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What is Colonoscopy: In simple words, Colonoscopy is passing a scope around your large bowel to inspect the inside of the bowel, identify the presence of any abnormalities like polyps, Tumors, Diverticulosis or Inflammatory bowel disease.
Indications for Colonoscopy: Please read carefully, The British Society of Gastroenterology has given us clear guidance on when a colonoscopy is indicated. This is summarized here.
Sedation or Anesthesia: The Colon is not a straight tube, Colon is bendy and has a concertina pattern, Going around the colon can cause some discomfort. The procedure can be done under conscious sedation which is the usual practice at NHS hospitals or under complete unconscious sedation which is the usual practice at the private sector.
Preparation for Colonoscopy: To achieve the best results, you need to work effectively to clean your colon prior to the procedure, You need to follow the coming steps carefully and actively:
The week Prior to your Procedure:
- Only Low Residue Diet is allowed, this is the type of food that does not stay for long in your colon. Please click on this “Low Residue Diet Sheet” to find what foods are allowed
- Increase your fluid intake as much as you can, this includes water, juice but not coffee or tea which do not count for the volume of fluid taken to flush your bowel as they are excreted mainly in urine.
- Take X2 Senna Tablets every night prior to sleep with a pint of water.
- Follow the instruction of taking your “Klean Prep / Plenvue / Moviprep” the day prior to your procedure. The instructions may vary slightly if your procedure is carried during the morning or the afternoon session.
The Day of the Procedure: I will meet you again, summarize the indications for your colonoscopy, explain about the procedure, benefits, the risks and alternatives, This is called the “Consenting process”. You will also meet my anesthetist who will explain to you about the sedation. You will then get taken to procedure room, you will receive your sedation and I will proceed. You will not remember the procedure itself at all but I will come and explain to you in details when you are fully awake about findings and next step of management.
Challenges: If instructions are not followed carefully prior to procedure, the colon may not be clear enough to complete a good and satisfactory diagnostic test, this may require a repeat of the whole procedure which may cause you a lot of inconvenience and be time and cost consuming.
Risks of Colonoscopy: The risks are relatively rare. Literature tells us that there is 1 in a 1000 risk of complications in the form of bleeding or perforation of the colon, the risks may increase if large polyps are identified and removed through a therapeutic procedure. Although these risks are very low, I have not seen them in my own private practice having completed thousands of these in my lifetime practice. You may pass few drops of bloods if biopsies taken, You may also feel some bloating . These symptoms usually disappear the day of the procedure upon passing the wind out.
Summary: Colonoscopy is the gold standard investigation to visualize the colon and identify any abnormalities like polyps and removing them to avoid progressing to a more serious condition like cancer. The procedure is safe. It requires adequate preparation and is completed as a day procedure.
If you have any queries please do not hesitate to discuss with me when we meet.
