Why should you get colonoscopy done?

Colonoscopy is indicated for patients who either have gastrointestianal/colon related problems or those who want to prevent colon cancer through early screening and detection.

What is Colon Cancer?

Colon cancer is cancer that occurs in the colon or rectum. Rectum connects the larger bowel to the anus.

How common is this cancer?

It is the second most common cancer.  Generally men and women age 50 and above are candidates for cancer screening.  People who have a relative that had colon cancer or polyps are in the high risk group

 What is screening?

Screening refers to performing colonoscopy to rule out cancer.  It is believed that polyps turn into cancer over a period of time.  Screening tests can find polyps, so they can be removed before they turn into cancer

Even though someone may have polyps or cancer they may not have any symptoms – hence no knowledge that this silent killer is growing inside them.  This is more true in the earlier stages when intervention and life saving are possible.

Is every colonoscopy a “screening colonoscopy”?

No.  Please read the definitions below for further clarification.

Diagnostic/Therapeutic Colonoscopy: Patient has past and/or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemia and/or any other abnormal tests.

Surveillance/High Risk Screening Colonoscopy: Patient is non-symptomatic (no gastrointestinal symptoms either past or present), but, has a personal history of GI disease, personal and/or family history of colon polyps, and/or cancer. Patients in this category are required to undergo colonoscopy surveillance at shortened intervals (e.g., every 2-5 years)

Preventive Colonoscopy Screening Diagnosis: Patient is non-symptomatic (no gastrointestinal symptoms either past or present), over the age of 50, has no personal or family history of GI disease, colon polyps, and/or cancer. The patient has not undergone a colonoscopy within the last 10 years.

What about virtual colonoscopy?

If you are 50 or older it is highly advisable to get colonoscopy done by a gastroenterologist.  This ensures detection, removal and pathology testing of any discovered polyps all in one procedure.

Please talk to your doctor about risk factors, frequency of colonoscopy and other related subjects.

What is Upper GI Endoscopy?

The term refers to looking inside esophagus, commonly known as the swallowing tube, which extends from the mouth to the stomach, whose other end is connected to the beginning of the small intestine also known as the duodenum. The esophagus carries food from the mouth for digestion in the stomach and duodenum.

Your doctor will use an endoscope – a long, thin, flexible tube with a tiny video camera and light on the tip. By adjusting the various controls on the endoscope, the gastroenterologist can safely guide the instrument to carefully examine the inside lining of the upper digestive system.

The high quality picture from the endoscope is shown on a TV monitor; it gives a clear, detailed view. In many cases, upper GI endoscopy is a more precise examination than X-ray studies.

Upper GI endoscopy can be helpful in the evaluation or diagnosis of various problems, including difficult or painful swallowing, pain in the stomach or abdomen, and bleeding, ulcers, and tumors.

 How Do I Prepare for the Procedure?

Important steps you can take to prepare for and participate in the procedure. First, be sure to give your doctor a complete list of all the medicines you are taking and any allergies you have to drugs or other substances.

Your doctor will also want to know if you have heart, lung, or other medical conditions that may need special attention before, during, or after upper GI endoscopy. You will be given instructions in advance that will outline what you should and should not do in preparation for the upper GI endoscopy. Be sure to read and follow these instructions.

A very important step in preparing for upper GI endoscopy: DO NOT eat or drink within eight to ten hours of your procedure. Food in the stomach will block the view through the endoscope, and it could cause vomiting.

If there is anything you don’t understand, ask for more information!

What Can You Expect During an Upper GI Endoscopy?

Everything will be done to help you be as comfortable as possible. Your blood pressure, pulse, and the oxygen level in your blood will be carefully monitored. Your doctor may give you a sedative medication; the drug will make you relaxed and drowsy, but you will remain awake enough to cooperate.

The nurses may spray your throat with a local anesthetic or you may be asked to gargle with a local anesthetic to keep you comfortable as the endoscope is passed.  A supportive mouthpiece will be placed to help you keep your mouth open during the procdure.

As the endoscope is slowly and carefully inserted, air is introduced through it to help your doctor see better. During the procedure, you should feel no pain and it will not interfere with your breathing.

Your doctor will use the endoscope to look closely for any problems that may require evaluation, diagnosis, or treatment.

In some cases, it may be necessary to take a sample of tissue, called a biopsy, for later examination under the microscope. This, too, is a painless procedure. In some cases, this endoscope can be used to treat a problem such as active bleeding from an ulcer.

What are the Possible Complications From an Upper GI Endoscopy?

Years of experience have proved that upper GI endoscopy to be a safe procedure. Typically, it takes only 15-20 minutes to perform.

Complications rarely occur. These include perforation – a puncture of the intestinal wall, which could require surgical repair, and bleeding, which could require transfusion. Again, these complications are unlikely. Be sure to discuss any specific concerns you may have with your doctor.

When your endoscopy is completed you’ll be cared for in a recovery area until most of the effects of the medication have worn off.  Your doctor will inform you about the results in a subsequent office visit along with any additional information you need to know.

What Can I Expect After My Upper GI Endoscopy?

You will be given instructions regarding how soon you can eat and drink, plus other guidelines for resuming your normal activity.

Occasionally, minor problems may persist, such as mild sore throat, bloating, or cramping; these should disappear in 24 hours or less.

By the time you’re ready to go home, you’ll feel stronger and more alert. Nevertheless, you should plan on resting for the remainder of the day. This means not driving, so you’ll need to have a family member or friend take you home.

In a few days, you will hear from your doctor with additional information such as results of the biopsy, or you may have questions you want to ask the doctor directly.

What is involved in this procedure?

For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a sigmoidoscope. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

Sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterwards when the air leaves your colon.

 How do I prepare for the procedure?

The colon and rectum must be completely empty for sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, Jell-O®, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions.

 What are the possible complications?

Bleeding and perforation of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.  You will be asked to sign an informed consent.

How will I find out the results?

If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.  Once the results are available (within a week) your doctor’s office will setup a follow-up appointment to discuss results and any required follow-up actions.