A colonoscopy is an endoscopic type of procedure that examines both the colon and the rectum. During a colonoscopy, polyps in the colon may be removed or tissue sampling may be collected for testing in the laboratory. Colonoscopy, which is performed through the rectum, can be carried out for both diagnostic and therapeutic purposes. The colon is examined with a flexible tube that has a light and a camera at the end.

Colonoscopy is performed for diagnostic purposes as well as bowel cancer or polyp screening.

For diagnostic purposes: 

A colonoscopy can be performed to diagnose problems in the intestine.

Colonoscopy should be performed in case of symptoms such as:

  • Persistent abdominal pain
  • Rectal bleeding
  • Chronic constipation
  • Unexplained anemia or iron deficiency
  • Chronic diarrhea
  • Unexplained weight loss.

Bowel cancer screening:

For early detection of colon and rectal cancer, it's important to have a colonoscopy, even if you don't experience any symptoms. Starting at age 50, it's recommended to be screened every five years. If you have a family history of colon or rectal cancer, your colonoscopy frequency may be different.

Management of polyps: People with a history of intestinal polyps may need to have regular colonoscopies. Early detection and removal of intestinal polyps through colonoscopy are one of the most important ways to prevent colon cancer. If there are too many polyps to examine the colon or if the colon is not completely clear, it is recommended to repeat the colonoscopy within a year.

Which doctor should I go to for a colonoscopy?

A colonoscopy may be performed for both diagnostic and therapeutic purposes. Colonoscopies, which examine the colon and rectum, can be operated on by gastroenterologists and general surgeons. Possible complications are best avoided if the procedure is performed by a doctor experienced in colonoscopy. To the same extent, you should choose a center that can perform emergency procedures to avoid possible risks such as intestinal perforation.

For people with inflammatory bowel diseases such as ulcerative colitis or Crohn's disease, it is crucial to consult with your gastroenterologist to determine the frequency of colonoscopy.

What are the risks of colonoscopy?

Colonoscopy is a completely safe procedure. However, sometimes adverse events may occur during or after the procedure.

  • - Bleeding
  • - Inflammation
  • - Outward herniation of the large intestine wall called a diverticulum
  • - Severe abdominal pain,
  • - adverse effect on the tranquilizer administered during the procedure
  • - Tear in the wall of the colon or rectum (perforation)
  • - May cause problems in people with heart or blood vessel disease.

How to Prepare for a Colonoscopy?

Before a colonoscopy, the following information should be given to the gastroenterology doctor who will perform the procedure;

- Pregnancy

- Lung diseases

- Heart diseases

- Diabetes

- Medications or drug allergy

For a successful colonoscopy, the bowel needs to be empty, which means it needs to be clean. Various methods are available to achieve this. If the bowel is not properly cleaned, lesions or structures called polyps may be missed during the colonoscopy, the colonoscopy may be prolonged (prolonged colonoscopies can be dangerous), and the colonoscopy may need to be repeated.

Colonoscopy prep diet

Colonoscopy prep diet:

You may have dietary or fluid restrictions before your colonoscopy; however, whether these diets need to be followed depends on the patient. Your doctor will determine if you need a diet for your colonoscopy after evaluating your medical condition.

The colonoscopy diet is based on avoiding high-fiber plant foods that leave a pulp. Eating high-fiber foods can cause problems with colon cleansing because they leave too much pulp behind.

The day before colonoscopy: Do not consume solid foods. Water, tea, and fruit juices may be consumed instead. Yogurt may be consumed once or twice a day before the colonoscopy. During the colonoscopy, it is important to avoid red liquids that may possibly look like blood. Do not eat or drink anything after midnight the night before the colonoscopy.

After 6:00 p.m., take whatever medications your doctor recommends to cleanse your bowels.

On colonoscopy day: no solid or liquid food should be consumed. Since the anesthetic will be administered during sedation for the colonoscopy, smoking and the use of tobacco products must be avoided.

Medications for colonoscopy preparation: Medications for colonoscopy and bowel cleansing methods come in a variety of forms. The physician performing the colonoscopy will adjust the medications and doses according to the patient.

As well as the diet prescribed for colonoscopy, a number of drugs such as sodium phosphate, laxatives, and drugs containing the active substances macrogol, mannitol and polyethylene glycol are also administered to cleanse the intestines. These drugs should be discontinued 4 hours before the colonoscopy.

In addition to these medicines, the colon may be cleansed with such methods as an enema and intestinal washing (irrigation method).

Colonoscopy Procedure

  • The same day of your colonoscopy, you are recommended to wear loose and comfortable clothing for post-test comfort.
  • Before the start of the colonoscopy, sedatives and painkillers in order to calm you down will be administered.
  • During a colonoscopy, the patient wears moon pants that flap opens for the procedure.
  • If necessary, electrodes can be attached to the body to monitor breathing, blood pressure and heart rate.
  • The patient is placed on his or her side on the examination table and the knees are pulled towards the chest to ensure positioning for colonoscopy.
  • Once the patient is in the colonoscopy position, the doctor inserts the colonoscope into the rectum.
  • The doctor performing a colonoscopy may introduce air to your bowel to make it easier to see the inside surfaces clearly. 
  • In case of any abnormality, a biopsy will be performed with a special instrument on the colonoscope. Likewise, if any polyp is detected, it may be removed with a special wire loop on the colonoscopy.
  • There is a small camera inside the colonoscopy tube. This camera transmits video/images to an external monitor, so that the doctor can examine your bowels better.
  • Once the images have been recorded and the procedure is complete, the doctor removes the colonoscope.

After Colonoscopy:

  • After the colonoscopy, the patient spends about an hour resting in the hospital.  The patient is discharged the same day after the colonoscopy.
  • Since the patient is being sedated, it is essential that a caregiver remains with them.
  • You should not drive, make important decisions, or go to work on the day of your colonoscopy.
  • For a few hours after your colonoscopy, you may experience bloating and flatulence due to air in your bowel. Walking may help with bloating.
  • Avoid heavy lifting or intense activity.
  • You may see a small amount of blood in your stool after your colonoscopy. A small amount of blood after a colonoscopy is usually not a problem, but if the bleeding persists, you should talk to your doctor.
  • You should wait a day before returning to your normal routine.
  • You can resume a normal diet after a colonoscopy. However, if tissue was taken for biopsy or polyps were removed during your colonoscopy, your doctor may recommend a special diet.
  • It's important to drink plenty of fluids after a colonoscopy.
  • Patients who take anticoagulants may be asked to stop taking them for a while, but you shouldn't stop taking them without your doctor's advice.
  • Watch for symptoms after a colonoscopy
  • Chills or fever
  • Persistent dizziness and nausea
  • Inability to go to the bathroom
  • Blood in your stool
  • Chest pain or heart palpitations
  • Heavy rectal bleeding
  • Severe abdominal pain or bloating
  • If you experience problems like vomiting, you should contact your doctor.

Particularly severe abdominal pain, fever, chills, nausea, and vomiting can be symptoms of a perforated colon.