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colonoscopy
is a type of imaging study in which a doctor uses a particular scope called a
colonoscope to examine the colon's lining.
A doctor may
recommend a colonoscopy to evaluate the colon for cancerous lesions, identify
areas of bleeding, or diagnose other gut-related disorders.
Before the procedure, a
doctor will prescribe a colonoscopy preparation or prep. While different prep
types exist, the aim is always to empty the colon of fecal matter so that a
doctor can view it clearly.
The colonoscopy procedure
involves inserting a thin scope with a light on the end into the rectum. The
doctor will advance the scope through the colon to examine it. They may also
remove samples of tissue for biopsy or remove an outgrowth of tissue known as a
polyp.
In this article, we look at
how to prepare for a colonoscopy appointment and what to expect before, during,
and after the procedure.
How to prepare for a colonoscopy
The week-long preparation
process will include several different steps as the day of the colonoscopy gets
closer.
One
week before
A person must only consume clear liquids in the 24 hours leading up to a colonoscopy.
A doctor is likely to
recommend specific dietary changes in the week leading up to a colonoscopy.
While canned or cooked
vegetables are acceptable to eat, people should avoid the following foods
during this week:
·
grains, including brown rice, oatmeal, and
wheat bread
·
nuts
·
seeds, including poppy or sesame seeds
·
whole kernel corn
·
raw fruits and vegetables
A doctor may also recommend
that people stop taking certain medications that could increase the risk of
bleeding during a colonoscopy. Examples include blood thinners, such as
warfarin and clopidogrel, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
People will need to stop
taking these medicines about 3 to 7 days before the procedure. A person should never
discontinue their medication without a doctor's specific recommendations.
Two
days before
At this point, people
should drink plenty of water or other liquids to ensure that they do not become
dehydrated when they begin their bowel prep. Drinking around eight 8-ounce glasses of water a day can help to reduce
the risk of dehydration.
A doctor may also recommend
avoiding foods that are red or orange at this point, as these could make a
person's colon look like it is bleeding.
24
hours before
It is crucial to consume
only clear liquids in the 24 hours leading up to the colonoscopy.
Examples of acceptable
clear liquids include:
·
clear broth or bouillon
·
coffee or tea, but with no milk or
creamer added
·
electrolyte-containing beverages, such as
sports drinks
·
gelatin
·
popsicles
·
strained fruit juices with no pulp
In general, if it is
possible to see through the food or drink, it should be acceptable within a
clear liquid diet. However, a person should always consult their doctor with
any questions about specific foods.
A doctor will often
prescribe an oral solution to drink to help clean out the colon. This solution
will cause the person to have frequent bowel movements until there is no fecal
matter left in their colon. Examples of oral solutions include GoLytely, Colyte, NuLytely, and TriLyte.
These solutions are likely
to have different dosage methods. Sometimes, a doctor will prescribe drinking
the entire solution the night before the colonoscopy. Other times, they will
recommend drinking one portion of the solution the night before and the
remainder on the day of the examination.
The solution is intended to
make a person go to the bathroom. Their bowel movements will turn into diarrhea.
The bowel prep can
sometimes make a person feel nauseous, bloated, thirsty, or dizzy. If this
occurs, the individual should give themselves a break of at least 30 minutes from drinking the prep and slowly sip on clear
fluids. If they can tolerate returning to drinking the prep, they should.
With a doctor's permission,
it may be possible to add a powdered drink solution that is not red, blue, or
purple to the prep to improve its taste.
During the bowel prep, a
person may benefit from:
·
staying near a bathroom so that they can go
to the toilet easily
·
wearing elasticated pants that are easier to
pull down
·
drinking clear liquids after swallowing the
prep to remove the unpleasant taste
·
applying petroleum jelly around the anal
opening or using baby wipes to reduce irritation to the anus
The bowel movements will
eventually turn clear or yellow. This change signals that a person's colon is
likely to be clear of fecal matter.
In case of problems with constipation, a doctor may also recommend
using a stool softener to make stools easier to pass.
What to expect at a colonoscopy appointment
The doctor and nursing staff will talk through the procedure beforehand with the patient.
By the time of the
colonoscopy appointment, a doctor will expect a person to be passing only clear
to yellow-tinted liquid after following the recommendations for drinking the
colonoscopy prep solution.
The individual's doctor
will explain the procedure. The person will also meet the nursing staff who
will be in the room with them during their colonoscopy, as well as anesthesia
representatives who will be providing sedation. This is a good opportunity for
the person to ask any questions they have regarding the procedure, including
risks and benefits.
A member of the medical
staff will insert an intravenous (IV) catheter into the person's vein so they
can receive medications during the procedure.
The person will then go to
the colonoscopy suite. An anesthesia professional will start giving medication
via the IV, which will cause the person to go to sleep. Most of the time, they
will still be breathing on their own throughout the procedure.
A doctor will insert the
colonoscope through the rectum and advance it to begin the examination. They
will look for irregularities in the colon's lining and, if they find anything
suspicious, such as a polyp, they might take a biopsy or remove it, if
possible.
Ideally, a person's colon
prep will be so effective that a doctor can advance the colonoscope far enough
into the colon to see where the small and large intestines join.
When the doctor has
completed the examination, they will remove the scope. The anesthesia
professional will stop administering medication, and the person will wake up.
It is not unusual to feel
sleepy or groggy after the procedure. For that reason, a person should always
have someone else available to drive them home from the appointment.
Results after a colonoscopy appointment
Following a person's
colonoscopy, a doctor will talk to them about any initial findings. This might
include reviewing images from the colonoscopy.
However, there might be a
wait of several days before the results of the colon biopsy are available. The
doctor should be able to advise the person about how long they might have to
wait.
If a colonoscopy is
positive, meaning cancerous or precancerous cells are present, the doctor may
recommend further interventions. These can include additional colonoscopies or
even surgery.
Risks from a colonoscopy
Colonoscopy risks tend to
be few.
The most serious potential
complication is a tear in the intestine's lining, although this is rare. A tear
can allow the intestine's contents to spill into the abdomen, which is very
dangerous. If a tear occurs, surgery will be necessary to repair the lining.
Other possible risks
include bleeding from a biopsy or polyp removal site. Some people may also
experience adverse reactions to either the colonoscopy prep or the medication
they had during the procedure.
Outlook
While colonoscopy
preparation can be unpleasant, it is a vital process to ensure a successful
examination.
If a doctor cannot see
enough of the colon, they may recommend performing another colonoscopy to
ensure that they have not missed anything. As a result, it is best to stick to
the original preparation plan.
A doctor will make
follow-up recommendations if the colonoscopy shows cancerous tissue to be
present.
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