What is colonoscopy?
Colonoscopy is an examination of the colon with a special long flexible camera. The camera is inserted via the anus.
Who should perform the colonoscopy?
Colonoscopists require accreditation with the Gastro Enterological Society of Australia (GESA). Surgeons or physicians can perform colonoscopy. Colorectal surgeons are surgeons who specialise in diseases of the colon and rectum and are highly trained in colonoscopy. In particular colorectal surgeons can perform other procedures at the same time as the colonoscopy such as haemorrhoid treatment.
Will any procedures take place during the colonoscopy?
We can take biopsies of any abnormality seen at the colonoscopy. Sometimes we will removed polyps (polypectomy) or treat haemorrhoids (rubber band ligation or haemorrhoidectomy). Other operations may also be performed with a colonoscopy as discussed by your surgeon.
Am I asleep?
The procedure requires anaesthesia (either full sedation or general anaesthesia). This will be administered by a qualified anaesthetist (not a sedationist). You will not be aware of any discomfort.
Do I need any special preparation?
You will need to be on a special diet for 24hrs before the procedure and also take a special preparation to clean out the bowel. You can work on the day before the procedure but will need to take the preparation at home as you will need to be near a toilet. Failure to complete the preparation will compromise the views obtained.
Will I need to stop or alter any medications?
It is vitally important to discuss your medications with your doctors. Blood thinning medications such as Plavix or Warfarin will need to be ceased. Other medications may require alteration as well. You will be given clear instructions.
What happens on the day of the procedure?
You will be notified by the hospital what time to fast from and what time to come to the hospital. You will be in hospital for approximately 6 hours. You will be admitted, undressed and then the procedure will take place in the operating theatre. After this you will go to recovery where you will wake up fully.
What happens after the colonoscopy?
You will be seen by Dr Pathma-Nathan before you go home and your results will be given to you. You will need to have someone to pick you up from the hospital. You cannot go home alone or be alone for the night after the procedure. Please ensure that you have adequate care provisions for this.
Will I have any symptoms after the procedure?
You may have some cramping abdominal pain for up to 24hs. You may also have some minor bleeding if a procedure has been performed.
When can I eat and drink?
You can eat immediately and will be fed in hospital. You may be advised on a specific diet on the day if necessary. Avoid alcohol for 24hrs.
When can I drive?
You can drive the next day unless you have been given medications that specify you cannot.
When can I return to work?
You can work the next day unless advised otherwise or have had an added procedure. You will be told when you can return to work.
What are the complications?
Colonoscopy is very safe with a low complication rate. There may be complications related to the anaesthetic drugs or where the injections were given. There may be problems related to your heart or breathing. These are more common if you have an underlying medical problem. Specifically to the colonoscopy there are risks of bleeding especially if a polypectomy or biopsy is performed. The bleeding may occur up to several days after the procedure. Please return to hospital if this occurs. The most serious complication is perforation of the colon. This is very rare but is a life-threatening problem.
Surgery is not always required but is often required. In the worst scenario a temporary colostomy may be required. Much care is taken to avoid this complication. It is more common if there is a disease process in the colon or if a polypectomy is performed. There will be severe abdominal pain and fever. If you are feeling unwell after the colonoscopy, especially with pain then please contact Dr Pathma-Nathan or the hospital urgently. You will be given contact details.
Can the colonoscopy miss something?
The test depends on seeing abnormalities on the colon lining. Sometimes the view is suboptimal due to poor preparation or angulation of the colon. Small abnormalities can be missed but colonoscopy is still considered the best tool to examine the colon.
What are the alternatives?
There are alternatives to colonoscopy but they are not as good. Imaging techniques such as barium enemas and CT scans are used but are reserved for patients unable to have colonoscopy for medical reasons.