Colonoscopic Polypectomy

What you should know

Colonoscopic polypectomy is surgery to remove colorectal polyps. Colorectal polyps are small lumps of tissue in the lining of the colon (large intestine) and rectum. Caregivers use a scope and small tools to remove the polyps. A scope is a thin, flexible tube with a light and tiny camera on the end.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • A colonoscopic polypectomy may cause you to have a slow heartbeat, decreased blood pressure, or increased sweating. You may have pain or bleeding as the scope is passed inside your colon and after your surgery. You may have bleeding or a burn on the wall of your colon from the removal of your polyps. Your colon may be perforated (torn) due to the increased pressure from the scope or from the instruments used. This may cause bowel contents to leak out of the colon and into your abdomen. If this happens, you will need to stay in the hospital and have surgery on your colon.

  • Without this surgery, your signs and symptoms may continue and worsen. Colorectal polyps that are not removed may develop into cancer and cause more serious problems.

Getting Ready

The week before your surgery:

  • Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.

  • Ask your caregiver if you need to stop using any of your current medicines. If you take aspirin, ibuprofen, or blood thinners, do not stop taking them without first asking your caregiver.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Dye may be used during your surgery to help caregivers mark the spot where they found your polyp. Tell your caregiver if you are allergic to any dye.

  • Tell your caregiver if you have other diseases, such as severe inflammation of the bowel or kidney problems. Certain medicines used to empty your bowel may not be good for you.

  • You may need to have blood, urine, or other tests. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.

  • Ask caregivers about directions for eating and drinking.

    • A clear liquid diet or a diet that helps to clean out your colon may be started 1 to 4 days before your surgery. Clear liquids may include plain gelatin, unsweetened fruit juices, clear soup, or broth.

    • Do not eat foods with residue or fiber that are not easy to digest. These include fruits, vegetables, cereal, nuts, peas, beans, popcorn, and tomatoes. Ask your caregiver for a list of foods to avoid.

    • Increase the amount of water you are drinking. Make sure you drink 8 to 10 (eight-ounce) cups of liquid, especially on the day before your surgery.

The day before your surgery:

Your bowel needs to be empty before your surgery. This will help the scope to pass through your colon easier and help your caregiver better see your polyps. Your caregiver will give you directions for emptying your bowel.

The night before your surgery:

  • Bowel preparation:

    • You may need a laxative or a liquid medicine called an enema. An enema uses warm water that is put into your rectum to help empty your bowel.

    • You may be given a bowel prep medicine to drink. Drink one 8-ounce cup of bowel prep medicine every 10 minutes until you are passing clear fluid. Ask your caregiver for more information about this medicine.

The day of your surgery:

  • Bowel preparation:

    • Do not eat or drink anything on the morning of your surgery. The images of your colon may not be seen clearly if it is not totally empty.

    • You may need an additional enema, using warm water, the morning of your surgery.

    • You may also be asked to drink an additional 4 to 8 cups (8-ounce cups) of the bowel prep medicine.

  • Ask your caregiver before you take any medicine on the day of your surgery. This includes insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

  • You will be taken to the room where the procedure will be done. You will be given medicine to help you relax. You will be asked to lie on your left side and raise one or both knees toward your chest. Your lower body will be covered with a sheet. Your caregiver will examine your anus and use a finger to perform a digital rectal exam to check your rectum. He may feel for your prostate if you are a man. If your bowel is not totally empty, your caregiver may give you another enema.

  • During your surgery, the colonoscope will be lubricated and gently placed into your anus. It will then be passed through the rectum and into the colon. Your caregiver may inject fluid under the polyp or use dye to mark it and make it easier to remove. He may pass a snare (wire loop) through the colonoscope and use it to hold the polyp. The polyp will then be burned or cut off of the wall of the colon. The polyps that are removed will be sent to a lab for tests. Your caregiver may take pictures of the inside of your colon during the surgery. When the surgery is finished, the scope will be slowly removed.

After your surgery:

You may pass some air that is left in your colon. You may see blood in your bowel movement (BM) from the removal of your polyps. When your caregiver sees that you are okay, you will be allowed to change clothes and go home. You will need someone to drive you home. Do not drive home alone. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever

  • You have constipation and the medicines are not helping to empty your bowel.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You are not able to eat or drink, or you are urinating less or not at all.

  • You have blood in your bowel movement.

  • You are not able to have a bowel movement.

  • Your abdomen becomes tender and hard.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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