Colonoscopy
A colonoscopy is a procedure that allows the doctor to look
directly at the lining of your bowel.
The colonoscope is a flexible tube about the thickness of
your index finger, with a bright light at the end.
It is passed into your back passage and along the bowel.
What are the benefits of having a colonoscopy?
This procedure allows the doctor or nurse to see most
problems immediately.
Sometimes the doctor or nurse may need to take a biopsy
(a small piece of tissue is removed
through the tube using tiny forceps).
You should not be able to feel the biopsy being taken.
We may need to treat your piles by placing a small rubber
band around them causing them to shrivel away.
We may need to remove a polyp (overgrowth of tissue)
by diathermy.
This is done by passing a narrow instrument through the
scope and directing a small electrical charge to the base of
the polyp.
Getting ready for the procedure
Before this procedure we will need to prepare your bowel by
giving you some medication to clear it.
Please read the bowel preparation leaflet, if you have been
given a copy.
Please have nothing to eat from taking your bowel
preparation until after the procedure.
You may drink clear fluids only up to 2 hours before your
appointment time.
Important
If you are taking Warfarin, Clopidogrel or any other blood
thinning drugs it is important that you tell the Endoscopy
Unit as soon as you are advised
when your appointment will be.
This is because sometimes special arrangements may need to
be made to stop this for a few days.
It may also be advisable to have a blood test a couple of
days before your appointment to see if the procedure is safe
to proceed.
If you are taking iron tablets, please stop these 5 days
before your procedure.
Please keep taking all other medication including blood
pressure tablets, including on the day of your procedure,
unless directed otherwise.
If you are diabetic please discuss this with the Endoscopy Unit
before attending or with your consultant.
If you answer yes to any of the following 2 questions,
please contact us for advice:
Have you ever been notified that you are at increased risk
of CJD or vCJD for public health purposes?
Have you received multiple (50 units or, on more than 20
occasions) transfusions of blood or blood components
(red cells, plasma, cryoprecipitate or platelets) since 1980?
Before you arrive please remove all nail polish and false nails
Can I have sedation for the procedure?
You may have a sedative injection for this procedure if you
wish, but you can choose not to have any.
If you have a sedative injection, you must not drive or go
home by public transport.
Therefore, you must make arrangements
for someone to collect you.
It is not appropriate to go home unaccompanied in a taxi.
Please note, hospital transport and ambulances are not
normally available for day patients.
You will need a responsible adult at home with you
for 24 hours.
What are the risks, consequences and alternatives associated
with having a colonoscopy?
You are unlikely to have any serious side-effects, however
you may experience abdominal discomfort;
this is caused by the air
which the doctor puts in during the examination.
This will normally last up to 12 hours and will pass
naturally.
Colonoscopy has a very low risk of serious complications
(0.2%).
The procedure can result in complications such as reactions
to medications, a hole or tear in the intestine and
bleeding.
Please be assured that these complications are rare (less
than 1 in 1000 procedures), but may require urgent treatment
and even an operation.
The most serious complication is a hole or tear in the
lining of the colon (a gastrointestinal perforation).
This is potentially life-threatening and may need immediate
major surgery to repair it.
Please be reassured that this only happens in less than 1 in
2000 procedures.
Any bleeding during the procedure can be treated at the
time, by injecting a drug into the blood vessels to make
them close up, or by applying an electrical current directly
onto the blood vessels to make them close up.
As with any procedure involving sedation, other
complications would include cardiopulmonary complications
such as temporary drop in blood pressure and oxygen
saturation, usually the result of overmedication and easily
reversed.
In rare cases, more serious cardiopulmonary events such as a
heart attack, stroke, or even death may occur;
these are extremely rare except in critically ill patients
with multiple risk factors.
It is very important that you inform (contact number below)
us if you have any severe pain, black tarry stools or
persistent bleeding in the hours or days after your
colonoscopy.
After a colonoscopy there can be an increased risk of this
happening.
If you are worried about these risks, please speak to your
consultant or one of the team before you sign
your consent form.
