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COLONOSCOPY & SIGMOIDOSCOPY PATIENT INFORMATION Colonoscopy is the endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions. Colonoscopy can remove polyps as small as one millimeter or less. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not. Colonoscopy is similar to but not the same as sigmoidoscopy, the difference being related to which parts of the colon each can examine. While colonoscopy allows an examination of the entire colon (measuring four to five feet in length), sigmoidoscopy allows doctors to view only the final two feet of the colon. A sigmoidoscopy is often used as a screening procedure for a full colonoscopy, in many instances in conjunction with a fecal occult blood test (FOBT), which can detect the formation of cancerous cells throughout the colon. Other times, a sigmoidoscopy is preferred to a full colonoscopy in patients having an active flare of ulcerative colitis or Crohn's disease to avoid perforation of the colon. Additionally, surgeons have lately been using the term pouchoscopy to refer to a colonoscopy of the ileo-anal pouch. The colonoscopy is performed by a doctor experienced in the procedure and lasts approximately 30-60 minutes. Medications will be given into your vein to make you feel relaxed and drowsy. You will be asked to lie on your left side on the examining table. During a colonoscopy, the doctor uses a colonoscope, a long, flexible, tubular instrument about 1/2 inch in diameter that transmits an image of the lining of the colon so the doctor can examine it for any abnormalities. The colonoscope is inserted through the rectum and advanced to the other end of the large intestine. The scope bends, so the doctor can move it around the curves of your colon. You may be asked to change position occasionally to help the doctor move the scope. The scope also blows air into your colon, which expands the colon and helps the doctor see better. You may feel mild cramping during the procedure. You can reduce the cramping by taking several slow, deep breaths during the procedure. When the doctor has finished, the colonoscope is slowly withdrawn while the lining of your bowel is carefully examined. During the colonoscopy, if the doctor sees something that may be abnormal, small amounts of tissue can be removed for analysis (called a biopsy), and abnormal growths, or polyps, can be identified and removed. In many cases, colonoscopy allows accurate diagnosis and treatment without the need for a major operation.