Colonoscopy
What is the equipment used in colonoscopy?
Colonoscope or endoscope for colonoscopy is separate from endoscope used in Gastroscopy. It is longer and larger as compared to scope used in Gastroscopy. The Diameter of scope is 12.8mm. As all endoscopes it has suction channel and air water channel. Therapeutic procedures can also be done with same endoscopes.
How is colonoscopy done ?
We generally do colonoscopy in short general anaesthesia. Procedure takes 20 to 30mins. Patient has to lie in left lateral position. Colonoscope is inserted through anus and slowly under visualization is passed in rectum, colon and terminal ileum through ileocecal valve. In colonoscopy we visualize large intestine and terminal part (10 to 15cm) of ileum (Small intestine). If any abnormality is seen biopsy can be taken at same time and send for analysis which helps to make the diagnosis and further treatment.
What kind of anesthesia is needed for colonoscopy?
Colonoscopy is done under short General anaesthesia.Sedation through intravenous cannula can be given so that patient sleeps during the procedure and is comfortable. Patient should be accompanied with a relative and will not be able to drive vehicle while going back home.
What are the pre-procedure instructions before colonoscopy?
One has to take oral medication solution to clean the intestines before colonoscopy. The preparation has to be taken in the morning if procedure is planned in afternoon or evening. If procedure is planned in morning, then preparation has to be taken at night.
1 packet of polyethylene glycol has to be dissolved in 2 litres of water and taken over 2hours. After that patient usually starts passing stools frequently. Patient should pass multiple stools and lastly should pass only water which will confirm that intestinal preparation is adequate for colonoscopy.
Patient should not take anything solid food after the preparation but one can take clear liquid which too has to be stopped 4 hours before the colonoscopy procedure.Night prior to procedure the dinner should be small amount and soft diet.
Before preparation liquid diet can be taken, but should avoid solid food. If preparation has to be taken at night than dinner should be taken at least 2 hrs before starting the preparation.Most of the time preparation is adequate but in certain patients who are constipated, elderly or those who vomited the preparation can have poorly prepared bowel. In such patients we need to postpone the procedure and take the preparation again.
Patient has to take his routine hypertension and thyroid medicines as per the schedule.Diabetes medicines should be consulted with doctor.
Diabetes medicines should be consulted with doctor.
- If patient develops vomiting while taking preparation, then one should consult hospital immediately.
- If after taking preparation patient is not able to pass stools and has developed abdominal distension then should come to hospital immediately.
Post procedure after Colonoscopy
Post procedure patient can have abdominal discomfort in view of air in large intestine which generally gets better after going to wash room. Post procedure patient needs to be in hospital for 1 to 2 hrs and then can be discharged. Patient can start taking orally after 2 to 3hrs.
Endoscopy images and report are given immediately after the procedure. If biopsy is taken, then the sample is sent to the laboratory for evaluation and report takes about 8 to 10 days.
What kind of anesthesia is needed for endoscopy?
- UGI endoscopy can be done under Local anesthesia (mostly) or sometimes General anesthesia.
- If endoscopy procedure is done under Local anaesthesia spray, patient can go home immediately and can drive vehicle also. Patient can eat after 20 mins once the effect of local anaesthesia wanes off.
- If patient is very apprehensive, sedation through intravenous cannula can be given so that patient sleeps during the procedure and is comfortable. If patient wants sedation then he or she should be accompanied with a relative and will not be able to drive vehicle while going back home.
Disinfection of Endoscope
Endoscopes used for both are separate and one cannot be used interchangeably. Endoscope is properly disinfected after every procedure. It is cleaned properly and kept in disinfectant for 20 minutes post procedure to prevent transmission of infection from one patient to other.
What are indications for doing a colonoscopy?
- Chronic Diarrhea
- Bleeding per rectum
- Abdominal pain
- Altered bowel habit
- Constipation
- Family history of colon cancer.
What are the complications of colonoscopy?
Colonoscopy is a very safe procedure in expert hands and there are generally no complications.
- Bleeding does not happen in diagnostic colonoscopy only if we are doing therapeutic colonoscopy there is a risk of bleeding roughly 2.6 per 1000.
- Perforation can occur again during diagnostic colonoscopy the risk is less it can increase with therapeutic colonoscopy.
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