AMITA Health Endoscopy Center Lincoln Park

Colonoscopy

Overview

Colonoscopy allows a physician to detect changes or abnormalities along the entire length of the large intestine. Its main use is screening for colorectal cancer, but it can be used to look for causes of constipation, chronic diarrhea, abdominal pain, or other intestinal issues. The last several inches of the large intestine (colon) are called the rectum.

A colonoscopy uses a flexible tube (colonoscope) with a light and camera at the end that is inserted into the rectum after sedation is given. The camera allows the doctor to view the inner lining of the large intestine and detect polyps and cancer. When necessary, the colonoscope can be used to take tissue samples (biopsy) or remove polyps. Polyps (adenomatous polyps) are clumps of lining cells on the inner intestinal wall that may be precancerous.

In 2018, the American Cancer Society revised the recommended age for a first-time colonoscopy to 45 years old due to an increase in colorectal cancer in those 45-49 years old. Colonoscopy is one of the most sensitive tests for CRC screening.

Preparation

Diet. You will have to follow a special diet for a day or two before the colonoscopy. Please confirm the details of your preparation with your gastroenterologist. Typically, you won’t be able to eat solid foods. Drinks are usually limited to clear liquids, but sometimes coffee and tea (without milk or cream), fat-free broth and strained fruit juices (no grape or red colors) are allowed. Any liquids consumed should not be red or purple in color, as they can be confused with blood.

Laxative. Your provider will usually recommend taking either a pill or liquid-form laxative to cleanse your bowel. The laxative is usually taken the night before and sometimes the morning of the exam; check with your doctor. Sometimes an enema is also recommended.

Medications. Remind your physician of your medications, supplements and vitamins at least a week before the colonoscopy. You may be instructed to adjust or temporarily stop your medications, especially blood thinners such as aspirin, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto) or clopidogrel (Plavix). Also, supplements or vitamins containing iron are usually stopped at least a week before the exam since they can darken the stool and make the procedure difficult if the bowel cleansing was inadequate. Fish oil may also need to be stopped a few days before; check with your doctor.

Medical history. Make sure your gastroenterologist and anesthesia team know all your medical history. Especially important is your history of heart disease, lung disease, or liver or kidney disease.

What happens during the procedure?

Just before the colonoscopy, you will lie on your side and the anesthesiologist will give you intravenous (IV) sedation. A colonoscopy uses a flexible tube (colonoscope) with a light and camera at the end that is gently inserted into the rectum and carefully steered around the bends of the large intestine. Air (and sometimes water) will be introduced through the scope to expand the colon and rectum and help the physician see the lining adequately. The camera allows the doctor to view the inner lining of the large intestine and detect polyps and cancer. When necessary, the colonoscope can be used to take tissue samples (biopsy) or remove polyps. The procedure usually takes about 30 minutes.

What happens after the procedure?

You will be moved to a recovery area when the doctor is finished. It will usually take 30-60 minutes to recover from the sedation. You may have mild abdominal discomfort, bloating, or cramping. You will need someone to drive you home due to the sedation. You should be able to resume normal activity the next day, but it can take up to 24 hours for the full effects of the sedation to wear off. Please ask your doctor about resuming any medications that were stopped before the procedure and when you may do so. You may notice a small amount of blood with your first bowel movement. Call your doctor if the blood continues or you notice blood clots, you have a fever of 100 degrees Fahrenheit or higher, or you are experiencing persistent abdominal pain.

Outcomes

If your colonoscopy findings were normal and no polyps were found, you may not need another study for 5-10 years. If polyps were removed or other biopsies were performed, these tissues will be sent to a pathologist for review. In the case of a polyp removal (polypectomy) or other biopsy, your physician will schedule a time to meet with you and discuss the results. Follow-up colonoscopy may be recommended depending on the number, size and type of polyps found.