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Colonoscopy National Digestive Diseases Information Clearinghouse What is colonoscopy? that make up the GI tract are the mouth, esophagus, stomach, small intestine, large Colonoscopy is a procedure that uses a long, intestine—which includes the appendix, flexible, narrow tube with a light and tiny cecum, colon, and rectum—and anus. The camera on one end, called a colonoscope or intestines are sometimes called the bowel. scope, to look inside the rectum and entire The last part of the GI tract—called the colon. Colonoscopy can show irritated and lower GI tract—consists of the large intestine swollen tissue, ulcers, and polyps—extra and anus. pieces of tissue that grow on the lining of the intestine. A gastroenterologist—a doctor who specializes in digestive diseases— performs this procedure. This procedure is different from virtual Esophagus colonoscopy, which uses a combination of Mouth x rays and computer technology to create images of the rectum and entire colon. Read more in Virtual Colonoscopy at Stomach www.digestive.niddk.nih.gov. What are the rectum and colon? The rectum and colon are part of the gastrointestinal (GI) tract, a series of hollow Small organs joined in a long, twisting tube from intestine the mouth to the anus—a 1-inch-long opening through which stool leaves the body. Large The body digests food using the movement intestine of muscles in the GI tract, along with the Appendix release of hormones and enzymes. Organs Rectum Anus The GI tract The large intestine is about 5 feet long in adults and absorbs water and any remaining Get Screened for Colon nutrients from partially digested food passed from the small intestine. The large intestine Cancer then changes waste from liquid to a solid The American College of matter called stool. Stool passes from the Gastroenterology recommends colon to the rectum. The rectum is 6 to screening for colon cancer 8 inches long in adults and is located between • at age 50 for people who are not at the last part of the colon—called the sigmoid increased risk of the disease colon—and the anus. The rectum stores stool prior to a bowel movement. During • at age 45 for African Americans a bowel movement, stool moves from the because they have an increased risk rectum to the anus. of developing the disease1 A gastroenterologist may recommend Why is a colonoscopy earlier screening for people with performed? a family history of colon cancer, a personal history of inflammatory A colonoscopy is performed to help diagnose bowel disease—a long-lasting disorder • changes in bowel habits that causes irritation and sores in the GI tract—or other risk factors for colon • abdominal pain cancer. • bleeding from the anus Medicare and private insurance • weight loss companies sometimes change whether A gastroenterologist also performs a and how often they pay for cancer colonoscopy as a screening test for colon screening tests. People should check cancer. Screening is testing for diseases with their insurance company to find when people have no symptoms. Screening out how often they can get a screening may find diseases at an early stage, when a colonoscopy that their insurance will health care provider has a better chance of cover. curing the disease. Read more about colon cancer at www.cancer.gov. 1Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American College of Gastroenterology guidelines for colorectal cancer screening 2008. American Journal of Gastroenterology. 2009;104(3):739–750. 2 Colonoscopy How does a person prepare and avoiding drinks that contain red or purple dye. The instructions will for a colonoscopy? provide specific direction about when Preparation for a colonoscopy includes the to start and stop the clear liquid diet. following steps: People may drink or eat the following: • Talk with a gastroenterologist. When – fat-free bouillon or broth people schedule a colonoscopy, they – strained fruit juice, such as apple should talk with their gastroenterologist or white grape—orange juice is not about medical conditions they have and recommended all prescribed and over-the-counter – water medications, vitamins, and supplements – plain coffee or tea, without cream or they take, including milk – aspirin or medications that contain – sports drinks in flavors such as aspirin lemon, lime, or orange – nonsteroidal anti-inflammatory drugs – gelatin in flavors such as lemon, lime, such as ibuprofen or naproxen or orange – arthritis medications The person needs to take laxatives and – blood thinners enemas the night before a colonoscopy. A – diabetes medications laxative is medication that loosens stool and – vitamins that contain iron or iron increases bowel movements. An enema supplements involves flushing water or laxative into the • Arrange for a ride home after the rectum using a special wash bottle. Laxatives procedure. Driving is not allowed for and enemas can cause diarrhea, so the 24 hours