Colonoscopy is the examination of the inside of the large bowel with a colonoscope, a long thin flexible tube with camera that is passed through the anus into the colon. Minor procedures such as the removal of polyps, dilatation of narrowing’s and tissue biopsies can be carried out through the scope. The procedure generally takes between 20 minutes to one hour.

 

 

What is the preparation for colonoscopy?

 

The colon must be completely clean for the procedure to be accurate and complete. Specific instructions will be given to prepare for your colonoscopy.

 

• You will need to avoid all solid food for 24hrs prior to the colonoscopy and have clear fluids only. Aim to drink 1.5 to 2 litres the day before the test and continue to drink clear fluids right up till your fasting time.
• Avoid high fibre foods including seeds, nuts and skins for 3 days before the procedure .
• To overcome any constipation leading up to your colonoscopy you may need to take the laxative Macrogol (brand names movicol, osmolax, clearlax) usually 1-2 doses a day.

• The bowel will be completely flushed out with a laxative preparation - MOVIPREP
• Refrigerating the solution can make it easier to drink, as can drinking the solution through a straw.
• Watery diarrhoea is the desired result, this may occur shortly after drinking the solution or may be delayed for several hours and the end result should be diarrhoea that looks like urine.
• If you become nauseated or vomit while drinking the solution, call Dr Meade’s rooms or the hospital for instructions.
• Tips that can help with nausea include stop drinking the solution for a while, walk around and resuming drinking at a slower pace.

 

 

Medicines

You can take most prescription medicines right up to the day of the colonoscopy. Some medicines increase the risk of heavy bleeding if you have polyps removed and or haemorrhoid banding done during the colonoscopy.

If you take an anticoagulant (blood thinning) medication (other than low dose aspirin) please call Dr Meade’s rooms to discuss with our practice nurse in advance, your prescribing doctor may also be able to advise when to stop your blood thinner prior to the procedure. Fish oil or iron supplements should be stopped 1 week before your colonoscopy.

 

Important information regarding your diabetic medication is outlined in your appointment confirmation letter. Please call our practice nurse if you require advice about diabetic medication and bowel preparation.

 

 

Transportation home

Patients are given light sedation during the colonoscopy, so you will need someone to take you home after your procedure. Although you will be awake by the time you go home, the sedative/anesthetic medicines cause changes in reflexes and judgment that can interfere with your ability to make decisions, similar to the effect of alcohol. You will not be able to drive home or go back to work after the procedure. You should be able to return to work in 12-24 hours.

 

 

What does the procedure involve?

 

An IV line will be inserted in your hand or arm. Your blood pressure, heart rate, and breathing will be monitored during the procedure; you will be given fluid and medicines through the IV line. With sedation provided by an Anaesthetist you will sleep during the procedure whilst being closely monitored.

 

The colonoscope is a long flexible tube, approximately the diameter of the index finger; to assist visualization of the bowel, air and sterile water are gently pumped through the scope into the colon to inflate it.

 

Occasionally narrowing’s of the bowel may prevent the instrument being inserted through the full length of the colon.

 

As cancer of the large bowel arises in pre-existing polyps it is advisable that if polyps are found at the time of examination that they should be removed.

 

Most polyps can be removed by placing a wire snare (loop) around the base of the polyp and cutting through the tissue. Electrical current may be applied to prevent bleeding; having a polyp removed does not hurt.

 

  

Safety and Risks

Please read this information carefully

 

It is important to outline the risks of colonoscopy to facilitate your informed consent.

 

• Depending on the reason for the colonoscopy, there maybe risks of NOT having the procedure, missed disease or delayed diagnosis, e.g. delayed diagnosis of cancer.
• Serious complications are very rare when doctors who are specially trained in colonoscopy perform the procedure.
• Perforation of the bowel is very rare (approximately 1 in 3000) but if it were to occur surgery may be required.
• When procedures such as removal of polyps are carried out, there is a slightly higher risk of perforation or bleeding from the site where the polyp has been removed. Bleeding is usually minimal and can be controlled.
• Other complications can include intolerance of the bowel preparation and reaction to the sedatives used.
• The risks of sedation are higher for some patients than others based on their general health: a specialist anaesthetist performs the sedation after a pre-procedure assessment.
• Pain, redness, or swelling at the injection site.
• Small benign polyps can be missed in up to 6% of cases. The detection of small polyps is seriously hindered by poor bowel preparation. 
• If you have any concerns about the bowel preparation or procedure please call and speak to our practice nurse in advance.
• You will also be able to speak with Dr Meade and your anaesthetist just prior to the procedure.

 

 

Post-procedure

 

• After the colonoscopy, you will be observed in the recovery area usually for about 30 to 60 minutes until the effects of the sedative medication wear off.
• The most common complaint after colonoscopy is a feeling of bloating and ‘wind cramps’, you should pass wind and not feel embarrassed doing this either during or after the procedure. This will relieve your feelings of bloating and cramping.
• You may have 1 or 2 watery bowel motions with urgency after the procedure, a continence pad maybe helpful.
• You may also feel groggy from the sedation medications you should not return to work, drive or drink alcohol until the next day, most people are able to eat normally after the test.
• Dr Meade will advise when it is safe to restart blood-thining medications.

 

 

After you leave hospital, if you have any concerns please call Dr Meade’s rooms on 3246 3190.

Acute symptoms may require more urgent medical assistance after hours.

 

• Increasing persistent pain unrelieved by medication
• Persistent bleeding from bowel or black tarry motions
• Rapid heartbeat, dizziness
• Increasing drowsiness, including difficulty rousing from sleep
• High temperature over 38°C
• Inability to keep fluids down
• Have any other concerns where you feel you need medical assistance

 

 

Follow Up Care

 

• It is normal to feel tired afterward, if your procedure was done later in the day, you may need to rest the following day. After the procedure Dr Meade will describe the results of the colonoscopy and give you a written report.
• If biopsies were done or polyps removed you can call Dr Meade’s practice nurse for histology results in 3-5 days, a copy of the histology report is also sent to your referring doctor.
• If there is any abnormal histology you will be contacted within one to two weeks.