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Procedures
 
Colonoscopy
 
About the Procedure
In this procedure, a flexible endoscope is passed through the rectum, and wherein possible, into the entire large intestine to where the small and large intestines meet. Colonoscopy is used to evaluate many problems including rectal bleeding, abdominal pain, diarrhea, constipation, an abnormal colon x-ray, and inflammatory bowel disease. During the procedure, the physician may extract small pieces of tissue (biopsies) for examination in the laboratory. Polyps may also be detected and removed, and abnormalities not visible on x-rays may be found.
 
Polypectomy
Polyps are abnormal growths of tissue on the bowel lining, and they vary in size from a small dot to approximately 1-2 inches. If your physician believes that removal of a polyp is necessary, the polyp can be removed with a biopsy instrument or with the use of a wire loop and electrocautery. The wire loop is passed through the colonoscope. The polyp's attachment to the intestine wall is severed by charging the loop with an electrical current. If additional polyps are detected, they may also be removed.
 
Possible Complications
Colonoscopy with biopsies and/or polypectomy is a safe procedure associated with very low risk when performed by specially trained and experienced physicians. As with any procedure, the potential for complications does exist.
 
One possible complication is perforation (a tear or burn through the wall of the bowel) that may allow leakage of intestinal contents. This complication usually requires surgery, but in selected cases are managed with antibiotics and intravenous fluids.
 
Bleeding may occur from the site of biopsy or polyp removal. This bleeding is usually minor and stops by itself, or it can usually be controlled by a cautery device inserted through the colonoscope. Rarely, transfusions, arteriography with infusion or surgery may be required to stop bleeding.
 
Other potential risks include drug reactions and complications from unrelated disorders such as heart attack and stroke (these problems may occur coincidentally at time of colonoscopy rather than be a complication of colonoscopy). Death from colonoscopy associated complications is rare, but it remains a remote possibility.
 
Patient Preparation
On the day prior to your colonoscopy, take only clear liquids such as water, black coffee or tea, plain gelatin (without fruit), lemon or lime gelatin (no red gelatin), broth, apple juice, cranberry juice, 7-Up or Sprite. Do not take your usual medications on the morning of the procedure unless specifically instructed to do so by your physician.
 
Your physician will provide instructions regarding bowel cleansing preparation. Notify your physician if you are taking anticoagulants such as Coumadin, Plavix or Aspirin.
 
Your Procedure
After your admission is complete, a staff nurse will start an intravenous line (IV). Just before starting the procedure, your physician will give you medication for sedation through the IV to make you relaxed and to minimize any discomfort. Colonoscopy is usually very well tolerated, and some patients fall asleep during the examination. Some discomfort may occur during the procedure, although the discomfort is usually not severe. Medication doses are adjusted to individual needs.
 
The entire procedure usually lasts from 45 minutes to one hour.
 
Because medications that are used will make you drowsy for many hours after the procedure, A COMPANION MUST ACCOMPANY YOU OR BE AVAILABLE TO TRANSPORT YOU HOME AFTER YOU LEAVE THE RECOVERY ROOM. You will not be allowed to drive yourself home after your procedure, and you should not plan to return to work for the rest of the day.
 
After Your Procedure
After your colonoscopy is completed, you will be taken to the Recovery Room. Your stay in the Recovery Room will last approximately 30-60 minutes depending on your response to the sedation administered. Nurses will watch you closely for any problems that may occur, although complications are exceedingly rare. AFTER APPROPRIATE OBSERVATION, YOU WILL BE DISCHARGED ONLY WITH SOMEONE TO ACCOMPANY YOU AND DRIVE YOU HOME.
 
At Home
You may feel some rectal irritation, distension, or mild abdominal pain after your procedure. If symptoms persist for more than one day, or if they intensify, notify your doctor. We suggest you do not eat heavily for the next meal after your procedure.
 
REMEMBER: IF YOU DEVELOP SEVERE ABDOMINAL PAIN OR TENDERNESS, RECTAL BLEEDING, FEVER OR CHILLS, NAUSEA OR VOMITING OR ANY SYMPTOMS THAT CONCERN YOU, CALL YOUR PHYSICIAN IMMEDIATELY OR GO TO THE NEAREST EMERGENCY ROOM.
 
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