Colonoscopy is a modern endoscopic diagnostic method that helps to examine the entire colon (large intestine). The procedure makes it easy to evaluate the condition of the anus, rectum before entering the cecum, ileocecal canal, and terminal ileum. A gastroenterologist performs colonoscopy using a colonoscope. The colonoscope is a flexible and long tube equipped with a backlit video camera. It also has a cutting needle for taking samples of tissue (biopsy) inside the colon for an examination.
The device is soft, bends easily, and moves delicately along the entire large intestine without injuring it or causing any discomfort to the patient.
It also shows real-time pictures of the large intestine on a monitor connected to it. The camera takes pictures at 10x magnification. The doctor examines the intestinal mucous membranes and has the opportunity to assess all its pathological changes.
Standard laboratory diagnostics fail to detect many bowel diseases. Colonoscopy is one of the very effective methods for diagnosing intestinal diseases like colon cancer and polyps.
When and why does the doctor recommend colonoscopy?
The doctor recommends colonoscopy for the following diseases and conditions:
- As a preventive measure for a person above 50 years old, even if he does not complain about any health issue. The risk of developing colon cancer increases around this age, and the onset of the disease is asymptomatic. Therefore, the doctor recommends undergoing a colonoscopy once a year.
- A person with a family history of colon cancer or the formation of polyps needs to undergo colonoscopy ten years before the recommended age. The probability of transmission of the disease at the genetic level is very high.
- The presence of blood in the stool indicates that there is bleeding from the gastrointestinal tract. You cannot see the latent blood in the faeces with a naked eye. To detect suspicious blood in the stool, the doctor may recommend a colonoscopy. Occult blood in the stool can indicate polyps, inflammation of the intestines, tumours, ulcerative colitis, and Crohn’s disease.
- The significant amounts of mucus in the faeces indicates a serious bowel complication that requires emergency medical intervention.
- Weight loss:- If a person begins to lose weight for no known reason.
- The presence of polyps in the intestine:- Polyps are abnormal tissue growths that can turn into cancer if ignored. A colonoscopy helps detect and remove polyps.
- Unstable stools, changes in diarrhoea, and chronic constipation
- The doctor suggests colonoscopy for patients with malabsorption syndrome- it can be a sign of irritable bowel syndrome.
Colonoscopy refers to low-traumatic diagnostic methods, but it has several contraindications, in which the procedure cannot be performed.
- A state of shock with a drop in blood pressure
- Acute respiratory infections, inflammation of the respiratory system, accompanied by an increase in body temperature
- Intestinal infections in the acute phase
- Heart failure.
- Blood clotting disorder
- Crohn’s disease, an acute stage of colitis with massive intestinal lesions
- Diverticulitis in the acute phase
- Pronounced disorders of human well-being
Also, there are relative contraindications to the procedure:
- Massive anal bleeding
- Anal fissures
- Acute stage of haemorrhoids
- The period of bearing a child
- The presence of a large hernia
- The early recovery period after undergoing abdominal surgery
- Poor preparation for bowel cleansing, etc.
The doctor evaluates the possible risks from a colonoscopy if a patient has the following diseases and conditions:
- Heart disease
- Allergy to medicines
- Lung disease
- Diabetes mellitus
- Treatment with drugs that affect the processes of blood clotting
The physician should be aware of the medications the patient receives. You may have to refuse them, and after the procedure, resume their intake.
Experts recommend starting preparation in advance:-
- You need to consume a low-fibre diet 2-3 days in advance and do an enema the day before and a couple of hours before the procedure. This method can be challenging for people with haemorrhoids, as it will be uncomfortable putting an enema on their own. Putting an enema can be uncomfortable for people with haemorrhoids. For that reason, you can use special laxatives to simplify preparation. These include Moviprep- helps with the cleansing of the colon before a colonoscopy. If a doctor recommends colonoscopy in the morning, drink 1 litre the night before and in the morning. If scheduled in the afternoon, you can prepare for it on the same day by drinking 2 litres of a solution in the morning.
- Avoid taking activated charcoal, iron supplements, as well as blood thinners ten days before the procedure.
A person who will have a colonoscopy for the first time will find the procedure exciting. Before starting, the doctor will give you the essential information to understand the method. During colonoscopy:-
- The patient lies on the couch on his left side and draws his knees to his stomach.
- The doctor treats the anus with an antiseptic drug and inserts a probe into it. Anaesthesia is not used. If the patient has a high pain threshold, then local anaesthetics can be used for pain relief. Sedation can also be done, but this reduces the diagnostic value of the procedure. Severe pain can occur if a person has acute inflammation of the intestines or adhesions are present in it. In this case, anaesthesia is indicated for a period of half an hour.
- After anesthesia, the doctor inserts a probe into the anus and slowly moves it forward. To straighten the folds of the intestine, the air is blown through the tube.
- The probe is then inserted 2 meters deep into the intestine. All this time, the doctor will assess the condition of the internal walls of the organ. The procedure continues for 20-30 minutes.
- Immediately after the study, you can drink and eat. If there is an unpleasant feeling of gas accumulation, you can drink a glass of water with activated carbon crushed in it (8-10 tablets) or one sachet of smectite. After the examination, it is best to lie in bed for a few hours, preferably on your stomach. One of the colonoscopy complications may be intestinal perforation during an examination, bleeding, but they occur rarely.
- In general, the procedure is useful in diagnosing and treatment of diseases of the large intestine. It allows you to complement traditional research methods. The method is safe and very informative at low cost and complexity.
Colonoscopy complication and risk factor
Colonoscopy is a safe diagnostic method, but a professional should carry out the procedure.
Complications are rare, but they are possible.
- Perforation of the intestinal wall.
- Bloating that goes away after a short time.
- Intestinal bleeding, which develops in 0.1% of cases
- Respiratory obstruction during the introduction of anaesthesia- it happens in about 0.5% of cases.
- After excision of polyps, the patient’s body temperature may rise to subfebrile levels. For 1-2 days, abdominal pains may bother you.
If a person develops the following symptoms after a colonoscopy, he should immediately consult a doctor:
- Weakness appears
- Decreased efficiency
- The head is spinning
- Diarrhoea develops, in which blood impurities are observed
- The body temperature rises to 38 ° C or more.
A colonoscopy is positive if any polyps or abnormal tissue growth is found in the colon. In most cases, polyps are noncancerous which can be removed during the colonoscopy test. The doctor may take the sample of the polyps (biopsy) for further examinations. Colonoscopy is the safest cancer screening test that accurately diagnoses any disease of the large intestine.