| Colonoscopy is a procedure in which the lining of the entire large intestine (large bowel or colon) is examined using a colonoscope. The colonoscope is a flexible instrument about one-half inch in diameter and about 4 feet in length. It transmits light, allowing the physician to examine the lining of the colon from beginning (cecum) to end (anus). Sometimes the last several inches of the small intestine can also be examined. The colon is inflated with air to widen the walls, enabling the physician to visualize inflamed tissue, abnormal growths, ulcers, bleeding, and spasms. Suction can be used to remove secretions.
Colonoscopy is recommended to evaluate conditions of altered bowel habit, unexplained diarrhea, constipation, abdominal pain, occult or frank blood in stools, colon polyps, cancer, or unexplained anemia. Colonoscopy also may be used as a precautionary measure to screen for presence of colorectal cancer or other abnormalities. The procedure also may be indicated to treat active bleeding from the bowel or as a follow-up when abnormalities first have been detected by other tests.
Colonoscopy is generally not performed in cases of bowel perforation or tear, severe diverticulitis, colitis, inflammatory bowel disease, clinically unstable individuals, or in those who have not followed the dietary restrictions and cleansing routine prescribed prior to the procedure. |
Source: Medical Disability Advisor
| Colonoscopy is often prescribed as a screening procedure to detect colorectal cancer or abnormal growths (polyps) that may increase cancer risk in the rectum and along the entire large intestine. Colonoscopy is also used to locate strictures, diagnose inflammatory bowel disease, and detect areas of hemorrhage that may be causing persistent bloody diarrhea, constipation, abdominal pain, or iron deficiency anemia of unknown etiology. Minor operative procedures can be performed using the colonoscope, including tissue biopsy, polypectomy, colon decompression, dilation of colonic strictures, electrocoagulation of bleeding sites, removal of foreign bodies, and electrocauterization (fulguration) of tumors. A biopsy taken during the procedure can confirm other test findings, x-rays, or imaging studies. Colonoscopy can be used to diagnose Crohn's disease and ulcerative colitis. |
Source: Medical Disability Advisor
| Colonoscopy is performed in a specialized endoscopy suite either in a clinic or as an outpatient procedure in a hospital. The individual is awake, but kept sedated with intravenous (IV) sedatives and analgesics. The day before a colonoscopy, the individual follows a clear-liquid diet and uses bowel-cleansing techniques described by their physician so that the colon is clear and able to be visualized.
After examining and lubricating the rectal opening, the physician inserts a long, flexible, lighted tube (colonoscope) into the individual's rectum, and guides it through the lower GI tract and up into the colon. The colonoscope transmits an image of the inside of the colon to a monitor so the physician can carefully examine it. Because the colonoscope is flexible, the physician can move it around the curves of the colon. As the examination progresses, the individual may be asked to change position occasionally to facilitate the scope's passage through the colon. To improve visualization, the physician may gently infuse air into the colon. This sometimes causes a sensation of abdominal fullness.
If colonoscopy reveals any unusual conditions, such as inflammation, ulcer, tumor, or abnormal growth (polyp), the physician may photograph them so they can be part of the individual's permanent medical record and allow other physicians to evaluate the results. To better evaluate any areas of suspected abnormality, the physician will take a brushing or biopsy of the colon lining. Brushing involves passing a tiny nylon brush though the center of the colonoscope, rubbing it against the lining of the colon, and retrieving bits of tissue for later analysis. Tissue samples (biopsy) or stool samples are collected with tiny metal forceps or suction devices that are introduced through special channels in the colonoscope. Both of these procedures are painless for the individual. Should a small polyp be discovered during the procedure, it is usually immediately removed with electrocautery snares. This may prevent colon cancer from developing and eliminate the need for major surgery. Laser therapy can also be done through a colonoscope.
Virtual colonoscopy is a new technique that uses x-rays delivered through a CT scanner to take cross-sectional views through the abdomen, and then reconstruct those views using computer software. The resulting set of images provides essentially the same sort of view of the colon as is obtained during an optical colonoscopy. Virtual colonoscopy is less invasive and takes only a few minutes to perform, compared with optical colonoscopy, which can last a half hour or more. Individuals need the same bowel preparatory procedures for both optical and virtual colonoscopy. Virtual colonoscopy is not yet widely available or definitively tested. |
Source: Medical Disability Advisor
| Colonoscopy generally provides reliable information for diagnosis and treatment when performed periodically. Normal results reveal colon tissue that is healthy.
Abnormal results indicate the following possibilities: inflammatory bowel disease, diverticulitis, ulcerative colitis, tumor, lower GI bleeding (hemorrhage), or polyp. Through colonoscopy and early detection, removal of polyps helps prevent colon cancer. |
Source: Medical Disability Advisor
| Principal complications of colonoscopy are a tear through the bowel wall (perforation of the colon) or bleeding (hemorrhage). Although perforation will require surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of either a biopsy or polyp removal. Typically minor in degree, such bleeding may stop on its own or be controlled by cauterization. Both perforation of the colon and bleeding are rare.
Individuals undergoing colonoscopy should inform their physician of all allergies and medical conditions. In some individuals, the IV site may become inflamed and tender. This is generally short-lived and not serious. It can be successfully treated by applying warm compresses to the area. Occasionally, an infection will develop, requiring antibiotics. Other complications can include either a reaction to the sedative medication or over-sedation, causing respiratory depression or low blood pressure (hypotension). Dehydration also might result because of laxatives and enemas required for pre-procedure bowel cleansing. |
Source: Medical Disability Advisor
| After a colonoscopy, most individuals are advised to avoid driving or operating machinery for the remainder of the day because sedation given before and during the procedure is likely to impair judgment and reflexes. Most individuals are ready to return to work the day following the procedure. |
Source: Medical Disability Advisor
| Elixhauser, A., et al. Procedures in US Hospitals, 1997: HCUP Fact Book No. 2. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ), 2004.Jani, Sunil S. "Virtual Colonoscopy: Are We There Yet?" BenchMarks 4 2 (2004): 1-1. National Cancer Institute. New Media Systems, LLC. 19 May 2005 <http://www.nci.nih.gov/newscenter/benchmarks-vol4-issue2>. |
Source: Medical Disability Advisor
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