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COLONOSCOPY PRINT SUMMARY
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COLONOSCOPY
Your Colon
The goal of a colonoscopy is to look for early signs of colon cancer or other
problems. When colon cancer is found early, most of the time it can be cured.
Your digestive system
After you swallow food, it ends up in your stomach, where it gets broken down.
From there, the now-mushy food moves into your small intestine, where it's
absorbed. Then it moves through an even wider tube. This is your colon (large
intestine), where waste is stored. In the colon, what's left of the food turns into
waste. This waste sits in the rectum. And the waste stays here until you push it
out through your anus. This is called a bowel movement.
About hemorrhoids
Hemorrhoids can form around the anus when a blood vessel swells and turns into a
lump. These can sometimes cause a little bleeding and be painful.
If I have any hemorrhoids, will they hurt during the colonoscopy?
The answer is no, not really. Most of the time, hemorrhoids don't cause pain during
the procedure. But they may feel irritated and bleed a little afterward.
Why Have a Colonoscopy?
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COLONOSCOPY PRINT SUMMARY
You're getting a colonoscopy done now to catch problems (if you even have any)
like colon cancer before they become serious. A colonoscopy also checks for bowel
diseases or any bleeding in your colon. Everyone should have their colon checked
once they hit 50.
You may be getting this done before you're 50 if:
There's a history of colon cancer in your family
You have a (or your doctor thinks you may have) a bowel disease like
ulcerative colitis or Crohn's disease
Another test your doctor ran found something that shouldn't be in there (like
blood or a polyp)
Other reasons a colonoscopy is done:
A big change in how you go to the bathroom
Bleeding
Pain in your belly
Loss of appetite
A condition like anemia
If you ever had polyps or colon cancer in the past, colonoscopies are done as a
safety check to make sure there aren't any new polyps, or that the cancer hasn't
come back.
What are polyps?
A polyp is a growth (extra tissue) that grows out of the wall of the colon. A polyp can
look like a little bump or like a little mushroom with a red tip and a stalk. They can
be as small as a little pea or bigger than a plum. Polyps can have cancer cells, but
polyps do NOT always mean there's cancer. But you want to remove them just to be
safe.
Before Your Procedure
Note: Just to make things simple, this document will refer to your doctor as "he."
Getting ready starts a week or 2 before your procedure. So make sure your doctor
has all the information he needs.
Let him know if you have any health conditions or allergies.
And make sure your doctor knows if you've ever had any surgery, especially
surgery on your belly (like if your appendix was taken out or if you had a
hysterectomy). This is because there could be scar tissue in the area around
your colon. This makes it harder for the doctor to move the scope or see.
For your safety, give your doctor a list of everything you take. This includes:
Aspirin
All prescription and over-the-counter medications
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COLONOSCOPY PRINT SUMMARY
Herbal supplements
Vitamins
Recreational drugs
For this procedure, it's also very important to tell your doctor if you take any:
Insulin or pills for diabetes
Arthritis medicine
Blood thinners or heart medicine
Vitamins that contain iron
Your doctor may have already told you to stop taking some of these a few days (or
even weeks) before your procedure.
Getting ready
Believe it or not, most people say that getting ready for a colonoscopy is the worst
part. Your doctor will give you a list of instructions that tell you exactly what you
need to do.
There are a few different ways doctors have people prepare. But no matter which
method your doctor uses, they all do the same thing: clean out your colon.
1 or 2 weeks before the procedure
Your doctor may ask you to avoid aspirin or any anti-inflammatory drugs like Advil™
or Aleve®. But Tylenol® is OK.
About food and drink
One or 2 days before, some people are put on a clear-liquid diet of water, broth,
plain coffee, or tea. Some kinds of popsicles, Jell-O®, and juice are usually OK as
well. But no solid food or dairy products (like milk).
Even if your doctor doesn't put you on the clear-liquid diet, you may want to eat light
for a few days before your procedure. After all, the less food in your colon, the
easier it is to clean it out.
Do NOT eat or drink anything that's purple or red
No red or purple Jell-O or popsicles
No red juice (like cranberry juice)
In your colon, red and purple can look like blood and make it hard for your doctor to
tell what's what.
The day before your procedure
You'll take either a cleansing drink, pills, or laxatives. Sometimes, doctors also give
suppositories or enemas to use at home. These also clear things out in there. If you
have the cleansing drink (and most people do), make sure you drink it all down.
"The Prep"
This part is called the prep. The prep is what cleans out your colon and makes you
go to the bathroom. And you'll go a LOT. When and how often you'll go depends on
which prep your doctor gives you. If you can, you'll be more comfortable if you do
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COLONOSCOPY PRINT SUMMARY
your prep at home since you need to stay close to the bathroom. And some people
use wet wipes, or put Vaseline® on that area to keep it from getting raw.
