Colonoscopy

patient information from your surgeon & SAGES

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Colonscopy

About colonoscopy

What is a colonoscopy?
Colonoscopy is a procedure that enables your
surgeon to examine the lining of the colon and
rectum. It is usually done in the hospital or an
endoscopic procedure room on an outpatient
basis. A soft, bendable tube about the thickness
of the index finger is gently inserted into the anus
and advanced into the rectum and the colon.

Why is a colonoscopy performed?

A colonoscopy is usually done:
1) as part of a routine screening for cancer,
2) in patients with known polyps or previous
polyp removal,
3) before or after some surgeries,
4) to evaluate a change in bowel habits or
bleeding or,
5) to evaluate changes in the lining of the colon
known as inflammatory disorders.

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About the procedure

What preparation is required?

The rectum and colon must be completely emptied of stool for the procedure to be
performed. In general, preparation consists of consumption of a special cleansing solution
or several days of clear liquids, laxatives and enemas prior to the examination. Your surgeon
and his or her staff will provide you with instructions regarding the cleansing routine
necessary for the colonoscopy.
Follow your surgeon’s instructions carefully. If you do not complete the preparation, it may
be unsafe to perform the colonoscopy and the procedure may have to be rescheduled. If
you are unable to take the preparation, contact your surgeon.
Most medications can be continued as usual. Medication use such as aspirin, Vitamin
E, non-steroidal anti-inflammatories, blood thinners and insulin should be discussed
with your surgeon prior to the examination as well as any other medications you might
be taking. It is essential that you alert your surgeon if you require antibiotics prior to
undergoing dental procedures, since you may also require antibiotics prior to colonoscopy.
You will most likely be sedated during the procedure and an arrangement to have someone
drive you home afterward is imperative. Sedatives will affect your judgment and reflexes for
the rest of the day. You should not drive or operate machinery until the next day.

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About the procedure

What can be expected during colonoscopy?

The procedure is usually well tolerated, but
there is often a feeling of pressure, gassiness,
bloating or cramping at various times during
the procedure. Your surgeon will give you
medication through a vein to help you relax
and better tolerate any discomfort that you
may experience. You will be lying of your
side or your back while the colonoscope is
advanced through the large intestine. The
lining of the colon is examined carefully while
inserting and withdrawing the instrument. The
procedure usually lasts for 15 to 60 minutes.
In rare instances the entire colon cannot be
visualized and your surgeon may request an
additional test such as a barium enema or a
CT colonography.

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About the procedure

What if colonoscopy shows an abnormality?

If your surgeon sees an area that needs more detailed evaluation, a biopsy may be
obtained and submitted to a laboratory for analysis. A biopsy is performed by placing
a special instrument through the colonoscope. Most polyps can be removed at the
time of the colonoscopy. The majority of polyps are benign (non-cancerous), but your
surgeon cannot always tell by the appearance alone. They can be removed by burning
(fulgurating) or by a wire loop (snare).

It may take your surgeon more than one sitting to do this if there are numerous polyps
or if the polyps are very large. Sites of bleeding can be identified and controlled by
injecting certain medications or coagulating (burning) the bleeding vessels. Biopsies
do not imply cancer, however, removal of a colonic polyp is an important means of
preventing colon and rectal cancer.

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What should I expect after the procedure?

What happens after colonoscopy?

Your surgeon will explain the results to you after your procedure or at your follow up
visit. You may have some mild cramping or bloating from the air that was placed into
the colon during the examination. This should quickly improve with the passage of the
gas. You should be able to eat normally the same day and resume your normal activities
after leaving the hospital. Do not drive or operate machinery until the next day, as the
sedatives given will impair your reflexes.
If you have been given medication during the procedure, you will be observed until
most of the effects of the sedation have worn off (1-2 hours). You will need someone
to drive you home after the procedure. If you do not remember what your surgeon told
you about the examination or follow up instructions. Call your surgeon’s office that
day or the next to find out what you were supposed to do.
If polyps were found during your procedure, you will need to have a repeat
colonoscopy. Your surgeon will decide on the frequency of your colonoscopy exams.

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Expected outcomes

What complications can occur?

Colonoscopy complications include bleeding from the site of a biopsy or polypectomy
and a tear (perforation) through the lining of the bowel wall. Other complications of
the procedure include the possibility of missed polyps or other lesions.
Should a perforation occur, it may be necessary for your surgeon to perform abdominal
surgery to repair the intestinal tear. Blood transfusions are rarely required. A reaction
to the sedatives can occur. Irritation to the vein that medications were given is
uncommon, but may cause a tender lump lasting a few weeks. Warm, moist towels will
help relieve this discomfort.
It is important to contact your surgeon if you notice symptoms of severe abdominal
pain, fevers, chills or rectal bleeding of more than one-half cup. Bleeding can occur up
to several days after a biopsy.

Sample colonoscopy images

Diverticula Diverticula Biopsy polyp Hemorrhoids

Sigmoid colon descending colon sigmoid colon seen on retroflexion
of endoscope

This brochure is not intended to take the place of your discussion with your surgeon about the
need for a colonoscopy. If you have questions about your need for a colonoscopy, your alternatives,
billing or insurance coverage, or your surgeons training and experience, do not hesitate to ask
your surgeon or his/her office staff about it. If you have questions about the exam or subsequent
follow-up, please discuss them with your surgeon before or after the examination.

Color images: Atlas of Minimally Invasive Surgery, Jones DB, et al. Copyright 2006 Cine-Med.

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Additional instructions:

SOCIETY OF AMERICAN GASTROINTESTINAL

AND ENDOSCOPIC SURGEONS (SAGES)
11300 W. Olympic Blvd., Suite 600
Los Angeles, CA 90064
Phone: (310) 437-0544
Fax: (310) 437-0585
www.sages.org
This brochure was reviewed and approved by the Board of Governors of the Society of American
Gastrointestinal and Endoscopic Surgeons (SAGES), March 2015
. It was prepared by SAGES Task Force on Patient Information.