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ENDOSCOPIC PROCEDURES
COLONOSCOPY
Colonoscopy allows the physician to look inside your entire large intestine, from the lowest part to the rectum all the way through the colon to the lower end of the small intestine. This procedure is done to search for the causes of unexplained changes in bowel habits. It is also used to look for early signs of disease in the colon and rectum. Colonoscopy allows the physician to clearly see inflamed tissue, abnormal growths, ulcers, bleeding, and muscle spasms.
When your physician orders this test in our office, your GI nurse will spend time with you to explain the procedure and to schedule a time convenient for you. The following points will be discussed and your questions carefully answered.
HOW DO I PREPARE FOR THE PROCEDURE?
For a thorough and safe examination, it will be essential for you to follow each step carefully.
On the day before your procedure you will be asked to take only clear liquids for the entire day (clear soups, Jello, and carbonated drinks, strained fruit juices or lemonade, or Gatorade. Nothing red in color). You will also need to take a special laxative to allow your bowel to be cleaned out for the examination. This step is very important and if not followed could result in a need to repeat the procedure. The laxative we use at our Center is a 3-ounce bottle of Fleets Phospho-Soda; you will be instructed to take one-and one-half tablespoons in 8oz. of water at 10 AM and one similar dose at 3 PM. This will allow your intestines to be cleared by bedtime so that you can get a good nights rest before your examination.
On the day of your procedure you will be asked to have nothing to eat or drink for eight hours before your examination. This will often mean you will be fasting from midnight until the following morning.
SHOULD I TAKE MY USUAL MEDICATION?
If you are taking Aspirin or Coumadin, your GI nurse will generally ask you to discontinue them for three days before your colonoscopy.
You may take your usual medications on the day before your procedure, with the exception of fiber supplements and Iron.
You will usually be asked not to take your regular medicine in the eight hours preceding your colonoscopy except for your heart and blood pressure medication. Special instructions will be given for patients with chronic conditions like Diabetes.
SHOULD I TAKE AN ANTIBIOTIC BEFORE THE PROCEDURE?
The most recent (Sept. 2000) recommendations from the .A.S.G.E. are as follows: It is only necessary to take a prophylactic antibiotic before colonoscopy if you have been diagnosed with endocarditits, have a prosthetic valve, a pulmonary shunt, or a synthetic vascular graft less than one year old. It is no longer deemed necessary to take antibiotics if you have mitral valve prolapse. For other procedures and conditions antiobiotics could be recommended on an individual lbasis.
WILL I BE ABLE TO DRIVE MYSELF HOME?
Definitely not. You must have a relative or friend drive you because of the after effects of the sedation. You will not be able to return to work or school that day and need to spend the remainder of the day resting. Most patients are able to resume their normal activities the day after the procedure.
WHAT ARE THE RISKS OF THE PROCEDURE?
Bleeding and puncture of the colon are possible complications of colonoscopy. However, such complications are uncommon. Most patients experience nothing more than mild abdominal tenderness and bloating. Your physician and/or nurse will go over possible complications with you and answer any questions before you sign your permission form.
WILL MY INSURANCE COMPANY PAY FOR COLONOSCOPY?
GI nurses are well aware of the insurance company’s requirements for payment. Most insurance companies, as well as Medicare and Medicaid, will pay for colonoscopy for the reasons your physician orders it. All procedures are carefully precertified with your insurance company before your scheduled date. If there is any problem, you will be alerted. For patients without insurance coverage, arrangements can be made by contacting Coral Fournier, Patient Accounts Manager.
WHAT WILL HAPPEN ON THE DAY OF MY PROCEDURE?
On the day of your procedure one of the Center nurses, will greet you and escort you to our new unit adjacent to our office. Once in the comfortable preparation room you will be asked to put on a gown, and relax on the stretcher. Then an IV will be started by one of the nurses who will put you at ease with their confidence and sense of humor and attach the special monitors. The state of the art monitoring equipment will carefully record your blood pressure, pulse, oxygen level, and heart rhythm throughout your procedure and recovery time. When the physician is ready to begin you will be wheeled into the procedure room where you will then be made comfortable on your side and given pain medicine and a mild sedative. Most patients are so relaxed they sleep through the procedure except to rouse long enough to change position if asked by the physician. The physician will insert a long, flexible, lighted tube into the rectum and slowly guide it into your colon. The scope will transmit an image of the inside of your colon. The scope will move around the curves of your colon and occasionally air blows into the colon, which inflates it and helps the physician to see well. If there is anything unusual in your colon, like a polyp or inflamed tissue, the physician will remove a piece of it (biopsy) or all of it (polypectomy) using tiny instruments passed through the scope. The tissue is then sent to the lab for testing. The colonoscopy takes 30 to 60 minutes.
You will then be wheeled back to the recovery area where the nurse will stay with you, monitoring your vital signs until you wake up. As soon as you are alert enough, you will be given something to drink and will be allowed to dress, however, you will need to stay in the physicians office for 30 minutes to 1 hour until the sedation wears off. You will then be discharged. Your GI nurse will give you a list of instructions to follow at home and will usually call the next day to check on you and be available to answer any further questions.
WHEN WILL I FIND OUT ABOUT THE RESULTS OF MY PROCEDURE?
The results of the procedure will be explained briefly to you and your family after the procedure, however most patients do not remember clearly what was said due to the sedation. Because of this your physician will want you to make a follow-up appointment to discuss the results of the examination as well as any biopsies that may have been taken. During this visit you and your physician will discuss a plan for further gastrointestinal care as necessary.
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