How will I know when I'm done going and when is my colon clean?
Your colon is clean when all that's coming out is clear or light, yellow or brownish
liquid. But there shouldn't really be anything large or solid.
After the prep
After you do your prep, you can drink some clear liquids. But do NOT eat or drink
anything for 4 or 5 hours before your colonoscopy. In fact, if your procedure is first
thing in the morning, do NOT eat or drink anything after midnight the night before.
If you need to take a pill, just take it with a sip of water. That's because you'll most
likely get something to make you drowsy for the procedure, and food in your
stomach can be very dangerous if you throw up. So make sure your stomach is
empty.
Your Colonoscopy
A colonoscopy takes about 30 minutes.
But expect to be at the hospital or office for about 2 or 3 hours.
Before the procedure
You'll go to a private area and a nurse will take your temperature, pulse, and blood
pressure. They may also hook you up to some monitors. Then they'll place the IV
and start the sedation so you're comfortable during the procedure.
Sedation
A colonoscopy is usually done with something called IV sedation. This is
medication that makes you drowsy but doesn't put you into a deep sleep. It's also
known as "twilight sedation." You may be able to speak and respond, but most likely
you won't remember much of the procedure at all.
Sometimes, a colonoscopy is done without sedation. This can be uncomfortable, but
there aren't any nerves in the colon to sense pain. The colon can feel stretching,
bloating, or cramping. Some people say that it feels like gas pain.
The colonoscopy
Your doctor will start with a rectal exam. This is just to make sure everything feels
normal and healthy.
1. A clean, lubricated scope is gently placed in your rectum. The scope is a long,
hollow, lighted tube, about as big around as a finger. It has a tiny camera that
sends a picture to a TV screen so the doctor can see the inside of your colon.
2. The scope then blows a little air into your colon. This makes it easier to steer
the scope and helps the doctor see.
3. When the scope goes in, it may feel like you need to go to the bathroom. Don't
worry, your colon is pretty cleaned out and this feeling should go away in a
little bit.
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COLONOSCOPY PRINT SUMMARY
4. If he sees anything (like a polyp or an area that looks inflamed) he'll remove it
or take a sample. This shouldn't hurt. As I mentioned, the colon doesn't feel or
sense pain.
5. Anything the doctor removes is sent to the lab. Remember, the doctor can't
tell if a polyp has any cancer just by looking at it.
6. If there's any bleeding, a special tool is used to seal it off and stop the
bleeding. You shouldn't feel this either.
7. The goal is to move the scope all the way to where the colon meets the small
intestine (see below). In most people, the scope passes through the colon just
fine.
8. But if the colon has some extra tight twists and turns, the scope can get
kinked and be hard to move. And sometimes, scar tissue or other problems in
the colon block the scope so it can't keep going. (If this happens, your doctor
will decide if any other tests are needed to see the rest of your colon.)
9. The doctor then slowly backs the scope out, taking another look at your colon
along the way.
10. The scope is gently removed, and the procedure is over.
After Your Procedure
Afterward, if you had IV sedation, you may feel a little groggy. You'll need to rest for
an hour or so until you're fully awake. In recovery, you'll be watched closely and
may get fluids through your IV.
After the procedure, expect to pass gas, and lots of it. This is common, normal, and
expected. The nurses are used to it, so don't feel shy. It'll make you feel better.
Your results
Your doctor may talk with you about what he saw. You may still feel groggy and a
little out of it, so you may want to have someone there with you. If he removed any
polyps or took samples, you'll have to wait a few days for the lab results.
You'll go home the day of the procedure. Because of the IV sedation, you'll need a
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COLONOSCOPY PRINT SUMMARY
ride home.
The rest of the day
You'll probably want to take it easy.
You may feel bloated, gassy, or have cramps.
Drink plenty of water.
Avoid caffeine. It can give you more cramps.
If there's a little blood when you go to the bathroom, don't panic. A little blood
is OK, but it should stop in a day or so.
Over the next week
Your colon will be going through some readjusting, so going to the bathroom won't
be normal. It takes a while for food to travel through your body.
Call your doctor if you have:
A fever of 101° F or higher
A lot of pain, bleeding, or large blood clots when you go to the bathroom.
These can happen even many days after a colonoscopy
A swollen, firm, or tender belly
Or call if you experience anything unusual. If you think something just feels wrong,
don't be afraid to call.
