What is a Colonoscopy?Colon
A Colonoscopy (lower endoscopy) is an examination of the lining of your large intestine (colon) via insertion of an endoscope (small diameter, flexible tube) into the anus and through the colon .   Abnormalities suspected by x-ray can be confirmed and others may be detected which are too small to be seen on x-ray.  If the doctor sees a suspicious area, he can pass an instrument through the endoscope and take a small piece of tissue (a biopsy) for more thorough examination in the laboratory.  Biopsies are taken for many reasons and do not necessarily imply cancer.  Polyps are abnormal, usually benign, growths of tissue which vary in size from a tiny dot to several inches.  Since polyps can turn cancerous with time or bleed, they are usually removed during colonoscopy using a small  wire loop or snare.

Do I really need a colonoscopy?
Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine.  It's greatest impact is primarily in its contribution to the control of colon cancer by polyp removal.  Before colonoscopy became available, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant.  Now, most polyps can be removed easily and safely without surgery.  Periodic colonoscopy is a valuable tool for follow-up of patients with previous polyps, colon cancer, or a family history of colon cancer.  It is also used to detect other chronic diseases of the colon, such as diverticulitis and diverticulosis, colitis and irritable bowel syndrome. 

What preparation is required?
A proper bowel prep is extremely important for this examination.  You make take either the Fleets Phospho-soda Prep, Loso Prep, or the Visicol Prep.

What should I expect during the procedure?
Your doctor will give you medication through a vein to make you relaxed and sleepy.  Please advise Dr. Hasan prior to the procedure if you are allergic to any medications.  While you are lying on your left side, the endoscope is inserted into the rectum and guided through the colon.    It is necessary to use some air to aid him in the examination.  This may cause you to feel distended and full.  If you have the urge to pass this air, it is permissible unless the doctor requests otherwise.  The large intestine is quite twisted and tortuous.  As the endoscope passes around some of these turns it may cause a cramping or tugging sensation.  This is usually relieved when the instrument is straightened.  The examination usually takes from 15 to 30 minutes to complete. 

What happens after the test?
You will be kept in the endoscopy area until most of the effects of the medication have worn off.  You will be asked to rest and try to pass the air which was introduced while examining the colon.  Unless otherwise instructed, you will be able to resume your regular diet after the colonoscopy.  You will be given appropriate discharge instructions and learning material before you go home.  You should make arrangements in advance to have someone stay at your home with you for the day.

Are there any complications from colonoscopy?
Colonoscopy and polypectomy is safe and is associated with very low risk when performed by physicians who have been specially trained in endoscopy procedures.  There is some risk to this procedure as there is to any other invasive procedure. Bleeding may occur from the site of biopsy or polyp removal.  It is usually minimal and stops on its own or can be controlled by cauterization through the colonoscope. Rarely, transfusions or surgery may be required.  A perforation (tear through the wall of the bowel) can infrequently occur.  This complication usually requires surgery but may be managed with antibiotics and intravenous fluids in some cases. Localized irritation of the vein may occur at the site of medication injection.  A tender lump develops which may remain several weeks to months but goes away eventually.  Other risks include drug reactions and complications from unrelated diseases such as heart attack or stroke.

When will I know what my test showed?
Dr. Hasan will talk to you or the person accompanying your before you leave the endoscopy department and  preliminary results can usually be given to you at that time.  If a biopsy or polypectomy  was done, the results will not be received from the laboratory for 3 to 4 days. 


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