Recommended follow-up interval for repeat colonoscopy of at least 10 years documented in colonoscopy report (End/Polyp)
CPT4 code
Name of the Procedure:
Colonoscopy (Colon Examination, Endoscopy of the large intestine)
Summary
A colonoscopy is a procedure in which a long, flexible tube with a camera on the end (colonoscope) is inserted into the rectum to inspect the inner lining of the large intestine (colon). The procedure is used to detect changes or abnormalities, such as polyps, in the colon and rectum.
Purpose
A colonoscopy is performed to screen for colorectal cancer, diagnose the causes of unexplained changes in bowel habits, and to evaluate symptoms such as abdominal pain, rectal bleeding, and chronic diarrhea or constipation. The goal is to detect and remove polyps and other abnormal growths to prevent colorectal cancer.
Indications
- Individuals aged 50 and older for routine screening
- Family history of colorectal cancer or polyps
- Presence of inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis)
- Symptoms such as rectal bleeding, persistent abdominal pain, and unexplained weight loss
Preparation
- Fasting: Patients must not consume solid food and should drink only clear fluids 24 hours before the procedure.
- Bowel preparation: A prescribed laxative is taken to cleanse the bowel.
- Medications: Some medications may need to be adjusted or temporarily stopped.
Procedure Description
- The patient lies on their side on an examination table.
- Sedation is administered intravenously to relax the patient and reduce discomfort.
- The colonoscope is gently inserted into the rectum and guided through the colon.
- The camera transmits images to a monitor, allowing the doctor to examine the colon's lining.
- If polyps or other abnormalities are found, they can be removed or biopsied using specialized instruments passed through the colonoscope.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
Colonoscopy procedures are usually performed in hospitals, outpatient clinics, or specialized endoscopy centers.
Personnel
The procedure is carried out by a gastroenterologist or a specially trained endoscopist, assisted by nurses and possibly an anesthesiologist.
Risks and Complications
- Common: Mild cramping, bloating, and discomfort.
- Rare but serious: Bleeding, perforation of the colon, adverse reactions to sedation, and infection.
Benefits
- Early detection and removal of polyps can prevent colorectal cancer.
- Accurate diagnosis and evaluation of gastrointestinal symptoms.
- Can lead to targeted treatments and management of bowel diseases.
Recovery
- Patients typically rest in a recovery area for 1 to 2 hours after the procedure.
- Mild cramping or bloating may be experienced for a short period.
- It's advised to avoid heavy lifting or driving for the rest of the day.
- Follow-up appointments will be scheduled as necessary, particularly if polyps or other concerns were found.
Alternatives
- Flexible sigmoidoscopy: examines only the lower part of the colon and may miss abnormalities higher up.
- Fecal occult blood test (FOBT): non-invasive but less accurate in detecting polyps and cancer.
- Virtual colonoscopy (CT colonography): less invasive but involves radiation exposure and may still require a traditional colonoscopy if abnormalities are found.
Patient Experience
- Patients may feel anxious about the preparation and the procedure but are usually sedated to ensure comfort.
- Post-procedure, patients might feel a bit groggy from the sedation and experience minor discomfort.
- Pain management includes instructions to soothe any cramps and proper hydration.