Risks and Benefits
Benefits
The main benefit of a colonoscopy is finding and removing any polyps or early signs
of colon cancer. In fact, colon cancer usually does not cause any pain or problems
early on. In other words, your body won't give you any early warning signs of colon
cancer. After all, you can't feel a polyp.
Getting a colonoscopy is one of the best things you can do to prevent colon cancer.
And, when colon cancer is caught early, most of the time, it can be cured. A
colonoscopy can also help figure out if something else like ulcerative colitis or
Crohn's disease is causing any problems.
A colonoscopy is very common and known to be very safe. But like any procedure,
a colonoscopy has some risks. This summary discusses some of the common risks,
but every patient and situation is different. There are also some very rare and
unusual risks that will not be covered here. So please do not consider this list
complete. If you have any questions, please ask your doctor.
Risks
There is a small risk that your colon could be torn or injured during
the procedure. If this happens, you may need surgery.
There's a small risk that the scope used to look at your colon (or any of the special
tools that are used) could injure, tear, or even poke a hole in your colon. Your
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COLONOSCOPY PRINT SUMMARY
doctor will watch for any signs of trouble while you're at the hospital. But in the days
after your colonoscopy, call your doctor right away if you have:
Pain in your belly that doesn't go away
A fever
A lot of bleeding
These are signs your colon may be injured. If this happens, you may need to be
taken to an operating room to have the injury surgically repaired.
There is a risk of bleeding both during and after the procedure. In
very rare cases, this may require surgery or other treatments. There is a risk of bleeding with any procedure. Bleeding is more common when a
polyp or tissue is removed. Bleeding may be obvious during the colonoscopy or
may appear several hours or days later. The bleeding may stop on its own, or your
doctor may use a special tool to control it. If the bleeding doesn't stop on its own,
another colonoscopy or surgery may be needed to stop it. Rarely, if too much blood
is lost, you may need a blood transfusion. All blood that is transfused is checked to
make sure it's clean and free of disease. But there is still an extremely small chance
that you could get a virus or your body could reject the blood. Signs of internal
bleeding are:
A large amount of red blood when you go to the bathroom
Severe pain
A high fever
If you think you may have bleeding, please call your doctor or seek emergency help
right away.
There is a risk of bad or allergic reactions to the medications that
are used. In unusual cases, you can die from these reactions.
You may have a bad reaction to the medications used before or during your
procedure. Signs of bad reactions can vary. You may have a minor reaction like a
rash. Or you may have more serious symptoms like feeling dizzy or trouble
breathing. Your lips or tongue may swell. Bad reactions or allergies to any of these
things can be very serious and even life threatening. Please tell your doctor if you
think you have any allergies at all. And tell your doctor if you or anyone in your
family has ever had a bad reaction to anesthesia. If you feel any of these symptoms,
stop your medications and contact your doctor or get emergency help right away.
There is a risk that a polyp or a problem could be missed during
your colonoscopy.
While doctors do their best to find and remove all polyps, these or other problems
can be missed if the colon wasn't properly cleaned out during the prep. Polyps and
other problems may also be hard to see if a patient eats something red or purple in
the days before the procedure. Colon problems can also be missed if they are very
small, hard to see, or because the structure of a person's colon makes it harder for
the doctor to find it. If, for any reason, your doctor has a hard time moving the scope
or getting a clear view, you may be asked to repeat the prep and have another
colonoscopy.
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COLONOSCOPY PRINT SUMMARY
Alternatives
Fecal occult blood test
This is a test you may have already had. Doctors usually run a fecal occult blood
test on everyone starting around age 50. This is a test where they check samples of
your waste for the kind of blood that you can't see on your own.
Barium enema
With a barium enema (lower GI), some white liquid (barium and water) is put into
the colon through the rectum. Then an x-ray is taken (see below). This x-ray helps
the doctor see if there are polyps or other problems.
Virtual colonoscopy
Virtual colonoscopy is pretty new and many places don't do them yet.
A tube is put in the rectum
The colon is filled with air
The colon is scanned
A computer creates a picture of the colon for the doctor
With both a barium enema and virtual colonoscopy, the colon needs to be cleaned
out. So you still need to do the prep.
Sigmoidoscopy
This is very similar to colonoscopy. But it only looks at the rectum and the lowest
part of the colon.
Which is the right test for you?
Any of these tests may be a good option for you. It depends on things like your age,
your family history, and whether or not you're already having any problems. In some
cases, though, doctors will want to get a close-up look at (and take samples from)
the whole colon. Or they may need to remove polyps they can only get to with a
colonoscopy.
If your colonoscopy or another test finds anything unusual, let people in your family
know. This is really important because colon cancer tends to run in families. And
this way, they can get looked at sooner instead of later. Either way, encourage your
friends and family to get checked regularly.
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