Colonoscopy (ko-lun-AH-skuh-pee) lets a doctor closely look at the inside of the entire colon and rectum. The doctor is looking for polyps which could be early signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope (ko-LAHN-uh-scope). The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly. The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s done. Your doctor decides how often you need this test, usually once every 10 years, unless you are at a higher risk for developing colon cancer. It’s important that you talk with your doctor to understand your risk for colon cancer, the guidelines you should follow for testing, and whether you need to start having the tests at age 50 or earlier.

Most people don’t find these exams painful, although some people have more discomfort than others. Patients are given medicine to make them sleep through a colonoscopy, so they don’t feel anything. Medicine usually isn’t used for a sigmoidoscopy. During both of these tests, air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. The air pressure may cause some discomfort and cramping. As with most medical tests, complications are possible with both of these tests. Some can be serious – for instance, bleeding and puncture of the colon – but they’re very uncommon. Make sure you understand how these tests work, how you can expect to feel during and after the test, and how to watch for possible problems that could come up afterward.

Many people consider the bowel preparation (often called the bowel prep) the worst part of these tests. For the doctor to see your insides clearly and get good pictures, your bowels need to be as cleaned out as possible. You probably will be told to avoid certain foods and medicines and might be put on a clear liquid diet for one or more days before these exams. You will take very strong laxatives and you might also need enemas to clean out your colon. If you can choose a day for your exam, pick one that will make it easy for you to be at home the day or evening before the test, when you do the preparation. You will get instructions from your doctor’s office ahead of time. Read them carefully since you will probably need to buy special supplies (like clear liquids, soups, and gelatin) and get laxatives. If any of the instructions are not clear or you do not understand them, call the doctor’s office and go over them step-by-step with the nurse. This is your chance to discuss any concerns about the bowel prep you might have. Preparing for colonoscopy (or sigmoidoscopy) makes you to go the bathroom a lot! As soon as you take the laxatives, you’ll need to stay close to a bathroom. They usually start working pretty quickly. They might still be working the next morning when you go for your colonoscopy appointment. Don’t be embarrassed to ask for a bathroom when you get there. People have to ask this all the time and the staff is used to it.

Most people feel OK after a colonoscopy. You could feel a bit woozy from the drugs (anesthesia). You’ll be watched as you wake up. You might have some gas because of the air that was pumped into the bowel, which can cause cramping and discomfort. Because of the medicines given for the test, you will need someone to take you home. Because colonoscopy is usually done with drugs that make you sleepy, most people miss work the day of the test.

YES.. You will be sleepy, uncomfortable, nauseated, or simply not yourself for several hours after your colonoscopy. In addition, your reflexes will be poor as a result of the sedatives that will be given to you. For this reason, you will not be able to drive (or operate heavy machinery) and you will need someone to accompany you and make sure that you get home safely.

If a small polyp is found, your doctor will probably remove it during the test. Over time some polyps could become cancer. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy (by-op-see) will be done. For the biopsy, part or all of the polyp or abnormal area is taken out through the colonoscope or sigmoidoscope. It’s sent to a lab for a doctor to look at under a microscope and check for cancer or pre-cancer cells. If a polyp or colorectal cancer is found during sigmoidoscopy, you will need to have a colonoscopy later to check for polyps or cancer in the rest of your colon.

Colorectal cancer screening helps people stay well and saves lives. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer or finding it early, when it’s easier to treat. There are 2 basic types of screening tests:
-Tests that mainly find cancer: These involve testing the stool (feces) for signs that cancer may be present. These tests are easier, but they are also less likely to detect polyps.
-Tests that can find both colorectal polyps and cancer: These tests look at the structure of the colon itself to find any abnormal areas. Colonoscopy and sigmoidoscopy fall in this group, along with double-contrast barium enema and CT colonography (virtual colonoscopy). These tests are preferred if they are available and you are willing to have them. Removing polyps can help prevent colorectal cancer from ever starting. And cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive 5 years later. And many will live a normal life span. But all too often people don’t get any of these screening tests. Then the cancer can grow and spread without being noticed. Early on, colorectal cancer doesn’t usually cause any changes that are noticed (symptoms). In most cases, by the time people do have symptoms the cancer is advanced and very hard to treat. Regular screening is the most reliable way to find these cancers in the early stages. Ask a doctor about the best screening plan for you.

The gastroenterologist who performed your colonoscopy will meet with you while you are resting in the recovery room. You may not remember this meeting, most people don't, due to side-effects from the sedatives that will be given to you, so you will be given the option of scheduling a follow up visit at the time of discharge.

You will be given a hard copy of the preliminary results at the time of discharge. However, it will take about one to two weeks to receive the results of any polyp biopsies or removals, if any.

The cleaner the colon, the clearer the colonoscopy.
Before your colonoscopy, you’ll need to take a colonoscopy prep at home starting the day before, or as directed by your healthcare provider.
A colonoscopy prep, is a prescription medication that cleans out your digestive tract. In other words, it causes episodes of diarrhea over several hours so that the colon is empty at the time of your colonoscopy and the healthcare provider can see the lining of the colon clearly.
A successful colonoscopy starts with a proper colonoscopy prep. That’s why it’s so important to follow instructions and do the prep properly. If you arrive for your colonoscopy with a dirty colon, your healthcare provider may have difficulty seeing if there are signs of cancer. Your healthcare provider may not even be able ro complete the colonoscopy. So to improve the likelihood of a successful colonoscopy, prep properly. Remember to follow your healthcare provider’s instructions, hydrate before you start your prep, stick to clear liquid diet, and finish your prep completely.

