Gastroscopy | Colonoscopy | Flexible Sigmoidoscopy

 

What is a Colonoscopy?

Colonoscopy is a procedure undertaken to examine the colon (large intestine) with a fibre optic scope. The scope is about 200cm long and 12mm in diameter. Whilst the scope is in the large bowel, images of the bowel lining are seen in real time on a monitor.

 

Colonoscopy

 

 

The purpose of the procedure is to investigate symptoms such as diarrhoea, rectal bleeding, abdominal pain or weight loss. It can also be used to look for polyps (mushroom-like growths of tissue) or cancers in asymptomatic patients, especially those with a family history of bowel cancer.

 

Therapeutic procedures (removal of polyps, treatment of bleeding etc) can also be performed through the colonoscope.

 

What do I need to do to prepare for a Colonoscopy?

• Please follow the patient instructions, which require you to fast (not eat or drink) and take your bowel preparation.

• Please don’t bring any valuables with you. Wear light clothing as you will be required to change.

• Bring your private insurance and medicare details with you.

• Nominate a contact person to pick you up.

• Some medications may need to be discontinued before colonoscopy.
Dr Jakobovits will discuss this with you prior to your colonoscopy appointment.

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What happens on the day of the procedure?

• Please arrive at the Day Procedure Centre at Cabrini Hospital Malvern at the designated time.

• Feel free to bring something to read/do as your arrival time is not the procedure time. The time taken for the cases ahead of you can vary depending on complexity so the exact procedure time is unpredictable. You need to check in and change into a hospital gown, which can take some time. Whilst our best intentions are for you to not wait too long, each procedure is unique and sometimes a person on the list in front of you will have an unexpected finding which may prolong their procedure time and your wait. You can expect to be at Cabrini for approximately 4 hours from arrival time to departure. Sometimes this is much faster and we can call your “pick up” person when you are ready to go.

• After undergoing a ‘bowel preparation’ (see Patient Instructions) the patient is admitted to the Day Procedure Unit and gets changed into appropriate hospital clothing. The patient is sedated (made sleepy) by a qualified anaesthetist who injects a sedative via a cannula (tiny hollow plastic tube) inserted into a vein. This is not a general anaesthetic but the patient is asleep and comfortable.

• A lubricated colonoscope is then passed through the anus into the large bowel and is carefully advanced to the deepest part of the large bowel where it meets the small bowel (ileo-caecal region). Often the scope is passed into the last part of the small bowel (ileum) where some diseases such as Crohn’s disease can be localised.

• Careful inspection is then undertaken as the scope is slowly withdrawn. Polyps that are seen are removed at the time if it is safe to do so. Any areas of concern, such as inflamed bowel or suspected cancers can be biopsied (small “pinch” of tissue removed) to allow examination under a microsope.

• The procedure usually takes about 20 to 30 minutes to complete but this can be highly variable depending on the findings.

• After the procedure, the anaesthetic drug wears off very quickly and you are given something to eat and drink. Dr Jakobovits will then review you before you go home and let you know of the examination findings and the follow up plan.

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What happens after the Colonoscopy?

• After the procedure you will be taken to the Recovery Area until any sedation given during the procedure has worn off.

• When you are awake, Dr Jakobovits will review you and explain the results of the examination to you. You will be given discharge instructions, including when to make a follow-up appointment.

• After something to eat and drink you will be able to go home – You are not allowed to drive home, or drive or operate dangerous machinery for the rest of the day/night. Do not sign any legal documents or drink alcohol during that same period of time.

• If you cannot find someone to pick you up after your procedure, you can go home in a taxi, but we will keep you for longer to make sure you are alright and it is our preference that a responsible adult be with you for the remainder of the day.

• On the morning of the following day you can resume all normal activities.

 

Safety and risks

• All activities carry some risk including driving a car. Medical procedures are no different, however Colonoscopy is a low risk procedure.

• The commonest complaint after a colonoscopy is a sensation of bloating which is caused by the air needed to be blown into the bowel to enable good views of the bowel lining. This usually dissipates very quickly.

• Bleeding can occur after polyps are removed or rarely after biopsies are taken. In the former case bleeding can occur up to 2 weeks after the procedure. If you have any concerns that you may be bleeding after a procedure contact Dr Jakobovits immediately.

• Infections following a colonoscopy are exceedingly rare due to the strict cleaning procedures undertaken on the equipment after each procedure.

• Perforation after colonoscopy has been quantified at 1/1000 cases for standard colonoscopy. Removal of larger polyps increases this risk. In the case of a perforation it is possible surgery may be required.

• Occasionally a complete colonoscopy may not be possible (the ability to examine the whole length of the large bowel). Factors that increase the possibility of incomplete colonoscopy include previous abdominal surgeries leading to scar tissue and diverticulosis (benign pockets forming in the colon), among other causes. If a complete colonoscopy cannot be performed a CT colonoscopy (special X-ray) can usually be done on the same day to examine the rest of the colon.

• Colonoscopy is not a perfect test. In the best hands there are areas of the bowel which cannot be seen and hence lesions, including possible cancers, can be missed.

 

Gastroscopy | Colonoscopy | Flexible Sigmoidoscopy

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