In an endoscopy, the doctor uses a flexible and thin instrument to examine the patient’s upper digestive system, including the esophagus, stomach and duodenum (the upper part of the small intestine). Endoscopy is commonly ordered to evaluate symptoms involving the abdomen or esophagus, including gastroesophageal reflux (GERD, or chronic heartburn) and ulcers. The endoscope uses a light and a camera to transmit images to a video monitor so the doctor can see inside the upper digestive tract. Endoscopy can also be used to perform minor procedures and to take biopsies, tiny samples of abnormal or suspicious-looking tissue that can be evaluated under a microscope. The procedure is performed in the office under sedation.
Colonoscopies are almost always performed in less than 30 minutes. Doctors use them to see inside the rectum and colon, mostly to detect issues like ulcers, inflamed tissue, and abnormal growths. Colonoscopies also help doctors quickly diagnose more serious conditions, including early-onset colorectal cancer, precancerous growths, unexplained changes in regular bowel habits, abdominal pain, weight loss, and rectal bleeding.
These body parts are the large intestine’s most essential components. In fact, both doctors and patients sometimes use the terms “colon” and “large intestine” interchangeably, even though the colon is technically only part of the large bowel (large intestine). Initially, semi-solid waste passes through a person’s small intestine; the waste dries out and collects into a stoll form as it passes through the colon. The rectum, which is normally about six inches long, links the colon and anus, where stool is expelled from the body. Additionally, the rectum has a network of nerves and muscles which control the bowel movement process.
The bowel prep process, which is contained in the doctor’s written pre-colonoscopy instructions, is usually a one to three-day process that’s designed to clear all solids from the colon, as well as any dyed liquids which can impede the detection and diagnosis process. During this period, patients may choose from a wide variety of clear liquids, including:
The night before the procedure, some doctors ask their patients to take a gentle laxative and/or use a mild enema. Many good laxatives or stool softeners are available over-the-counter in either pill or powder format; likewise, an over-the-counter enema typically uses either a water-only or a mild soap solution to softly flush out the anus.
Be sure and tell your doctor about any known medical conditions you have or any vitamins, supplements, or other medications, vitamins, or supplements that you regularly use, including:
Finally, be sure you arrange for a ride home from the doctor’s office, because the mild sedative which the doctor uses needs at least 24 hours to fully wear off
Step One: Large Intestine Examination
During their colonoscopies, patients lie flat on their left sides on the examination table. To help them relax, most doctors use a mild sedative, and possibly some pain relief medication; deeper sedation is sometimes required in some situations. All this time, doctors closely monitor patient vital signs and make every effort to ease any physical or emotional discomfort.
Once the patient is fully relaxed, the doctor uses a specialized colonoscope (a thin, flexible, and lighted tube) to view the rectum’s interior before slowly proceeding to the colon; to expedite this process, the colonoscope slowly releases a gas that expands the large intestine, promoting a better view. The scope has a miniscule, high-resolution camera that wirelessly transmits video in real time to a computer screen, so the doctors can carefully examine all of the intestinal lining. It’s perfectly normal for the doctors to ask that the patients occasionally reposition themselves, to both relieve any discomfort they may feel and facilitate a better visual transmission. After the tip of the scope reaches the small intestine’s opening, the doctors get another view as they slowly remove the scope.
Some colonoscopy side effects include bleeding and intestinal abrasion, but these side effects are quite rare and nearly always mild.
Step Two: Polyp Removal and Biopsy
In the latter part of the colonoscopy, doctors gradually remove any suspicious polyps (growths) and send them to a laboratory for biopsy. Doctors nearly always remove several colon polyps, even from healthy adults, and the growths are usually benign. Since many colorectal cancer cases start with polyps, this stage is very important to the patient’s overall health and well-being.
Doctors quickly and professionally remove this tissue using small tools that are passed through the scope, so most patients experience no additional discomfort and usually do not even notice the difference between the scope and the tools. In the unlikely event that the patient bleeds, doctors intervene with small electrical probes or specialized medication.
Step Three: Recovery
Some slight bloating or cramping is almost inevitable immediately after the colonoscopy and is not a cause for concern. Most patients remain at the clinic for one or two hours so the staff can monitor their recovery progress and the sedative can work its way through their bodies. Nearly everyone can go back to work and resume all other normal activities the following day, provided that they strictly adhere to the discharge instructions.
If you are one of the few patients who develop any of the symptoms below, contact your doctor straightaway:
Most people should have routine colonoscopies after their 50th birthdays, or earlier if there is a family history of certain types of cancer, any personal history of an inflammatory bowel disease, or some other risk factor.