Colonoscopy

What you should know

• A colonoscopy is a procedure that examines the colon (large bowel). Caregivers use a colonoscope, which is a soft, bendable tube with a light and tiny camera on the end. A colonoscope takes pictures of the inside of the colon and may be seen on a TV-like screen. The colon is the long tube that connects the small bowel with the anus (opening through which stool passes). The colon absorbs water from digested foods and turns the digested food into stool. It stores the stool until it passes out through your anus.
  
  
• In a colonoscopy, diseases and conditions that affect the colon may be diagnosed. These may include diseases that cause changes in bowel movements (BM), bleeding, blockages, inflammation (swelling), or infections. It is also used to look for polyps (growths) or early signs of cancer (tumor) in the colon or rectum (rear end). A biopsy may be done where a small amount of tissue is taken from the bowel and examined. Your caregiver may also remove stool that is blocking your colon. With a colonoscopy, conditions of the colon, such as blockages or polyps, may be diagnosed and treated, and their symptoms relieved.

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 colonoscopy is a common and safe procedure. You may have pain or bleeding as the scope is passed inside your bowel. You may also have a slow heartbeat, decreased blood pressure, increased sweating, or faint (pass out). Your colon may get perforated (torn) due to the increased pressure from the scope and air that are passing through it. 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. Following your caregiver's advice during and after the procedure may decrease your chances of having any problems.
  
  
• Without this procedure, diseases may not be diagnosed and proper treatment may not be given. The signs and symptoms you have may continue and worsen. You may have problems eating, digesting food, or moving your bowel. This may lead to other serious medical problems, such as a blockage of your colon. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

Getting Ready

The week before your procedure:

• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• 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.
  
  
• Tell your caregiver if you have had other similar procedures before and when they were done. These may include a past colonoscopy, a barium enema (lower GI procedure), or a sigmoidoscopy.
  
  
• Tell your caregiver if you have other diseases, such as severe (bad) inflammation of the bowel or kidney problems. Certain medicines used to empty your bowel may not be good for you.
  
  
• If you are a female, tell your caregiver if you know or think you might be pregnant.
  
  
• Tell your caregiver if you have heart or lung diseases, or had surgeries in the past, such as abdominal (stomach) surgeries. If you are a female, this may include a surgery where your uterus (womb) was removed.
  
  
• You may need to have blood, urine, or stool 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 procedure. 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, fried foods, and bread.
    
    
  • Increase the amount of water you are drinking. Make sure you drink 8 to 10 (eight-ounce) cups of liquid, especially the day before your procedure.

The day before your procedure:

Your bowel needs to be empty before your procedure. This will help the scope to pass through your colon easier and show better pictures. Your caregiver may tell you to take a cathartic (laxative). These medicines may give you diarrhea (loose, watery stools), but will quickly clean out your bowel.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  
• Ask your caregiver what to do to prepare your bowel for surgery. Your caregiver may ask you to do one or more of the following:
  
  
  • Aside from the laxative, you may need a liquid medicine called an enema. An enema uses warm water that is put into your rectum (rear end) to help empty your bowel. The directions should be on the package. Your caregiver may also teach you how to do this.
    
    
  • You may be given 8 to 12 cups (8-ounce cups) of special 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 procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Bowel preparation:
  
  
  • Do not eat or drink anything on the morning of your procedure. The images may not be seen clearly if your colon is not totally empty.
    
    
  • You may need an additional enema, using warm water, the morning of your procedure.
    
    
  • You may also be asked to drink an additional 4 to 8 cups (8-ounce cups) of the special bowel prep medicine. This may be done if you drank the bowel prep medicine the night before.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include 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.
  
  
• If you are staying in the hospital after your procedure, bring your personal belongings with you. These include your bathrobe and toothbrush.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• 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 procedure. 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 on a stretcher to the colonoscopy room and then moved onto a special bed or table. You will be given medicine to help you relax, especially if you feel anxious or nervous. You will be asked to lie on your left side and will need to raise one or both knees toward your chest. Your lower body will be covered with a sheet. Your caregiver will examine your anus (rear end) and use a finger to perform a digital rectal exam (DRE) to check your rectum. He may feel for your prostate if you are a male. If your bowel is not totally empty, your caregiver may give you another enema.
  
  
• During your procedure, the colonoscope will be lubricated with jelly and gently placed into your anus. It will then be passed through the rectum and into the colon. Your caregiver will also put water or air into the colon to help clean or distend (expand) it. Tissue samples may be taken from the walls of the bowel and sent to a lab for tests. He will also remove stool or polyps (growths) that may be in your bowel using small tools. Your caregiver may videotape or take pictures of the inside of your colon while doing the procedure. When the procedure is finished, the scope will be slowly removed and your anus will be wiped with gauze.

After your procedure:

You may lie in bed and rest for a while since the procedure may be a little tiring. You may also pass some air that may be left in your colon. If a sample was taken from inside your colon, you may see blood in your BM. When your caregiver sees that you are OK, you will be allowed to change clothes and go home. You will need someone to drive you home if you were given medicine to relax you. Do not drive home alone. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have constipation (dry, hard stools) and the medicines are not helping to empty your bowel.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• You are not able to eat or drink, or are urinating less or not at all.
  
  
• You have blood in your bowel movement (BM).
  
  
• You are unable to have a BM.
  
  
• Your abdomen becomes tender and hard.
  
  
• Your signs and symptoms are getting worse.
  
  
• Your vomit (throw up) has blood or bile in it.

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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.

Learn more about Colonoscopy (Precare)