WHAT IS A COLONOSCOPY?

A colonoscopy is a procedure that allows direct visualisation of the lining of the large bowel (colon). It is performed using a thin flexible tube (colonoscope) with a camera and a light on the tip which is used to look at the area being examined. The procedure is the most accurate way we have of looking at the large bowel (colon) to establish whether there is any disease present. It also allows for a sample of tissue (biopsy) to be taken for examination by the pathology department and The removal of polyps that can grow on the bowel wall.

GETTING READY FOR THE PROCEDURE

Blood thinning medication may need to be stopped prior to the procedure. To obtain a clear view, the colon must be completely empty. You will receive detailed instructions about how to prepare your bowel for the procedure and it is essential that you follow these instructions exactly. When you arrive in the unit, it is important to tell the doctor or nurse about any medications (prescription or non) or antibiotics you are taking and also about any allergies or bad reactions you may have had in the past. If you are a diabetic you must inform your doctor pre-admission.

You will be asked to undress and to wear a gown and dignity shorts. Please bring a dressing gown and slippers with you. If you are on any medications (apart from tablets for diabetes) these should be taken as normal on the morning of your procedure. However if you are on iron tablets these should be discontinued one week prior to your procedure. On arrival, the procedure will be explained to you and you are asked to bring this signed consent form agreeing that you understand the procedure and its implications.

DURING THE PROCEDURE

In the procedure room, you will be made comfortable lying on your left side with your knees drawn up. A needle will be placed in your arm and you will be given sedation to make you feel relaxed and drowsy but not completely asleep or unconscious (this is not a general anaesthetic). You will also receive oxygen through your nose and some air will be put into the bowel to enable the doctor to have a clear view of the area. A nurse will remain with you during the procedure to monitor your pulse and blood pressure. After the procedure you will be taken to a recovery area whilst the sedation wears off after which you will be able to get up, get dressed and have something to eat and drink. You may notice some windy pains due to the air that has been put into the bowel.

POTENTIAL PROBLEMS

Failure of the Procedure: This is usually a very successful procedure allowing the whole colon to be visualised in over 90% of cases. Occasionally it may not be possible to advance the instrument all the way around your colon and further tests such as a scan or x-ray may be required.

Drug Reaction: The sedation used for the procedure is usually very safe with only a very slight risk of a reaction. Bleeding: If a polyp is found during the course of the procedure, this will be removed which may result in some bleeding. This bleeding can often be stopped straight away but may occasionally be more serious or even occur a few days later. Depending on the size, the risk of bleeding is 1 in 200 polyps removed. Many polyps are the type which can turn into cancer if left untreated for a long period of time and removing them when still benign eliminates this risk.

Perforation: It is possible to damage the large bowel lining making a hole. This allows bowel contents to escape causing severe inflammation in the abdomen (peritonitis). An operation is nearly always required to repair this hole. The risk of this happening is approximately 1 in every 2000 examinations.

Missed Pathology: It is important to remember that no test is perfect and even with complete examination significant disease may be missed in up to 5% of cases.

FOLLOWING YOUR PROCEDURE

Following your procedure you may have some crampy pains and bloating which will pass soon after. You will remain fasting for 1 hour after the procedure. The consultant will meet with you to discuss your test and follow up care, prior to discharge.

PLEASE NOTE THAT FOLLOWING A SEDATED PROCEDURE YOU WILL NOT BE PERMITTED TO LEAVE THE HOSPITAL UNACCOMPANIED. WE THEREFORE ASK THAT YOU MAKE ARRANGEMENTS TO HAVE A FRIEND OR RELATIVE COLLECT YOU. YOU ARE ADVISED TO HAVE A RESPONSIBLE ADULT STAY WITH YOU FOR THE NEXT 12 HOURS.