Colonoscopy

Colonoscopy

A video on colonoscopy – http://www.youtube.com/watch?v=wA9QtgVQWOw

What is a Colonoscopy?

A colonoscopy is a procedure that enables the doctor to see inside your large bowel. It allows the doctor see the surfaces of the bowel directly by using a fiberoptic tube which can provide far more detail and accuracy than an X-ray.

A colonoscopy also allows biopsies (small pieces of tissue) to be taken for examination by a Pathologist.

Sometimes this procedure also includes a Polypectomy, where a polyp—an abnormal growth of tissue growing up/out from the bowel lining—is removed. This is done by passing special forceps, wire snare or loop through the colonoscope and removing the polyp from the bowel wall by means of an electric current. Taking biopsies or removing polyps causes no discomfort.

Prior to your procedure

• Please confirm your booking five days prior to your procedure. Phone: 011 640 7355/011 647 3445  (Monday to Friday between 8.00am to 4.30 pm)
• Take note of the date of your procedure
• Take note of the time of arrival
• It is important to note that your arrival time is not your procedure time. Your arrival time allows time for admission and appropriate preparation prior to your procedure. Once admitted, your nurse can give you an approximate time of your procedure. Please also be aware that there can be waiting times due to emergencies and unforeseen delays. You will be in the unit for approximately three to four hours.
• Discuss with your doctor which medications you will need to stop prior to your procedure (e.g. Aspirin, iron, Diabetic medications, anti-inflammatory medications). It is important that you mention all medications you take in case special precautions are required.
• Arrange for someone to take you home from the hospital. Please bring their contact details to hospital with you. Please note that we do not have waiting areas in the unit for relatives and friends. If you are catching a taxi please arrange someone to accompany you.

Diet preparation

The following diet must be followed, in conjunction with the bowel preparation, three days prior to your procedure.

Days 1 and 2 of your diet plan

Breakfast

You may have:

• refined cereal with milk e.g. cornflakes, rice bubbles
• eggs, pancakes
• white toast/bread
• tea/coffee.

Lunch and dinner

You may have:

• any kind of meat
• fish, cheese, egg
• white pasta/rice/bread
• canned or cooked vegetables
• canned/cooked/fresh fruit without skins or seeds
• ice-cream, custard.

Avoid:

• wholemeal, grain flour, bread and cereals (muesli, oats)
• dried fruit or nuts
• fruit and vegetable skin and seeds, lentils or baked beans.

Day 3 of your diet plan (day before procedure)

You may only have clear fluids before and following your bowel preparation.

You may have:

• tea/coffee (no milk)
• clear soups
• bonox
• diet cordial/soft drink
• clear juice
• jelly (avoid red or purple drinks and jellies).

Warm fluids will help clear your bowel more quickly. You are encouraged to drink plenty of fluids during this time to prevent dehydration.

For a successful colonoscopy it is important that the bowel lining be thoroughly visualised by the doctor. The preparation is a lavage which will cleanse your bowel. Inspect the toilet bowel to determine if the bowel motion has the appearance of urine with no solid matter.

Bowel preparation

You will receive two small packets of bowel preparation.

What to do if the following occurs during bowel preparation

Vomiting—This may occur for a number of reasons including “the thought of drinking more will make me sick” or fluid not passing from the stomach as quickly as expected.

If this occurs:

• stop drinking for 30 minutes
• have a hot drink and walk around.

If vomiting persists, stop the preparation and notify the staff in the morning as your drinking must be continued under supervision and your appointment may need to be rearranged.

Try your best to continue, as the procedure can only be performed if your bowel is totally cleaned. A clean bowel can only be obtained by drinking the preparation.

Fail to have a bowel motion—Each patient is different in the time involved from drinking the preparation until the diarrhoea commences. It is preferable to be at home when commencing the preparation kit. Some people take a lot longer to pass the preparation than others, however if you are not experiencing any pain and the bloating is minimal, then you are okay to continue. Once the diarrhoea has commenced, continue drinking the preparation as per instructions.

Wind pain and discomfort—Some patients experience “gripey” pain while taking the preparation. This is sometimes due to colonic spasm. Sucking on peppermint lollies or drinking peppermint tea will usually assist in settling this discomfort. You may also experience these symptoms after your procedure. It is normal to experience this discomfort for up to 48 hours.

Severe pain and vomiting—This is very unusual. In most cases you are the best judge of your health. In a situation where you become very ill, and after a reasonable period of time you fail to improve, it is wise to contact your GP for advice as you may have an underlying condition that is causing the problem.

The day of your procedure

Please bring your:

• medical aid card
• completed registration form
• medications that you may need to take after your procedure (e.g diabetic medications, anti-inflammatory medications).

Please do not:

• bring any valuables
• wear any jewellery.

On arrival to Linkisfield Clinic, please report to the Main Reception at the ground level

On your admission your nurse will explain the procedure fully to you and answer any of your questions and concerns. Your procedure will take about 20 to 40 minutes.

You will be kept comfortable. To prevent discomfort during the colonoscopy you will receive intravenous sedation that will cause you to become slightly drowsy and you may have no memory of the procedure. You will still be able to respond to directions and you will able to breathe normally.

After your procedure

You will be transferred from the procedure room on a trolley to recovery, where your observations will be monitored. When the sedative effect has worn off and you are feeling more awake you will be given a light meal prior to going home.

It is not usual for your doctor to visit and discuss things with you after your procedure because you are still drowsy. Your results will be discussed with you at your follow-up appointment.

An appointment will be made prior to discharge and you may be given either a written or a verbal explanation of possible complications by the nursing staff.

Because a sedative is used for this procedure you:

• must arrange for someone to take you home. They will need to collect you from either the ward or the endoscopic unit.
• will need to have someone accompany you if you are catching a taxi home
• are required to stay in hospital for a minimum of two hours following the procedure
• are required, by law, not to drive a vehicle (including bikes and motor bikes), operate machinery or sign contracts/legal documents for a minimum of 24 hours.

What to expect after your colonoscopy

You may:

• resume your normal daily routine including working the day after your procedure unless otherwise instructed
• resume normal eating habits unless otherwise instructed
• have a feeling of fullness in the abdomen.

For at least 24 hours after your procedure you should not:

• drive a car, motorcycle or ride a bicycle
• drink any alcohol
• make any important decisions or sign important papers
• walk home
• use hazardous machinery including the stove
• engage in sports or heavy lifting
• travel alone by public transport (bus, train or plane).