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Colonoscopy

What is a colonoscopy?

Colonoscopy is a diagnostic procedure that allows the physician to examine the entire length of the large intestine. Colonoscopy can assist in identifying problems with the colon, such as early signs of cancer, inflamed tissue, ulcers, and bleeding. Colonoscopy is also used to screen for colorectal cancer, the second leading cause of cancer deaths in the U.S.

An endoscope - a long, flexible, lighted tube (also called a colonoscope), is inserted through the rectum into the colon. In addition to allowing visualization of the internal colon, the colonoscope enables the physician to irrigate, suction, inject air, and access the bowel with surgical instruments. During a colonoscopy, the physician may remove tissue for further examination and possibly treat any problems that are discovered.

Reasons for the Procedure

A colonoscopy may be used to examine colon polyps, tumors, ulceration, inflammation, diverticula (pouches), strictures (narrowing), and foreign objects within the colon. It may also be used to determine the cause of unexplained chronic diarrhea or gastrointestinal bleeding or to evaluate the colon after cancer treatment.

Colonoscopy may be indicated when the results of a barium enema and/or sigmoidoscopy warrant further examination of the colon.

There may be other reasons for your physician to recommend a colonoscopy.

Screening guidelines for colorectal cancer:

Colorectal cancer screening guidelines for early detection from the American Cancer Society recommend that beginning at age 50, both men and women should follow one of the examination schedules below:

• Annual fecal occult blood test (FOBT)
• Flexible sigmoidoscopy (FSIG) every five years
• Double-contrast barium enema every five years
• Colonoscopy every 10 years

Risks of Procedure

As with any invasive procedure, complications may occur. Complications related to colonoscopy include, but are not limited to, the following:

• Persistent bleeding after biopsy
• Peritonitis (inflammation of the lining of the abdominal wall)
• Perforation of the intestinal wall (rare)

If you are pregnant or suspect that you may be pregnant, you should notify your physician.

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Certain factors or conditions may interfere with a colonoscopy. These factors include, but are not limited to, the following:

• Use of soap suds enemas prior to the procedure, which irritate the lining of the mucosa
• Presence of barium from previous tests used to examine the colon (such as a barium enema)
• Inadequate preparation of the bowel before the procedure
• Problems which may interfere with the passage of the colonoscope, such as narrowing of the colon, surgical adhesions, or disease such as chronic inflammatory disease