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Why is a colonoscopy performed?

Colonoscopy is used to explain symptoms such as blood in the stool, belly pain, constipation, and diarrhea, or for suspected conditions that do not have symptoms.

Sometimes colonoscopy is used to clarify an abnormality seen on a variety of imaging studies or x-rays. The most common reason to have the test is to check for abnormal growths (polyps) that tend to appear over time in some people.

Polyps vary in size from about the size of a pea to several inches and are usually harmless. However, some polyps can become cancerous and for this reason, they are usually removed. This procedure is called a "polypectomy." In most cases your doctor cannot tell which polyps may eventually become cancerous, so the whole polyp, or at least a sample of it, needs to be examined under a microscope. The ability to safely and painlessly remove such growths before they become trouble has made colon cancer one of the most preventable cancers in the world.

What preparation is required?
Your doctor will tell you what sort of diet and cleansing routine to follow before the test. Your cooperation in this preparation will allow the gastroenterologist get the clearest and most accurate views possible. In general, the 'prep' involves drinking a special cleansing solution, along with plenty of clear fluids, and taking special laxatives by mouth. Be sure to tell your doctor about conditions such as diabetes, heart or kidney, disease. You should plan your prep diet ahead of time and check with your doctor if you have any questions.  For specific prep instructions see our "Procedure Prep Instructions" page located on the navigation bar.

Can I take my regular medications?
Most medications can continue to be taken as directed, but some can interfere with the preparation or the examination. You should tell your doctor about all your medications, especially aspirin products, anti-inflammatory medications such as ibuprofen, pain medicines, blood thinners, Coumadin, insulin, or iron supplements. Don't forget to mention "over the counter" supplements that you may be taking as well. You should also tell your doctor if you normally require antibiotics before dental procedures, since you may have the same needs before your colonoscopy.

What happens during a colonoscopy?
Most doctors perform colonoscopy in a room that resembles in a small operating room. After your medical history has been reviewed and the medical staff has explained the procedure and answered any questions you may have, you will sign a permission form.

You will then be connected to equipment that monitors your vital signs. Before the procedure, an IV will be started in your arm so that sedatives and other medications can be administered.

You will lie on your side or back while your doctor slowly advances the scope through your colon. The procedure usually takes 15 to 60 minutes, although you should plan on two to three hours for waiting, preparation, and recovery.

Colonoscopy is well tolerated and rarely causes much pain. Some patients feel pressure, bloating, or cramping during the exam. Your doctor might give you a sedative to help you relax before and during the exam.

In some cases, usually because of a very twisty or floppy colon, the doctor may not be able to pass the scope through the entire large intestine to where it meets the small intestine (terminal ileum). Although another examination may be needed, your doctor may decide that the limited exam is sufficient.

What happens if the colonoscopy shows something abnormal?
One of the main advantages of colonoscopy over other types of tests is its ability to sample abnormal areas of the colon for further evaluation. Sometimes your doctor will take biopsies in areas that look normal to the naked eye. If you are having a colonoscopy because of internal bleeding, your doctor may decide to seal off the bleeding vessels with special instruments passed through the scope. Such procedures rarely cause any pain.

What happens after a colonoscopy?
Your physician will explain the results of the examination, but you'll probably have to wait for the results of any biopsies. If you received sedatives during the exam, you will need to have a friend or relative take you home. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day. Because your doctor used air to inflate the colon to get the best possible views of the lining of the colon, you might experience some cramping or bloating. This feeling should disappear once you start passing gas. Although you should be able to eat shortly after the examination, your doctor might restrict your diet and activities if a procedure, such as removing a polyp, was performed.

What are the possible complications or risks of colonoscopy?
Colonoscopy and the special techniques mentioned above are very safe when performed by specially trained doctors with experience performing these types of procedures. As with any medical procedure, even in expert hands, unintended events may happen and you need to be aware of the potential consequences.

There is a small risk of having a reaction to a sedative or antibiotic given during the exam. In most cases medications are available to counteract these side effects. Another possible complication is tearing or perforation of the lining of the intestine. Should this occur, an infection may develop in your belly and surgery may be needed to seal the injury. Another risk is bleeding, usually at the site of a biopsy or polyp removal. Most cases of bleeding stop without treatment or can be controlled at the time of procedure.

What sort of things should concern me after the colonoscopy?
Although complications after colonoscopy are uncommon, it is important to be aware of early signs that something is wrong. You should not hesitate to contact your doctor if you feel severe abdominal pain, dizziness, fever, or chills or notice blood in your stools.