Colonoscopy

What is a colonoscopy

• A colonoscopy is a procedure that looks at the inner lining of a person’s large intestine also known as the colon. 
• It is a screening tool to look for polyps (tiny fast growing cells that can become cancer) or cancer in the colon or rectum     
• Removing polyps or finding cancer at an early stage increases your chance at a full recovery
• Can also evaluate for inflammation, or help evaluate causes of bleeding or changes in bowel habits.

When do I need a colonoscopy?

• Most people should begin screenings at age 45 
• People with a strong family history or other
   medical conditions may need one sooner 
• If you have had precancerous polyps in the past, you will be recommended to have your next colonoscopy sooner to remove these before they become cancer.

What to expect

• Your surgeon will meet with you prior to your procedure and discuss any concerns you may have
•  Following your procedure your surgeon will give you a copy of your report, and discuss any important findings.
• If anything was removed or biopsied, it will take 2-4 days for the pathologist to evaluate this under the microscope and give a final diagnosis. Someone will call you and/or send a letter to you and your primary physician regarding the findings and follow-up plans

Common Findings

• Polyps. Often precancerous (adenomas). These are often completely removed during your colonoscopy, but if your colon makes polyps, you will likely continue to do so. It is recommended to have colonoscopies more often to remove these polyps before they become cancer. Your surgeon will tell you when you need your next colonoscopy depending on the number, size, and pathology of your polyps. This is sometimes not known until your pathology returns.
• Diverticulosis. This is a common finding. These are areas of weakness in the colon wall; leading to “outpouchings” in the colon wall. Most common on the left side (sigmoid) colon. Often these do not cause symptoms, but they can bleed, become inflamed, or even perforate. We recommend a high fiber diet or fiber supplement and plenty of water to help prevent complications of your diverticula.
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• Hemorrhoids. These are very common, but unlikely to cause any significant issues other than pain/blood with bowel movements. Typically caused by straining with bowel movements. We recommend a fiber supplement, increased water intake and stool softeners if needed for soft, formed stools. Avoid straining with bowel movements. Sitz baths will help to decrease swelling. There are surgical options if these remain uncontrolled despite conservative measures. Please see page for more information and follow up if needed.

Cancer. If you are found to have cancer on your colonoscopy you will be recommended for “staging”. This will involve CT imaging, bloodwork for tumor markers and follow up with your surgeon to discuss surgical treatment, or other treatments if needed. Please see colon removal page

Preparing for a colonoscopy

• A successful colonoscopy requires an
  adequate preparation of the large bowel
  that facilitates clear visualization of the
  mucosal surface

The day before the procedure

• DO NOT EAT ANY SOLID FOOD OR MILK PRODUCTS FOR THE ENTIRE DAY. You may have clear liquids (see clear liquid diet list). You will remain on clear liquids ONLY until after the procedure. 
• Refrain from alcohol for 24 hours prior to procedure
• 1pm the day prior to procedure take 4 Dulcolax tablets with 8 oz of water. This is a laxative and may cause diarrhea. Please remain close to home or a bathroom.
• 3pm mix one of the 32 oz bottles of Gatorade or Powerade with approximately half of the bottle of Miralax Drink the entire mixture within a 2 hour time period. 
• 5pm drink the other 32 oz bottle of Gatorade or Powerade with the rest of the Miralax added to it. Again, drink the entire mixture within a 2 hour time period. 
• It is important to complete the entire prep for your colonoscopy as it provides optimal visualization of your colon.
• You can continue clear liquids for the rest of the evening but nothing after midnight.

Important note

• You may take Tylenol/acetaminophen as needed
• You must be off coumadin or Plavix for 5 days prior to procedure
• You must be off phentermine for 7 days prior to procedure
• Check with your prior care provider or cardiologist on when to resume these medications
• You must have a driver for this procedure. If you choose to drive within 24 hours after your procedure, you will be considered under the influence and law enforcement will be notified.