These days, in most patients over 45 years with bleeding, a colonoscopy will be advised to exclude causes further up the bowel such as polyps or even cancer. This is recommended also if there is a family history of bowel cancer.
Biopsies may be taken, polyps if present can be removed and sent for pathological examination.
The procedure will be done at Masada Hospital as a day case if you are insured. If not, other arrangements will be made.
Colonoscopy is a safe procedure. It involves taking a fluid the day before the procedure to clean the bowel right out. It is done under anaesthetic as a day case by myself – a qualified Endoscopist, a specialist in this field. There are extremely rare complications to the procedure. This is perforation of the bowel or severe bleeding and it may result in emergency surgery. Removing polyps increases this risk slightly. The incidence of complications may be 1 in 1000 or 2000.
Colonoscopy is the passage of a long flexible instrument to allow the lining of the large bowel to be examined. It is capable of detecting polyps, tumours or inflammation of the large bowel or even the end part of the small bowel. Biopsies may be taken and polyps removed. These specimens are always sent for pathology to be examined under the microscope.
Colonoscopy is usually carried out when there are symptoms related to the bowel such as abdominal pain, bleeding or anaemia, that is a low count from bleeding. Family history of polyps or tumours is another indication for colonoscopy.
Preparation for Colonoscopy
The bowel must be completely empty and cleaned. This is done by taking the appropriate medication the day before the procedure as directed by our staff and instruction sheet. A variety of preparations to suit individual needs, these include Picolax and Glycoprep.
You should take your medication the day of examination. Aspirin medication is stopped for 4 – 5 days before the procedure, as is iron medication.
For women, the oral contraceptive pill may become ineffective because of the bowel prep, so alternative contraceptive should be used for 10 days.
Any patients on blood thinning tablets such as Warfarin require separate advice. Diabetics also need specific advice.
Risks of Colonoscopy
There is a small risk, possibly 1 in 1500 or 1 in 2000 of bleeding or damage or perforation of the bowel wall by the instrument. Should this occur complicated surgery might be required. Another possible problem is severe bleeding. This can occur after biopsies or the removal of a polyp. This bleeding usually settles down, but surgery can also be required. Fortunately these events are rare.
After the Procedure
You would always be seen by myself after you have had the procedure and you are awake. You may not always remember the discussions. You will be given something in writing. Usually a letter will be sent to you advising about further follow-up and the need to repeat the colonoscopy at a later date. This is particularly the case with patients who have polyps or a family history of bowel cancer.
Your referring doctor will be sent a written report and a copy of the pathology report.
If you are unclear about any of the reports or the need for follow up please contact our office.