Name of the Procedure:

Colonoscopy, Flexible; with Biopsy, Single or Multiple

Summary

A colonoscopy is a medical procedure in which a long, flexible tube with a camera (colonoscope) is inserted into the rectum to examine the inner lining of the colon. During this procedure, the doctor may take tissue samples (biopsies) for further analysis.

Purpose

The procedure is used to investigate symptoms such as abdominal pain, rectal bleeding, or changes in bowel habits. It helps in diagnosing conditions like colorectal cancer, polyps, inflammatory bowel disease (IBD), and other abnormalities. The goals are to identify potential problems early and determine appropriate treatment.

Indications

• Chronic diarrhea or constipation
• Unexplained abdominal pain
• Rectal bleeding
• Positive fecal occult blood test
• Personal or family history of colorectal cancer or polyps
• Follow-up on previous abnormal findings

Preparation

• Patients typically must follow a special diet for 1-3 days before the procedure.
• They will take a prescribed bowel-cleaning agent the day before to clear out the colon.
• Fasting is required from midnight before the procedure.
• Any blood-thinning medications may need to be adjusted in consultation with a doctor.
• Pre-procedure diagnostic tests may include blood tests and physical examinations.

Procedure Description

1. The patient is given a sedative for comfort.
2. The patient lies on their side on an examination table.
3. The colonoscope is gently inserted into the rectum and guided through the entire colon.
4. The camera on the colonoscope sends images to a monitor, allowing the doctor to examine the colon's lining.
5. If needed, tissue samples (biopsies) are taken using special tools through the colonoscope.
6. Any polyps found may also be removed during the procedure.

Duration

The procedure typically takes about 30-60 minutes.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Gastroenterologist or colorectal surgeon
• Nursing staff
• Anesthesiologist or sedation nurse (if sedation is used)

Risks and Complications

• Mild cramping or bloating after the procedure
• Adverse reactions to sedation
• Bleeding, especially if a biopsy or polyp removal is performed
• Rare risks include perforation of the colon and infection

Benefits

• Early detection of colorectal cancer and polyps
• Accurate diagnosis of intestinal issues
• Immediate removal of polyps, reducing cancer risk
• Improved treatment plans based on biopsy results

Recovery

• The patient will be monitored until the effects of the sedative wear off.
• Someone will need to drive the patient home, as they cannot drive themselves.
• Mild discomfort, such as bloating or gas, may be experienced.
• Patients can usually resume their normal diet the same day.
• Any specific post-procedure instructions will be provided by the doctor.
• Follow-up appointments might be necessary to discuss biopsy results.

Alternatives

• Sigmoidoscopy: Examines only the lower part of the colon
• Virtual colonoscopy (CT colonography): Non-invasive imaging technique
• Stool tests (e.g., fecal occult blood test, FIT, Cologuard): Non-invasive but less comprehensive

Comparatively, colonoscopy is more invasive but offers direct visualization and the opportunity to perform biopsies and remove polyps.

Patient Experience

• Patients may feel drowsy or groggy due to sedation.
• Some cramping or bloating may occur but usually subsides quickly.
• Pain management includes the use of sedatives and, if necessary, mild pain relievers post-procedure.
• Overall, many patients report minimal discomfort and appreciate the clarity this diagnostic test provides.