the patient.

In addition to feeding the colonoscopy, to clean the intestines; Many drugs such as sodium phosphate, laxative drugs, drugs containing macrogol active substance, mannitol, polyethylene glycol are used. These drugs must be finished 4 hours before colonoscopy.

In addition to these drugs, the colon can be cleaned with methods such as enema and intestinal washing (irrigation method).

How is a colonoscopy done?

  • In order to be comfortable after the procedure on the day of the colonoscopy, it is recommended to wear plenty of comfortable clothes.
  • Medication sedation and pain reliever are applied to the patient to calm down before starting a colonoscopy.
  • During the procedure, an outfit called colonoscopy pants that will leave the patient’s back open is worn.
  • Electrodes can be attached to the body to monitor the patient’s breathing, blood pressure and heart rate, if necessary.
  • The patient is placed on the examination table and his knees are pulled towards his chest, and a colonoscopy position is provided.
  • After taking the colonoscopy position, the doctor inserts the colonoscope into the makata.
  • In order to make the procedure easier and get a clearer view, the doctor can give the intestines some air.
  • If any abnormal areas are noted, a biopsy will be performed with a special instrument on the colonoscope. Likewise, if a polyp is found, polyps can be removed with a special wire loop on the colonoscopy.
  • Includes a small video camera at the end of the colonoscopy device. The camera sends images to an external monitor so the doctor can examine the inside of the colon more comfortably.
  • When the acquired images are saved and the procedure is finished, the doctor will remove the colonoscope.

After colonoscopy

  • After the colonoscopy, the patient is rested in the hospital environment for about 1 hour. Patients are sent home on the same day after the colonoscopy.
  • It is important to have a person with him to accompany the patient because he has taken sedatives.
  • On the day of the colonoscopy, cars should not be driven, important decisions should not be made and they should not be returned to work.
  • A few hours after the colonoscopy, bloating and gas pain may occur due to the air in the intestines. Walking can be good for gas pains that can be experienced.
  • Heavy lifting or strenuous activities should be avoided.
  • A small amount of blood may appear in your stool after a colonoscopy. Usually, a small amount of blood is not a problem after colonoscopy. However, if the bleeding continues, it is necessary to consult with the doctor.
  • It is necessary to wait for 1 day to return to the daily dream.
  • After the colonoscopy, normal diet can be started. However, if tissue for biopsy was removed during the colonoscopy or if the polyp was removed, the doctor may recommend a special diet.
  • It is important to consume plenty of fluids after colonoscopy.
  • Patients who use blood thinning medication may be asked to stop these medications for a while. However, no medication should be left without a doctor’s recommendation.
  • Note the symptoms after a colonoscopy
  • Chills or fever
  • Do not pass dizziness and nausea
  • Not being able to go to the toilet
  • Blood in the stool
  • Chest pain or heart palpitations
  • Multiple rectal bleeding.
  • You experience severe abdominal pain or bloating
  • In case of problems such as vomiting, you should talk to your doctor.

Particular symptoms of severe abdominal pain, fever, chills, nausea and vomiting can be symptoms of colon perforation.

Curious questions about colonoscopy

How long should the colonoscopy be repeated?

Colonoscopy is vital for early diagnosis of bowel cancer. People who do not have any risk factors should start routine colonoscopy controls at the age of 45-50. Patients in the risk group with a family history of colon cancer may need to start routine colonoscopy controls at an earlier age. The frequency of repetition of the colonoscopy may also vary depending on the results of the procedure. Patients who do not have any abnormalities such as polyp in the results of the colonoscopy are recommended to repeat the colonoscopy scans every 5 years.

In the presence of abnormal structures and polyps during colonoscopy, the frequency of follow-up changes. The number of polyps, the type of polyps and the size of the polyps are effective at the frequency of colonoscopy follow-up.

It is useful to repeat the colonoscopy within 1 year, if the number of polypes that prevent the colon from being examined or the intestines cannot be completely cleaned.

It is important for people with inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease to consult with the Gastroenterology physicians who monitor the frequency of colonoscopy.

What can be done against nausea during the preparation of a colonoscopy?

Liquid medications taken to clean the intestines before a colonoscopy can sometimes cause severe nausea. If there is a feeling of nausea or vomiting, liquid drugs taken to clean the intestines should be stopped for a short time. After 30 minutes – 1 hour break, the drugs should be taken again. It may be beneficial to drink liquid medicine slowly in order not to experience nausea or vomiting. Nausea medication can be taken in consultation with the doctor. An important trick is to drink the medicine by cooling it or use cold water beside the medicine.

What can be done against breech crack and irritation when preparing for a colonoscopy?

