Questions about Colonoscopy
What is the colonoscopy?
Colonoscopy is called as the eye examination of the rectum, sigmoid colon, inpatient colon, splenic flexura, transfer colon, hepatic flexura, resulting colon, check, and appendix orifice and the last part of the small bowel (ileum) starting from the anus, i.e. the last part of the large bowel, respectively, with the videoendoscopic device. The process is completed when the same distance is carefully monitored backwards and exits the anus.
Pathologies seen during colonoscopy can be sampled from cancer focal or polyps. Lesions that can cause bleeding can be destroyed by burning thanks to different apparatus that can be passed through the ducts inside the colonoscopy. Polyps can be completely removed depending on their size.
Is Colonoscopy a Painful Procedure?
Nowadays, there is no pain when patients are put to sleep by a method called sedoanalgesia.
After the procedure, it is effective to use CO2 gas to inflate the bowels in order to reduce gas pain. Because carbon dioxide gas is easily released into the blood line through the lungs, when the patient wakes up, it leaves the bowels.
Does Virtual Colonoscopy or Capsule Colonoscopy Replace Traditional Colonoscopy?
No. Because in both virtual colonoscopy and capsule endoscopy, operations can not be performed such as taking polyps, taking biopsies, stopping bleeding from bleeding a bleeding focus. For this reason, both the virtual colonoscopy and the capsule endoscopy should only be preferred for screening purposes or in the presence of situations that prevent traditional colonoscopy.
Who and Why Is Colonoscopy Performed?
- For investigating abdominal pain
- In male patients of all ages with iron deficiency anemia
- In post-menopausal women with iron deficiency anemia
- For investigating chronic constipation
- For investigating chronic diarrhea
- In people whose recent defecation habits have changed markedly (constipated diarrhea while constipated, constipated ones, those with a constipated diarrhea alternately)
- For investigating the cause of blood sight in feces
- For investigating the cause of bloody diarrhea
- In purpose of the cancer screening in males and females who are 50, 60, and 70 years old, even if they do not have any complaints
- Family members under the age of 50 who have bowel cancer should be screened for cancer ten years before the age of the source case
The mistakes usually made for colonoscopy is that I have no complaints about my intestines. Treatments can be fully beneficial when diagnosed when a complaint has not yet occurred. For instance, leading lesions such as the colon polyps can be found and removed before the colon cancer occurs. Thus, a possible cancer is prevented before it ever occurs. Therefore, it is important to know the reasons for colonoscopy for screening purposes.
Why Is Bowel Cleansing Important Before Colonoscopy?
Intestinal cleansing is the most important point for optimal colonoscopy. In a clean intestine, if the patient does not have a family history of colon cancer with a examination until ileum, the need for colonoscopy will be removed for about 10 years in general after a clean colonoscopy. In a dirty intestine, small polyps, angiodysplasia, which may be the focus of bleeding, can be overlooked.
What are the considerations in preparation for colonoscopy?
Summary of the preparation
Intestinal preparation applications may vary from center to center. We prohibit the taking of food that has been bitten and consumed in our own patients for the last day and a half. We’re only wanting patients to consume transparent, non-colored liquids that can be only drank. Liquid-heavy dietary processing is free until the last six hours remain. In the last six hours, we want that the patient do not take anything from the mouth to prevent the risk of aspiration in terms of anesthesia (sedoanalgesia) especially in people who will be put to sleep by colonoscopy procedure. If liquid foods consumed close to the procedure did not leave the stomach and the patient vomits during the procedure, it cannot prevent the escape of vomit fluid to the lungs and may cause aspiration pneumonia in this person. This is why nothing has been taken out of the mouth for the last six hours.
HOW TO MAKE PREPARATION AND CLEANING FOR THE COLONOSCOPY?
In patients undergoing colonoscopy due to diarrhea, intestinal preparation may be kept shorter in time to be performed the next day. For constipated people, it can be extended up to two days for complete cleaning
If the patient is over 60 years of age and has additional accompanying problems such as diabetes and kidney disease, the drug options to be used will change. In addition, there are antiflatulent syrups used to prevent bowel gases from making bubbles on the surface. Your doctor will decide which laxative drug to use.
You should not consume any food that you can bite with your mouth during the whole preparation. On the other hand, you should only consume plenty of any liquid food you can drink and love. These include tea, soup, juice, pleasant, mineral water, buttermilk, milk, and grainless soups. Liquid foods can continue to be consumed until 2 hours before colonoscopy. Thus, the patient should be prevented from being hungry or dehydrated.
