A colonoscopy includes patient’s colon, rectum and anus. It’s a type of endoscopy, which means that it uses an endoscope, a flexible tube with a lighted camera on the end that’s inserted into patient’s body. There are different types of endoscopes for different parts of the body. In a colonoscopy, the colonoscope passes through patient’s anus and rectum into the colon. Along the way, it sends pictures of the inside of patient’s large intestine to a screen.

How does the colonoscopy procedure work?

• The colonoscope is a small, lighted camera attached to the end of a long, thin, flexible tube called a catheter.
• A doctor inserts the colonoscope through patient’s anus and slowly advances it through the colon to the end, where it meets the small intestine.
• While advancing, the catheter pumps air into patient’s colon to inflate it. The camera transmits video of the inside of the colon to a monitor.
• Doctor will watch the monitor for anything abnormal. When the doctor reaches the end of the colon, he/she will bring the colonoscope back out the same way, watching a second time.

When patient needs a colonoscopy?

A colonoscopy may be preventive, diagnostic or therapeutic — and often, it’s all of these. A doctor may advise a colonoscopy for routine screening if you’re at a statistically higher risk of developing colorectal cancer. While screening, a gastroenterologist may also remove suspicious tissues for biopsy and other testing and prevention.

Screening

Most people will have their first colonoscopy for routine colon screening. Statistically, one’s risk of developing colorectal cancer goes up as a person age.

A person may be due for a colonoscopy screening if he/she:

• Had tissue removed during your last colonoscopy.
• Have a family history of colorectal cancer.
• Have an inherited disease that raises your risk, such as familial adenomatous polyposis (FAP) or Lynch syndrome.
• Have inflammatory bowel disease.
• Have irritable bowel disease.
• Had Crohan’s disease.
• Had tuberculosis (GIT).

Diagnosis

Some people have colonoscopies because they have symptoms that a doctor must investigate more closely. A colonoscopy provides a better view of patient’s large intestine than other types of imaging tests that don’t go inside the body. A doctor might need this better view to figure out what’s causing the symptoms or confirm their suspicions.

Symptoms that might require a colonoscopy include:

• Unexplained rectal bleeding or discharge.
• Unexplained changes in bowel habits, such as diarrhea, constipation or incontinence.
• Unexplained persistent abdominal pain.
• Unexplained weight loss or lack of weight gain in children.

Diseases or conditions that a colonoscopy might help diagnose include:

• Chronic colitis, such as ulcerative colitis or Crohn’s disease.
• Intestinal ischemia and ischemic colitis.
• Diverticulosis and diverticulitis.
• Ulcers and perforations.
• Large bowel obstructions.
• Colorectal polyps and colorectal cancer.

Treatment

One benefit of endoscopic procedures like colonoscopy is that if doctor finds a problem during the procedure, they might be able to treat it at the same time. Endoscopists receive training to perform minor procedures with special tools that they pass through the endoscope. During a colonoscopy, they commonly remove any polyps (abnormal growths) that they find and test them for diagnosis. Removing polyps also prevents possible cancer from developing or spreading.

During the colonoscopy, the endoscopist can:

• Remove polyps (polypectomy).
• Seal wounds.
• Inject medications.
• Remove blockages.
• Place stents.
• Treat tissues with laser therapy.

How do I prep for my colonoscopy?

Colonoscopy prep is very important to the success of the procedure. Doctor will provider his patient detailed instructions to follow in the days leading up to the appointment. The purpose of these preparations is to make sure patient’s large intestine is as clean and clear as possible for colonoscopy. If it isn’t, endoscopist might not be able to see what he/she need to see and might have to reschedule the colonoscopy, and patient might have to redo these preparations another time.

Patient will begin by adjusting his/her diet a few days ahead of the colonoscopy. Typically, patient will eat a low-fiber diet for two or three days, followed by a clear liquid diet on the last day. The afternoon or evening before the colonoscopy, give your patient a laxative formula to purge the bowels (by pooping everything out). Patient will spend the next several hours in and out of the bathroom a lot. Say your patient to be comfortable and get a good night’s sleep. The colonoscopy will usually occur the following morning.

The day of the appointment

It will be better if patient bring someone with to appointment who can drive him/her home. Since it takes a full day for the anesthesia to completely wear off, most healthcare places won’t check the patient in for the colonoscopy unless patient have/has a responsible driver with. (They’ll be hanging out for about two hours altogether.) After check-in, a doctor will lead the patient to a room where he can change into a hospital gown. A nurse will install an IV line into patient’s arm to begin delivering sedatives and pain medication to the bloodstream.

Do you stay awake for a colonoscopy?

You can have general anesthesia (a controlled loss of consciousness, like sleeping) or you can have conscious sedation (a depression of awareness — you might fall asleep or stay awake, but in either case, you probably won’t remember it much afterward). You’ll discuss your options for anesthesia with a healthcare provider in advance, so you’ll know what to expect on the day of the procedure. Your healthcare provider will help you select the right type for your body and your needs.

