Gastro.... Associates & GA Endosocopy

Colonoscopy (updated 11/29/14)



Screening for colon cancer
with
colonoscopy is recommended for patients over 50 years old and others at high risk.

What is Colonoscopy?

Colonoscopy is the visual examination of the large intestine (colon) using a lighted, flexible fiber-optic or video endoscope. The procedure is performed as an outpatient test. Throughout the country the majority of these are performed in outpatient centers or ambulatory surgery centers. The physician’s at GA Endoscopy were trained in endoscopic techniques as part of their specialty training in gastroenterology. Quality indicators for colonoscopy include documentation that the entire colon was examined (a picture of the cecum / terminal ileum), withdrawal time (time spent looking at the colon cecum to anus) and adenoma detection rates (ADR) in screening exams(a particular type of polyp thought to cause most colon cancers). With a 70 cm to 80 cm length of colon to view and allowing time for washing some areas look at the withdrawal time that your doctor records for colonoscopies. Is 6 minutes an adequate exam? GA Endoscopy has QA (Quality Assurance) plans in place looking at these three quality indicators for all physicians performing colonoscopy.

The colon or large intestine begins in the lower right abdomen and looks like a big question mark as it moves around the abdomen, ending in the rectum. It can be examined with about 70 to 90cm of the endoscopic (a flexible tube that has and image censor in the tip and a biopsy channel for instruments).

Preparation (the patient is in charge)

To obtain the full benefits of the exam, the colon must be clean and free of stool. The patient receives instructions on how to do this. It involves drinking a solution (preferred) using a split dose technique, which flushes the colon clear of debris. Usually the patient drinks only clear liquids the day before the exam. The physician advises the patient regarding the use of regular medications during that time (see downloads section for colon prep sheets).

Procedure

The patient is sedated (conscious sedation); the endoscope is inserted through the anus and moved gently around the bends of the colon. If a polyp is encountered, a thin wire snare is used to remove the polyp. Electrocautery (electrical heat) may be applied to painlessly remove it and control bleeding. Other tests can be performed during colonoscopy, including biopsy to obtain a small tissue specimen for microscopic analysis.

Your sedation may take 10 minutes, and then the procedure 15 to 30 minutes. Times vary depending on the preparation of the colon and the findings during the test. The sedated patient seldom remembers this event. A recovery area is available to monitor your vital signs until the patient is fully awake. It is normal to experience mild cramping or abdominal pressure following the exam. This usually subsides in an hour or so. In some patients monitored anesthesia care or MAC is required to allow the procedure to be performed which does increase overall cost. For the majority of patients (ASA class 1 and ASA class 2) conscious sedation with the use of a narcotic and benzodiazepine is adequate given under the direction of our physicians. This avoids the cost of anesthesia and the potential risks that are associated with deeper levels of sedation.

After the exam, the physician explains the findings to the patient and family. If the effects of the sedative are prolonged, they may suggest an appointment at a later date. If a biopsy has been performed or a polyp removed, the results of these are not available for two to three days.


Side Effects and Risks

Bloating and distention may occur for about an hour after the exam until the air is expelled. Serious risks with colonoscopy, however, are very uncommon. One such risk is excessive bleeding, following the removal of a polyp. This may require a procedure to stop the bleeding. In rare instances, a tear in the lining of the colon can occur (a perforation). These complications may require hospitalization and rarely surgery. Despite careful performance of colonoscopy at intervals recommended by the physician colon cancer may still develop. This is known as an interval colon cancer and is rare. These tumors are either very aggressive fast growing lesion, a lesion in an area that is not well seen (very small flat lesions) or missed polyp.

sample photo of colon polyp

colon polyp
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Gastroenterology Associates
of Southeast Missouri
& GA Endoscopy

1429 North Mount Auburn
Cape Girardeau, MO 63701

Phone 573-334-8870

Fax 573-334-7340