WHAT SHOULD BE OR NOT IN THE COLONOSCOPY DIET?
- There should be no greens and fibrous foods.
- These colorless (especially red and purple ones are prohibited) liquids should be consumed without pulp.
- It can be weak tea, broth, juice, soups, coffee, soda, sports drinks, and regular water.
DO YOU NEED TO MAKE CHANGES TO THE DRUGS YOU USE?
You should inform your doctor about other medications you use prior to colonoscopy preparation. Your doctor may temporarily cut some of these or ask you to continue.
- Your doctor may cut the diabetes medications to prevent occurring hypoglycemia during the preparation.
- Hypertension medications can be taken with close blood pressure monitoring.
- Blood-chirping drugs are decided according to the patient’s clinic. In some cases, the doctor who is the basis for discontinuation of these drugs is inconvenient and they are cut off if they say they can be discontinued. Sometimes it is not approved to be discontinued. In this case, the drugs are continued. However, since there may be a risk of bleeding in interventional processes, they can sometimes be replaced with short-acting effect low molecular weight heparins.
- Aspirin, painkillers, and iron pills should be cut if possible. Small redness and aphthous ulcers can cause diagnostic difficulties on the bowel surfaces.
HOW LONG WILL THE COLONOSCOPY TAKE?
It takes about 10 minutes to monitor a diagnostic colonoscopy to see the last 15 cm of the ileum. The procedure may be long due to the cohesion in the intestines of the patient, previously intra-western operation and obesity.
In addition, interventional procedures such as polypectomy, EMR, argon plasma coagulation, and metal clip application extend the processing time.
Also lack of good bowel cleansing and inflating the intestines with chamber gas instead of carbon dioxide in the process will be factors that prolong the process.
WHAT ARE THE CONSIDERATIONS AFTER COLONOSCOPY?
If carbon dioxide gas is used during colonoscopy, the carbon dioxide gas supplied to the intestines passes into the blood and is released through the lung until the patient wakes up. In this way, the patient will not have a gas distention that will cause pain in the intestines. On the other hand, in cases where colonoscopy is performed using room air, there may be some gas pain in these people as room gas cannot be easily removed from the intestines if there is a condition with an increase in spasm, such as irritable bowel syndrome. If there are no complications in the procedure, gas jamming or bloating based on gas gradually decreases and disappears within the first 1 hour. However, if the patient has a rare abdominal pain and gas pain, you should see the doctor who is doing the procedure. The risk of perforation, albeit low, should be kept in mind. Small perforations are also closed by colonoscopy with metal clips or similar metal clip apparatuses. If these are not enough, the opening is closed with surgical intervention.
PRICES OF COLONOSCOPY
The difference prices for colonoscopy in private hospitals and examinations can vary between 500 – 3000 TL.
WHEN SHOULD PEOPLE HAD COLONOSCOPY HAVE THE NEXT COLONOSCOPY?
For patients without a risk factor, it should be every 10 years. For patients who have a family history, it should be every 5 years. For patients who have a polyp, it should be between 2 to 3 years based on type of polyp.
WHAT ARE THE DAMAGES AND RISKS OF COLONOSCOPY?
There is a perforation risk in colonoscopy that is fewer than 1/5000. However, this risk may be higher in colonoscopy performed in the form of severe acute colitis, taking large polyps in interventional processes. Other than that, there is no special harm or risk of colonoscopy. Sedoanalgesia is a procedure followed by anesthesia department comb, but it is performed safely in patients who do not have additional problems (such as heart disease, COPD).
IMPORTANCE OF CARBON DIOXIDE USE IN COLONOSCOPY PROCEDURES
In conventional methods, the colonoscopy device provides the vision by inflating the intestines with normal chamber gas. As it is known, room gas consists of oxygen and nitrogen gas. In some cases, gas pain can cause distress to both the patient and the doctor after the procedure is finished. In some patients with low pain thresholds, sometimes these gases may need to be removed and be aspired by performing colonoscopy again.
If carbon dioxide is inflated by giving carbon dioxide gas into the intestine during colonoscopy in centers with carbon dioxide inflator, carbon dioxide gas can pass through all membranes very easily, so it is quickly removed from the lungs during and after the procedure. Thus, even when the patient wakes up from sedation yet, he is free of intestinal gases. Thus, the use of carbon dioxide gas saves the patient both comfort and time because the doctor does not have to take the gases.