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Dr. Minocha is a practicing gastroenterologist and author of "Natural Stomach Care: Treating and Preventing Digestive Disorders with Best of Eastern and Western Therapies".
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or the lower GI scope visualizes the interior of the colon directly. This
is in contrast to barium enema or the lower GI x ray, which looks at the
Colonoscopy is recommended for evaluation of altered bowel habit, unexplained diarrhea, constipation or abdominal pain, occult or frank blood in stools, colon polyps or cancer or unexplained anemia.
It is generally not performed in cases of perforation or tear in the bowel, severe diverticulitis or colitis and clinically unstable patients.
Colonoscopy >>Top of Page
Before the procedure
You will be given written instructions as to what to do before the test. This generally involves taking some kinds of laxatives to cleanse out the colon prior to the test.
Alternatives to PEG include drinking a 1.5 ounces of Fleet phospho-soda with water at noon and repeating it in the evening before the procedure. It is avoided in patients with kidney failure. Some physicians use a combination of citrate of magnesia, Fleet enemas, laxative tablets and suppositories.
Above laxative protocols are effective in most, but not all patients. If you are unable to finish your laxative or are still having brown stools despite finishing your laxative, call your doctor. He/she may wish to give you additional laxatives. Remember, it is in your best interest to have a clean colon on the day of the exam. It will make the procedure easier, safer and more accurate. Patients with chronic constipation and neurological problems may require several days of colonic cleansing using combinations of various cathartics.
On the day of the test
Arrive at the test site at least one hour before the procedure. Bring someone with you or make arrangements to be picked up after the procedure. Because sedatives are administered during the exam, you cannot and will not be allowed drive home by yourself. After initial registration, a nurse will take history and make his/her assessment. A needle/catheter will be inserted into a vein for IV access. This catheter allows for administration for fluids as well as medications for the procedure.
Colonoscopy >>Top of The Page
After a brief discussion with your doctor, sedatives will be administered intravenously.
After starting the sedation, the doctor will perform a rectal exam with a finger, and then insert the scope into the rectum. The scope is advanced all the way to the junction of the small intestine and the colon. This corresponds to the right lower part of the abdomen. Along the way, there can be some discomfort due to any sharp curves of the colon that may be encountered, as well as the air put into the colon to inflate it.
Inflation of colon using air allows the doctor to see the entire circumference of the wall of the colon. The doctor may give you additional sedatives during the procedure depending upon how you are feeling, as long as your heart, respiration and blood pressure are fine.
The doctor may take biopsies or excise polyps during the procedure. You will not feel that because nerves in the gut respond to distention by air or the scope, but not to cutting sensation.
Just like accidents while driving, complications may occur during colonoscopy. Bleeding, perforation of the bowel, cardiac, respiratory and blood pressure problems, and even death may occur. The rate of complications is low. Your doctor recommends the test if the benefits outweigh the risks.
After the test
You will be monitored in the recovery room for about 20-60 minutes depending upon your mental status and your heart and respiration. You will be discharged to home with the family member or friend that came with you. You will be groggy for the next few hours and cannot go to work that day. Full recovery by the next day is the norm, and you may drive and go to work.
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