Name of the Procedure:

Colonoscopy through stoma; with biopsy, single or multiple
Common Name: Stoma Colonoscopy with Biopsy

Summary

A colonoscopy through a stoma involves inserting a flexible tube with a camera (colonoscope) into the stoma (an opening on the abdomen connecting to the colon) to inspect the colon. If necessary, tissue samples (biopsies) are taken for further examination.

Purpose

This procedure helps diagnose and monitor conditions affecting the colon, such as inflammatory bowel disease (IBD), cancer, or abnormal growths. The goal is to identify and assess any abnormalities, ensuring proper treatment and management.

Indications

• Presence of blood in the stool
• Persistent abdominal pain or cramping
• Changes in bowel habits
• Unexplained weight loss
• History of colon polyps or cancer
• Monitoring and follow-up for patients with IBD

Preparation

• Fasting for a specified period before the procedure
• Bowel preparation with laxatives
• Adjusting medications as advised (e.g., blood thinners)
• Undergoing pre-procedure assessments such as blood tests

Procedure Description

1. The patient is positioned comfortably, often lying on their side.
2. Sedation or anesthesia is administered to ensure comfort.
3. The colonoscope is gently inserted through the stoma.
4. The colonoscope transmits images to a monitor, allowing the doctor to examine the colon's lining.
5. Biopsies are taken using special instruments if any abnormalities are found.
6. The colonoscope is carefully withdrawn, and the biopsy samples are sent to a lab for analysis.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

It is performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Gastroenterologist or surgeon
• Nurses
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Bleeding, especially if a biopsy is taken
• Perforation of the colon
• Infection
• Adverse reactions to sedatives or anesthesia
• Discomfort or pain at the stoma site

Benefits

• Accurate diagnosis and assessment of colon conditions
• Early detection of colon cancer or polyps
• Targeted treatment planning
• Better management of chronic conditions like IBD
• Improved patient outcomes through ongoing monitoring

Recovery

• Observation for a few hours post-procedure if sedatives are used
• Mild bloating or cramping, which typically resolves quickly
• Follow-up instructions on diet and activity levels
• Results discussed in a follow-up appointment
• Limited activity for 24 hours if sedation was administered

Alternatives

• Virtual colonoscopy (CT colonography)
• Stool tests for blood or abnormal DNA
• Flexible sigmoidoscopy (limited to the lower part of the colon)
• Pros and cons: less invasive but may not detect all abnormalities or allow for biopsies

Patient Experience

• Patients may feel anxious but can expect minimal discomfort due to sedation.
• Mild bloating or cramping during recovery.
• Pain management includes over-the-counter pain relievers if necessary.
• Reassurance and support from healthcare professionals throughout the process.