A clear liquid diet consists of clear liquids — such as water, broth and plain gelatin — that are easily digested and leave no undigested residue in your intestinal tract. Your doctor may prescribe a clear liquid diet before certain medical procedures or if you have certain digestive problems. Because a clear liquid diet can't provide you with adequate calories and nutrients, it shouldn't be continued for more than a few days.

Clear liquids and foods may be light-colored so long as you are able to see through them. Foods can be considered liquid if they are even partly liquid at room temperature. You can't eat solid food while on a clear liquid diet.

Purpose: A clear liquid diet is often used before tests, procedures or surgeries that require no food in your stomach or intestines, such as before colonoscopy. It may also be recommended as a short-term diet if you have certain digestive problems, such as nausea, vomiting or diarrhea, or after certain types of surgery. Diet details.

A clear liquid diet helps maintain adequate hydration, provides some important electrolytes, such as sodium and potassium, and gives some energy at a time when a full diet isn't possible or recommended.

The following foods are allowed in a clear liquid diet:
- Water (plain, carbonated or flavored)
- Fruit juices without pulp, such as apple or white grape
- Fruit-flavored beverages, such as fruit punch or lemonade
- Carbonated drinks, including dark sodas (cola and root beer)
- Gelatin (no red or purple coloring)
- Tea or coffee without milk or cream
- Strained tomato or vegetable juice
- Sports drinks
- Clear, fat-free broth (bouillon or consomme)
- Honey or sugar
- Hard candy, such as lemon drops or peppermint rounds
- Ice pops without milk, bits of fruit, seeds or nuts

Any foods not on the above list should be avoided.

Clear liquids include water, plain broth and gelatin. Black coffee is a considered a clear liquid, but coffee with cream or milk is not. Liquids such as milk and orange juice are not clear liquids. Additionally, please remember that you should not drink anything red, as this can be confused with blood.

Our first concern is your health and safety. You will be given sedatives to help you relax during your colonoscopy, and these medications affect your body’s ability to hold food and liquid in your stomach. If you eat or drink on the day of your colonoscopy, there is a risk that food or liquid will travel up into your esophagus, where you could breathe it into your lungs. This can cause pneumonia and leadto life-threatening complications.
If you eat or drink anything on the day of your colonoscopy, your colonoscopy will be rescheduled. On the day of your colonoscopy, you should only drink the last few glasses of laxative preparation and a small sip of water with approved medications.

Yes. Generally this will not be a problem, and if we remove a polyp then we will ask you not to take aspirin or NSAIDs for one week.

Yes, but stop taking the vitamins right away.

You should check with the doctor who prescribed the Coumadin about how far in advance you should stop taking Coumadin prior to a colonoscopy. For most procedures you can still come in as scheduled, but should realize that under certain circumstances you might be at increased risk for bleeding.

Yes. You should take all hypertension and cardiac medications at your usual times with a sip of water.

The procedure you will have will be performed by a (1) Gastroenterologist (2) At a separate medical facility. (3) Anesthesia will be administered by an anesthesiologist. (4) Pathology slides will be read by a pathologist. You can expect to receive separate bills from each of the following:
1. Physician: Gastroenterologist who performed your colonoscopy. Bill from the Physician (Gastroenterology Center): When you have a procedure, the physician bills for the professional fee. The physician bill will include the basic procedure and any additional procedures which may be required such as: dilation, polypectomy or biopsy. Due to many variables during the procedure, a definite cost cannot be determined until the physician has completed the procedure. The total cost incurred may be obtained from the physician’s office after the procedure is completed. Co-pays and deductibles are to be paid prior to the procedure being scheduled. Please note that if you have been scheduled for screening colonoscopy and the physician finds a polyp or tissue that has to be removed during the procedure, this colonoscopy is NO longer considered a screening procedure, it is considered a surgical (diagnostic) procedure and will be coded and billed to your insurance company as such. If so, more likely your insurance benefits will change accordingly. Please check with your insurance company prior to starting your procedure preparation. In performing procedures, our physician is practicing the standard of care which we believe best serves your needs. Medicare and/or your insurance company may not accept the same standards and indications for a certain procedure and therefore may deny payment for your procedure.
2. Medical facility (hospital or outpatient surgery center). Bill from the Medical Facility: You are scheduled to have your procedure performed in a medical facility. You will have a charge from this facility. This is a separate bill from the physician’s charges. Please check with the assigned medical facility in advance for more information and to learn about their policy.
3. Anesthesiologist (if used). Bill for the Anesthesia (if used): An anesthesiologist that has been chosen by the medical facility will administer the anesthesia. You will receive a separate bill from the anesthesiologist. Please check with the medical facility for more information about the anesthesia.
4. Pathologist (if specimens taken). Bill for the Pathology (if specimens taken): A pathologist that has been chosen by the medical facility will read the specimen slides. You will receive a separate bill from the pathologist. Please check with the medical facility for more information.