Irritation and breech crack may occur as the toilet is frequently used during the cleaning of the intestines. It is very useful to use baby diaper cream or vaseline to prevent such problems. Wet wipes can be preferred instead of toilet paper since toilet will be used frequently. It is also preferable to sit in warm water after the toilet and dry the skin with a soft cloth.

What are the dimensions of the colonoscopy tube?

A flexible tube-shaped colonoscopy tube has a tiny camera and light at the end. In addition, there is an airing apparatus on the colonoscopy device for more comfortable viewing from inside the large intestine, and another apparatus for removing polyp-like structures from the intestine when necessary. The colonoscopy tube is about 60 cm. long and 1 cm. in diameter.

Which methods are alternative to colonoscopy?

Colonoscopy is the most effective method in detecting colon cancer at an early stage, but it is available in alternative tests. The efficacy of these methods in determining colon cancer is different in patients who do not want to undergo a colonoscopy or are not eligible for a colonoscopy.

  • Stool sample (fecal immunochemical tests): It is a stool test performed to determine the invisible bleeding because the large intestine tumors usually cause bleeding. The patient can take the stool sample at home. However, it should not touch the feces to be tested. It is a test that should be repeated every year.
  • Fecal blood test in stool (fecal): Combining it with Fecal Immunochemical Tests to determine colon cancer can be as effective as colonoscopy.
  • Double contrast barium enema: X-ray examination of the large intestine. Like the colonoscopy, the large intestine needs to be completely cleaned. Although double-contrasted barium enema can give effective results in identifying large polyps, small polyps can be overlooked. As a result, if a suspicious condition or polyp is detected in the large intestine, the patient may have to undergo a colonoscopy procedure.
  • Capsule colonoscopy: The large intestine can be controlled with images obtained by drinking the capsule containing a camera that takes an image of the digestive system as a pill. The results of this application, which is not very common, are not seen as satisfactory.
  • Virtual Colonoscopy: Control of the large intestine with computed tomography (CT). In order to obtain a healthy image, the large intestine must be cleaned. Before the virtual colonoscopy, a contrast liquid is drunk for better viewing of the colon. Compared to colonoscopy, it contains less risk, it can be easily applied in elderly and blood thinners, the normal life can be started immediately and its speed can be listed as its advantages. However, there are disadvantages such as skipping small details, exposure to radiation even at a low rate, and normal colonoscopy is required for intervention in polyp or abnormal situations.
  • Sigmodoscopy: It is a method that examines the last part of the large intestine. With this method, changes in the left half of the large intestine can be observed. The patient does not need to be prepared the day before as in colonoscopy. Enema is sufficient in the hospital. Sigmoidoscopy is recommended for problems such as it is recommended for young patients with bleeding with rectal blood, changes in stool diameter, hemorrhoidal or fissure (crack, tear) complaint.

When is the colonoscopy not performed?

The patient must have approval to perform a colonoscopy. In cases where the patient approves;

  • The intestines are not cleaned sufficiently
  • Patients who are more likely to experience puncture in the bowel during a colonoscopy
  • Patients with severe intestinal inflammation
  • Patients with abdominal inflammation
  • It is more appropriate not to perform colonoscopy in patients at risk of heart attack.

How long does a colonoscopy last?

Colonoscopy takes between 20 minutes and 1 hour. However, in order for the patient to have a comfortable colonoscopy, it may take 1-2 hours to get rid of the effect of sedation drugs. In addition, in order to obtain a good image, the feeling of flatulence and flatulence created by the air delivered to the intestines changes between 1-2 days.

Is colonoscopy a painful procedure?

During the colonoscopy application, patients do not feel pain and pain as they are anesthetized or given sedatives. Patients mostly complain of gas pains experienced after colonoscopy. Therefore, consuming and walking plenty of fluids after the procedure gives positive results.

What should diabetes patients pay attention to during the preparation period before colonoscopy?

It is important to maintain blood sugar levels in patients with diabetes. Diabetics should pay more attention to the diet applied during colon cleansing before colonoscopy. It should be remembered that liquid food can be taken, although solid foods are prohibited the day before Colonoscopy. In order to maintain the blood sugar level, drinks such as apple juice, orange juice without pulp can be consumed.

Does the colonoscopy prevent the baby from breastfeeding?

The effect of anesthesia or tranquilizing drugs applied during colonoscopy is removed from the body approximately 1 day later. Although the anesthetic drugs applied are unlikely to pass to the baby through breastfeeding, precautions such as breastfeeding the baby before colonoscopy, storing milk if possible, and then giving it can be taken. In cases where there is no chance to hide milk and breastfeeding is obligatory, the milk that comes after milking the first milk can be given to the baby.

 

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