Colonoscopy

Colonoscopy diagramThe term "colonoscopy" refers to a medical procedure during which a special device, known as a colonoscope, is used to look inside the colon (large bowel). The colonoscope is a long, thin, flexible tube with a tiny video camera and a light on the end. By adjusting the various controls on the colonoscope, we can carefully guide the instrument in any direction to look at the inside of the colon.

Colonoscopy is an important way to check for colon cancer and to treat colon polyps. Polyps are abnormal growths on the inside lining of the intestine; they vary in size and shape and, while most polyps are not cancerous, some may turn into cancer. This is why colonoscopy is often used to remove polyps, a technique called a polypectomy.

Colonoscopy is also a safe and effective way to evaluate problems such as:

Colonoscopy preparation

A variety of preparations can be used to clean out the colon prior to colonoscopy so that your your doctor's view of the colon is not obscured by stool. The following are a list of options that Dr. Zinkin will discuss with you. The particular choice will depend on your preferences, but may be influenced by your medical history. Click on a choice for detailed instructions for that prep.

Moviprep - Choose if you are doing an evening before prep or split dose prep.

Prepopik - A newer prep, generally well tolerated. Choose if you are doing an evening before prep or a split dose prep.

SUPREP - Choose if you are doing an evening before prep or a split dose prep.

Nulytely - effective and safe, but requires drinking a full gallon. Choose if you are doing an evening before prep or a split dose prep.

Nulytely with 2 day liquid prep - for patients who have a very difficult time fully cleaning out.

Miralax - Easy to tolerate and pleasant tasting, although not FDA approved - choose if you are doing an evening before prep or a split dose prep.

During the Colonoscopy

During the procedure, everything will be done to ensure that you will be as comfortable as possible. An intravenous line, or IV, will be placed to give you medication (usually propofol) to put you to sleep. Once you are asleep, a rectal exam is performed with a gloved, lubricated finger; then the lubricated colonoscope will be gently inserted.

As the scope is carefully advanced to the beginning of the colon ("cecum") and then slowly withdrawn while the lining of your colon is carefully inspected. The time needed for colonoscopy will vary, depending in part on what is found and what is done; on average, the procedure takes about 15-20 minutes. Afterwards, you will be cared for in a recovery area until most of the effects of the medication have worn off. At this time, your doctor will inform you about the results of your colonoscopy and provide any additional information you need to know.

Possible Complications

Although colonoscopy is a safe procedure, complications can rarely occur, including perforation or puncture of the colon walls, which could require surgical repair. When polyp removal or biopsy is performed, hemorrhage — heavy bleeding — may result, and sometimes require blood transfusion or reinsertion of the colonoscope to control the bleeding. You should also be aware that colonoscopy is not perfect and even with a skilled physician, some colon lesions (abnormalities) might be missed.

After the colonoscopy

Plan to rest for the remainder of the day after your colonoscopy. This means not driving, so you will need to arrange to have a family member or friend take you home. We also ask that you not work and not make any important decisions for the remainder of the day. Occasionally, minor problems may persist, such as bloating, gas or mild cramping, which should disappear in 24 hours or less. You should be able to resume all normal activities by the following day.