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Colonoscopy


Overview

Colonoscopy

A colonoscopy (koe-lun- OS-kuh- pee) is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum.

During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.

If necessary, polyps or other types of abnormal tissue can be removed through the scope during a colonoscopy. Tissue samples (biopsies) can be taken during a colonoscopy as well.

Why it's done

Your doctor may recommend a colonoscopy to:

  • Investigate intestinal signs and symptoms. A colonoscopy can help your doctor explore possible causes of abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea and other intestinal problems.
  • Screen for colon cancer. If you're age 50 or older and at average risk of colon cancer — you have no colon cancer risk factors other than age — your doctor may recommend a colonoscopy every 10 years or sometimes sooner to screen for colon cancer. Colonoscopy is one option for colon cancer screening. Talk with your doctor about your options.
  • Look for more polyps. If you have had polyps before, your doctor may recommend a follow-up colonoscopy to look for and remove any additional polyps. This is done to reduce your risk of colon cancer.

How you prepare

Before a colonoscopy, you'll need to clean out (empty) your colon. Any residue in your colon may obscure the view of your colon and rectum during the exam.

To empty your colon, your doctor may ask you to:

  • Follow a special diet the day before the exam. Typically, you won't be able to eat solid food the day before the exam. Drinks may be limited to clear liquids — plain water, tea and coffee without milk or cream, broth, and carbonated beverages. Avoid red liquids, which can be confused with blood during the colonoscopy. You may not be able to eat or drink anything after midnight the night before the exam.
  • Take a laxative. Your doctor may suggest taking a laxative, in either pill form or liquid form. You may be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure.
  • Use an enema kit. In some cases, you may need to use an over-the- counter enema kit — either the night before the exam or a few hours before the exam — to empty your colon.
  • Adjust your medications. Remind your doctor of your medications at least a week before the exam — especially if you have diabetes, high blood pressure or heart problems or if you take medications or supplements that contain iron.

Also tell your doctor if you take aspirin or other medications that thin the blood, such as warfarin (Coumadin); newer anticoagulants, such as dabigatran (Pradaxa) or rivaroxaban (Xarelto), used to reduce risk of blot clots or stroke; or clopidogrel (Plavix).

You may need to adjust your dosages or stop taking the medications temporarily.










Results

Your doctor will review the results of the colonoscopy and then share the results with you.

Negative result

colonoscopy is considered negative if the doctor doesn't find any abnormalities in the colon.

If you're at average risk of colon cancer — you have no colon cancer risk factors other than age — your doctor may recommend waiting 10 years and then repeating the exam if your colon preparation was adequate. If there was residual stool in the colon that prevented complete visualization, your doctor will likely recommend a repeat exam sooner.

Positive result

A colonoscopy is considered positive if the doctor finds any polyps or abnormal tissue in the colon.

Most polyps aren't cancerous, but some can be precancerous. Polyps removed during colonoscopy are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous.

Depending on the size and number of polyps, you may need to follow a more rigorous screening schedule in the future.

If your doctor finds one or two polyps less than 0.4 inch (1 centimeter) in diameter, a repeat colonoscopy in five to 10 years may be adequate, depending on your other risk factors for colon cancer. If you have larger polyps, more polyps or polyps with certain cell characteristics, your doctor may recommend another colonoscopy in three to five years — again, depending on your other risk factors.

If one or more cancerous polyps are removed during your colonoscopy, your doctor may recommend a follow-up colonoscopy in as little as three months, six months or a year. If you have a polyp or other abnormal tissue that couldn't be removed during the colonoscopy, your doctor may recommend a repeat exam with a gastroenterologist who has special expertise in removing large polyps or surgery.

Problems with your exam

If your doctor is concerned about the quality of the view through the scope, he or she may recommend a repeat colonoscopy or a shorter time until your next colonoscopy. If your doctor wasn't able to advance the scope through your entire colon, a barium enema or virtual colonoscopy may be recommended to examine the rest of your colon.