Alternatives
A barium enema or a special CT scan to look at the bowel may
sometimes be performed.
This means putting white x-ray fluid into your bowel and/or
air through a tube placed in your back passage,
then by inflating your bowel with air,
it allows pictures to be taken
This procedure is not as effective as colonoscopy and cannot
allow treatment to be undertaken at that time.
Therefore, you may have to undergo a colonoscopy
at a later date.
Patients who have polyps removed should be aware of the very
slight chance of some bleeding from the back passage.
If this occurs at the hospital the doctor or nurse will see
you and give advice.
If however you have left the hospital it will need to be
treated in either of the following ways:
For a very small amount of fresh bright red blood, take no
immediate action.
For a sudden passing of a large amount of fresh bright red
blood or severe pain, which is worse when coughing, Contact
your GP or go directly to the Emergency Department.
We hope that by giving you this advice before undergoing the
procedure you will feel more confident about knowing what to
do in the unlikely event of a complication occurring.
We would like to reassure you that this would
be a very rare occurrence.
What should I expect?
On arrival at the unit a receptionist will check your
details.
You will be asked some questions about your general health,
the medicines you are taking and any allergies you may have.
The doctor or nurse will then explain the procedure, and ask
you to sign a consent form
(if you already haven't signed one).
If you have any questions or worries at this point please do
not be afraid to raise them.
Please tell the doctor or nurse if you have had any other
endoscopy examinations or any allergies or bad reactions to
medication.
A nurse will then take you to the changing rooms where you
will be asked to put on a hospital gown (it is useful to
bring your own dressing gown and slippers).
Once you have changed you will be asked to wait in a pre-
procedure room.
Before the procedure a small needle will be inserted into
the back of your hand to enable us to give you sedation and
painkillers.
You will be made as comfortable as possible on a trolley,
lying on your left side with your knees bent up.
After sedation, the tube will be gently inserted into your
back passage.
Air will be passed through it to inflate the bowel.
This will allow clearer views of the lining of the bowel.
It may cause you a little discomfort and abdominal cramping,
but it will not last too long.
You may get the sensation of wanting to go to the toilet,
but as your bowel is empty there is no danger of this
happening.
You may pass some wind, but please do not feel embarrassed -
it is only the air that is being passed.
The procedure may take 15 - 60 minutes.
Please expect to remain in the unit for up to 3 hours.
Sometimes we may have to attend emergencies who must take
priority.
You may wish to bring a newspaper or book with you to read.
When do I get the results?
We will usually give you the results after the procedure.
However, if you have had biopsies taken or polyps removed,
these will have to go to the laboratory
for further examination.
In this instance you may be asked to attend another
outpatient appointment or we may write to you with the
results.
Discharge information and at home advice
Please be reassured that you are unlikely to have any
serious side-effects.
However if you are worried or experience any problems which
are not mentioned, please do not hesitate to contact
the Endoscopy Unit.
If it is after 7.00pm, contact your GP out of hours service
or the Emergency Department for advice.
For the first 24 hours after your procedure The sedative drugs remain in your body for
24 hours and during this time
are gradually excreted from the body.
Therefore there are certain things that you should and
should not do.
You should:
Ensure that a responsible adult stays at home with you for
24 hours.
Rest quietly at home for the rest of the day, go to bed or
lie on the settee.
Drink plenty of fluids, but not too much tea or coffee.
Eat a light diet eg. soup or sandwiches.
Avoid greasy or heavy food as this may cause you to feel
sick.
Lie flat if you feel faint or dizzy.
Contact your GP if you have not passed urine 12 hours after
your procedure.
For at least 24 hours after your procedure you must not:
Drive.
Your insurance company may refuse to meet a claim if they
feel you have driven too soon.
Go back to work.
Operate any domestic appliances or machinery.
Drink alcohol.
Make any important decisions or sign any important documents.
Be responsible for looking after small children.
If you have any queries, or require further information
please contact the Endoscopy Unit