Is colonoscopy a painful procedure?

With sedation, patient shouldn’t feel pain inside the colon. This is true even if a provider removes tissue or performs laser therapy inside the colon. But patient might feel a little gas pain or pressure when the colonoscope advances into the colon. That’s because the colonoscope actually blows carbon dioxide gas into the colon to inflate it for better viewing. It’s usually not too noticeable once the inflation part is done. Patient will be lying comfortably in the fetal position on a hospital bed, and patient may even sleep.

Who performs a colonoscopy?

A gastroenterologist or a colorectal surgeon performs most colonoscopies. Both are specialists in gastrointestinal diseases and receive special training in endoscopic procedures involving patient’s gastrointestinal (GI) tract. Endoscopic procedures like colonoscopy aren’t just for looking inside the body — they can also be interactive. Endoscopists can take tissue samples and perform minor interventions through the endoscope. Their certification qualifies them to perform these procedures and to interpret the results.

How long does a colonoscopy take?

It takes about 15 minutes to advance the colonoscope to the end of patient’s large intestine and another 15 minutes to bring it back out the way it came. In this way, the doctor examines the entire large intestine twice. If the doctor finds something in the process that they need to remove or treat, this will add extra time. Colon polyps are common: they turn up in about 30% of routine colonoscopies. Although most are benign, it’s standard procedure to remove them on sight. This may add another 15 minutes.

What happens after the procedure?

Patient will spend the first hour after the procedure recovering in the healthcare center. This is so patient have time to wake up from the anesthesia. The healthcare team will continue to monitor patient’s vital signs and watch for any signs of complications. When patient is awake, the gastroenterologist will go over what they found during the exam and any procedures they performed. If doctor took a tissue sample for biopsy, patient would get those test results a little later.

How long does it take to recover from a colonoscopy?

It takes about 24 hours for the anesthesia to wear off completely. The next day Patient’ll feel more like himself every hour. Patient might feel some gas pain, bloating or nausea in the first hour or two, but this should pass quickly. Patient will return to normal diet as soon as he/she feels ready. If the doctor removed the tissue, patient might have some light rectal bleeding for a few days afterward.

What are the potential risks or complications of colonoscopy?

Risks and complications include:

• Injury to the colon wall, such as a tear,
• Uncontrolled bleeding from tissue removal,
• Infection requiring antibiotics,
• Reactions to the anesthesia.

What are abnormal results from a colonoscopy?

Abnormal results may include:

• Uncontrolled gastrointestinal bleeding.
• Benign, precancerous or cancerous polyps.
• Inflammation (colitis) from infection, ischemia or autoimmune disease.
• Chronic tissue damage, such as scarring.
• Obstruction or narrowing of intestine (stenosis).
• Abnormal pouches in intestinal lining (diverticulosis).

There are several other screening tests for colorectal cancer. Colonoscopy is the most sensitive test, meaning it’s the most likely to detect early cancer or precancerous conditions. Detecting potential cancer as early as possible is important to preventing and treating it effectively. Colonoscopy is also the only screening test for colorectal cancer that’s both diagnostic and therapeutic at the same time. When doctors find suspicious tissue during a colonoscopy, they can remove it during the same procedure.

Alternative screening tests for colon cancer include:

• Fecal occult blood tests. These tests analyze a sample of patient’s stool to look for signs of diseases. Different variations look for evidence of blood in patient’s stool using different methods. One type also analyzes the DNA in the stool to look for changes that might indicate the disease. Patient must repeat these tests every one to three years. If he/she gets a positive result from a fecal occult blood test, the next step will be to follow up with a colonoscopy and a tissue biopsy.
• Virtual colonoscopy. A virtual colonoscopy is a type of CT scan that produces highly detailed, 3D images of the colon from a CT scanning bed. It’s a “virtual” colonoscopy because it looks inside the colon virtually, with images taken from outside of the body. Patients have to prep for a virtual colonoscopy the same way they do (doctors advise him/her) for a traditional colonoscopy to make sure their bowels are clear. But patient won’t need anesthesia. Doctors recommend getting this test every five years.

What are the advantages of colonoscopy for cancer screening over the alternatives?

Advantages of a traditional colonoscopy include:

• Higher sensitivity. It’s more likely to detect diseases and cancerous changes sooner.
• All-in-one diagnosis, treatment and prevention. If other tests come back positive, patient will have to follow them with a traditional colonoscopy anyway to formally diagnose and treat cancer.
• Patient only need it every 10 years. If patient’s results are normal, he/she won’t have to retest for a while.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

None of above-mentioned medicine(s) is/are the full/complete treatment but just hints for treatment; every patient has his/her own constitutional medicine.

Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.

 Senior research officer at Dnepropetrovsk state medical academy Ukraine.

Location:  Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.

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