How is the test done?
After you arrive and change into a gown, a nurse will ask you questions about your medical history and medicines you take. The nurse will put an IV into your arm and take you to the Endoscopy Room. You will be given oxygen to breathe. You will be hooked up to monitors that measure your blood pressure, heart rate and oxygen level during the test. Your doctor will explain the procedure and risks, and have you sign a consent form. The doctor will then give you a special medicine through the veins to sedate you. Most people will gradually lose awareness of their surroundings before the procedure begins.
When you are sedated, the doctor will place a long scope inside you. This has a video camera on it and will help the doctor to see your colon. If tissue is found that does not look normal, biopsies may be taken to study in more detail. If polyps are found, the doctor may remove them using special tools. Polyps are small tumors in the colon that may become cancer or contain cancer. Other procedures using a scope may be done such as stretching the colon, injecting medicines, or cauterizing bleeding spots. Most colonoscopies take about 20 to 45 minutes after sedation to be completed.
After the procedure, a nurse will monitor you and check your vital signs until you wake. Most patients find the procedure to be quite comfortable and are surprised when they wake and learn that it is over.
What are the risks of the test?
These procedures and tests are important to help the doctor examine you. Many exams and tests have risks. At times, though unusual, a serious medical condition that is present may not be found in these exams. Some of the risks of a colonoscopy are:
- Internal bleeding
- Perforation of tissues
- Aspiration pneumonia
- Heart attack
- Adverse reactions to medications
- Clotting or infection in the veins where the medicine is given
Such complications can sometimes lead to surgery, or very rarely, death.
Are there other options to the test?
An alternative to a colonoscopy is a barium x-ray of the colon, called a "barium enema." Barium x-ray studies are not as sensitive in finding disease. At least 10% of polyps are not seen. In addition, a colonoscopy must often be done to further study any abnormal findings and biopsy or remove abnormalities found on barium x-rays.
Preparation for the test
Three days before the exam
For three days prior to the procedure, you should avoid nuts, seeds, corn, popcorn, grapes, oranges, grapefruit, beans, peas, tomatoes, and blueberries.
Day before the exam
For the FULL day prior to your procedure, you should be on clear liquids. That means you should NOT eat any solid food the entire day before the colonoscopy. Clear liquids can include nonalcoholic drinks such as coffee, tea, soda, jello (please avoid red or orange jello since they may look like blood in the bowel), juices (grape, apple or white cranberry), and clear soups (chicken broth, bouillon). Please avoid all milk products.
Day of the exam
You should not take anything by mouth after midnight the night before your procedure if you are scheduled for a morning exam. If the exam is scheduled for the afternoon, you may have clear liquids in the early morning. You should not have anything by mouth 4 hours prior to the procedure unless you are told otherwise. This includes gum, lozenges, candy and chewing tobacco.
Patients on Aspirin or Plavix
If you take aspirin and/or Plavix due to a prior heart attack, stroke, heart rhythm problems, blood clots or have a heart stent in place, you should continue these medications. If you take aspirin daily but have no history of any of the above conditions, you should stop the aspirin five days prior to your exam.
Patients on Coumadin
If you take Coumadin or any other blood thinner such as Lovenox and have not been seen in our office, you will need to make an appointment with one of our Physician Assistants prior to scheduling your colonoscopy.
Patients on Iron
Stop any iron supplement 5 days before your colonoscopy. This includes multivitamins containing iron and herbal remedies.
For the preparation of your colonoscopy, please read the insert in the special mixture carefully and follow all the instructions. This is very important because your bowels must be completely cleansed for the procedure. If they are not completely cleansed, your doctor could require you to re-prep and perform the colonoscopy another day.
You must arrange for someone to drive you home, because you may be drowsy after the procedure and driving will be unsafe. Have your driver come with you when you arrive to confirm your pick-up time. The procedure will not be done unless proper transportation arrangements have been made.
Feel free to call our office about the procedure or the preparation process with any questions.