after the procedure to allow person should stay close to a bathroom time for the anesthesia to wear off. during the bowel prep. • Cleanse the bowel. The gastroenterologist Laxatives are usually swallowed in pill form will give written bowel prep instructions or as a powder dissolved in water. Some to follow at home. A gastroenterologist people will need to drink a large amount, orders a bowel prep so that little to usually a gallon, of liquid laxative at no stool is present inside the person’s scheduled times. People may find this part intestine. A complete bowel prep of the bowel prep difficult; however, it is lets the person pass stool that is clear. very important to complete the prep. The Stool inside the colon can prevent the gastroenterologist will not be able to see the gastroenterologist from clearly seeing colon clearly if the prep is incomplete. the lining of the intestine. Instructions People should call the gastroenterologist may include following a clear liquid diet if they are having side effects that are for 1 to 3 days before the procedure preventing them from finishing the prep. 3 Colonoscopy How is a colonoscopy The gastroenterologist can remove polyps during colonoscopy and send them to a lab performed? for testing. Polyps are common in adults and A gastroenterologist performs a colonoscopy are usually harmless. However, most colon at a hospital or an outpatient center. In most cancer begins as a polyp, so removing polyps cases, light anesthesia and pain medication early is an effective way to prevent cancer. help people relax for the test. The medical staff will monitor people’s vital signs and try The gastroenterologist may also perform to make people as comfortable as possible. a biopsy, a procedure that involves taking A nurse or technician places an intravenous a small piece of intestinal lining for (IV) needle in a vein in the arm to give examination with a microscope. The person anesthesia. will not feel the biopsy. A pathologist—a doctor who specializes in diagnosing For the test, the person will lie on a table diseases—will examine the tissue. while the gastroenterologist inserts a colonoscope into the anus and slowly The gastroenterologist may pass tiny tools guides it through the rectum and into the through the scope to remove polyps and take colon. The scope inflates the large intestine a sample for biopsy. If bleeding occurs, the with air to give the gastroenterologist a gastroenterologist can usually stop it with better view. The camera sends a video an electrical probe or special medications image of the intestinal lining to a computer passed through the scope. Colonoscopy screen, allowing the gastroenterologist to usually takes 30 to 60 minutes. carefully examine the intestinal tissues. The gastroenterologist may move the person What can a person expect several times so the scope can be adjusted for better viewing. Once the scope has after a colonoscopy? reached the opening to the small intestine, After the colonoscopy, a person can expect the gastroenterologist slowly withdraws it the following: and examines the lining of the large intestine • People may need to stay at the hospital again. or outpatient center for 1 to 2 hours after the procedure. • Cramping or bloating may occur during the first hour after the test. • The anesthesia takes time to completely wear off. • Full recovery is expected by the next day, and people should be able to go back to their normal diet. For the test, the person will lie on a table while the gastroenterologist inserts a colonoscope into the anus and slowly guides it through the rectum and into the colon. 4 Colonoscopy • A member of the health care team will Bleeding and perforation are the most review the discharge instructions with common complications from colonoscopy. the person—or with an accompanying Most cases of bleeding occur in people who friend or family member if the person have polyps removed. The gastroenterologist is still groggy—and provide a written can treat bleeding that occurs during the copy. The person should follow all colonoscopy right away. However, a person instructions given. may have delayed bleeding up to 2 weeks after the test. The gastroenterologist • A friend or family member will need diagnoses delayed bleeding with a repeat to drive the person home after the colonoscopy and treats it with an electrical procedure. probe or special medication. Perforation • If the gastroenterologist removed polyps may need to be treated with surgery. or performed a biopsy, light bleeding from the anus is normal. A study of screening colonoscopies found 2.1 serious complications per 1,000 Some results from a colonoscopy are procedures performed.2 available immediately after the procedure. After the anesthesia has worn off, the gastroenterologist will share results with the person or a designee. Biopsy results take a Seek Help for Emergency few days to come back.
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