Your Procedure

Colonoscopy

Welcome to Mercy Health Partners. We thank you for choosing us for your healthcare. This information is to help you better understand the colonoscopy procedure and answer any questions that you have by guiding you step by step through the procedure, telling you what to expect before, during and after your visit. We hope this will ease any uncertainties or fears that you might have before the procedure and make your experience at MHP as enjoyable as possible.

What is a Colonoscopy?

A colonoscopy is a procedure that allows a physician to examine the inner lining of the rectum and colon (large intestine) for any abnormalities. The procedure is performed by using a colonoscope. A colonoscope is a long flexible tube that has a miniaturized color-TV camera inside of it allowing the physician to examine the colon on a television monitor.

Your Care Team

You will be cared for by a number of people before, during, and after your procedure. They include:

• A Gastroenterologist or Internal Medicine Physician
• Your Primary Care Physician
• A Gastroenterology technician
• Consulting physicians, if your medical condition so requires
• Nurses
• Many others who are here to make sure you receive the best possible care

Before the Procedure

Preparation:

For the procedure to be accurate and complete, the colon and large intestine must be completely clean. Particles of stool that are not cleansed can interfere and impede the physician’s view. Your physician will give you detailed instructions regarding the necessary dietary restrictions to be followed and the colon cleansing routine to be used. Generally, the preparation consists of a special diet made up of a large quantity of clear liquids and a special cleansing fluid like Golytely, Nulytely or Fleets phospho-soda.

Medications:

Most medications can be continued as usual, but there are some medications that can interfere with the preparation or the examination.

• Do not take aspirin for 7 days prior to your colonoscopy. Tylenol is okay.
• Do not take anti-inflammatory medications for 3 days prior to your colonoscopy.
• Do not take iron tablets, including multi-vitamins with iron, for 5 days prior to the colonoscopy.
• If you take insulin or oral diabetic medications, request special instructions
• Notify your physician’s office immediately if you:
    - Are currently taking anticoagulants (blood thinners, coumadin)
    - Have a history of bleeding problems following a surgery cut
    - Have a history of rheumatic heart disease, mitral valve prolapse, heart valve replacement, or any artificial joints
    - Have a history of severe medical conditions

What to bring:

You will be asked to change into a patient gown for the procedure. You will need to bring loose fitting clothing that can be easily removed and folded. Any jewelry and valuables should be left at home. The medication that will be administered during the procedure will cause you to be drowsy for several hours. Therefore if the procedure is being performed on an outpatient basis, a friend or family member should be present to drive you home and to receive your instructions from the physician. You must not drive for 24 hours following your procedure. Expect to be in the hospital for about three hours.

During the Procedure

The procedure should take between 30 to 45 minutes. When you arrive for the test, you will be asked to change into patient gown. A small painless oximeter will be placed on your fingertip to monitor your pulse rate and breathing functions during the exam. A nasal oxygen tube may be used to administer oxygen flow during the exam. Then your physician will intravenously inject Demerol (a painkiller) and Versed (a tranquilizer) unless you are allergic to these drugs. These medications will make you drowsy and relaxed, minimizing any discomfort of the examination. It is common for the patient to fall asleep.

Once the medications have taken affect, the physician will then lubricate the rectum to allow for easy passage of the colonoscope. This maybe slightly discomforting, but not painful. The physician will then guide the scope through the entire colon. To help increase the physician’s visibility, air will be gently infused into your colon. Your physician may ask you to turn during the procedure to facilitate the passage of the colonoscope.

If your colonoscopy reveals anything abnormal such as inflammation, an ulcer, a tumor or a polyp, your physician may take a biopsy. To perform a biopsy, a physician passes metal forceps through the scope and cuts off a tiny sample of the colon tissue. Samples taken from a biopsy are sent for further testing. Both procedures are completely painless.

Polyps:

The inner lining of the colon and rectum is normally smooth. However, growths called polyps can sometimes appear on the lining of the large intestine. Most polyps are benign (non-cancerous). Nevertheless, polyps are removed so that they can be more carefully examined in a lab to ensure that there are no traces of cancer.

In the past, the removal of polyps could require major abdominal surgery resulting in up to one week of hospitalization and one month off from work. Today, a colonoscopy allows most polyps to be removed during the procedure, permitting you to return to your normal activity the next day. Tiny polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. During a polypectomy, the physician passes a wire loop (snare) through the colonoscope and severs the polyp from the intestinal wall with an electrical current. You should experience no pain during a polyp removal.

Any tissue samples or polyps will be sent to the pathology laboratory where a pathologist will examine them for possible signs of cancer. Keep in mind that if a biopsy or polypectomy is performed it does not necessarily mean that you have cancer.

After the Procedure

When the procedure is finished, you will be moved to a recovery bay for approximately 30-60 minutes until most of the medication has worn off. Once your medication has started to wear off, your physician will discuss with you and your driver the procedure’s findings and the discharge instructions. Because of the drugs you have taken (and their relaxing effect) it is important for your driver to be with you at discharge. When the Pathology results are returned, your physician will contact you to discuss these results with you and arrange any additional treatments or tests if necessary.

Discharge instructions:

• Do not drive, operate any motorized equipment, or drink any alcohol for 24 hours, as the medication you were given may cause dizziness or drowsiness and slower reaction times.
• Avoid making critical decisions or signing legal documents for 24 hours.
• You can drink liquids one hour after the procedure. At discharge you may resume eating, usual medications and normal activity.

What to Watch For:

Problems rarely occur after a colonoscopy. However, it is important for you to be aware of the early signs of possible complications.

Call your physician immediately if you notice any of the following:

• Temperature above 100.6 degrees F
• Unusual abdominal or chest pain
• Black or Bloody stools

Special Instructions:

• Gaseous discomfort is normal and expected after certain procedures. Passing flatus (gas) and belching is encouraged. Bending (flexing) your knees while lying down may help relieve the flatus.
• You may develop a lump and /or redness at the site of where medication was administered during the procedure. Apply a warm compress (cloth soaked in warm water) to the area. Call your physician in 24 hours if the situation has not improved.
• Do not take aspirin or other over the counter pain medications without first consulting your physician.

For More Information:

Your care is very important to us. We hope that the information you have just read will be helpful to you. If you have any unanswered questions, the Endoscopy department will be glad to answer any question you might have.

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