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Doctor Certified

Last updated: 02/17/2009

Diagnosis/Preparation

The physician should be notified if the patient has allergies to any medications or anesthetics, bleeding problems, or is pregnant. The doctor should be informed of all the medications the patient is taking and if he or she has had a barium enema x-ray...

examination recently. If the patient has had heart valves replaced, the doctor should be informed so that appropriate antibiotics can be administered to prevent infection. The risks are explained to the patient beforehand, and the patient is asked to sign a consent form.

The colon must be thoroughly cleansed before performing colonoscopy. Consequently, for two or more days before the procedure, considerable preparation is necessary to clear the colon of all stool. The patient is asked to refrain from eating any solid food for 24–48 hours before the test. Only clear liquid such as juices, broth, and gelatin are allowed. Red or purple juices should be avoided, since they can cause coloring of the colon that may be misinterpreted during the colonoscopy. The patient is advised to drink plenty of water to avoid dehydration. A day or two before the colonoscopy, the patient is prescribed liquid, tablet, and/or suppository laxatives by the physician. In addition, commercial enemas may be prescribed. The patient is given specific instructions on how and when to use the laxatives and/or enemas.

On the morning of the colonoscopy, the patient is not to eat or drink anything. Unless otherwise instructed by the physician, the patient should continue to take all current medications. However, vitamins with iron, iron supplements, or iron preparations should be discontinued for a few weeks prior to the colonoscopy because iron residue in the colon can inhibit viewing during the procedure. These preparatory procedures are extremely important to ensure a thoroughly clean colon for examination.

After the procedure, the patient is kept under observation until the medications' effects wear off. The patient has to be driven home and can generally resume a normal diet and usual activities unless otherwise instructed. The patient is advised to drink plenty of fluids to replace those lost by laxatives and fasting.

For a few hours after the procedure, the patient may feel groggy. There may be some abdominal cramping and a considerable amount of gas may be passed. If a biopsy was performed or a polyp was removed, there may be small amounts of blood in the stool for a few days. If the patient experiences severe abdominal pain or has persistent and heavy bleeding, this information should be brought to the physician's attention immediately.

For patients with abnormal results such as polyps, the gastroenterologist will recommend another colonoscopy, usually in another year or so.



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Other Information

Colonoscopy is the endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions. Virtual colonoscopy, which uses 2D and 3D imagery reconstructed from computed tomography (CT) scans or from nuclear magnetic resonance (MR) scans, is also possible, as a totally non-invasive medical test, although it is not standard and still under investigation regarding its diagnostic abilities. Furthermore, virtual colonoscopy does not allow for therapeutic maneuvers such as polyp/tumor removal or biopsy nor visualization of lesions smaller than 5 millimeters. If a growth or polyp is detected using CT colonography, a standard colonoscopy would still need to be performed. Colonoscopy can remove polyps as small as one millimeter or less. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not. Colonoscopy is similar to but not the same as sigmoidoscopy. The difference between colonoscopy and sigmoidoscopy is related to which parts of the colon each can examine. Sigmoidoscopy allows doctors to view only the final two feet of the colon, while colonoscopy allows an examination of the entire colon, which measures four to five feet in length. Often a sigmoidoscopy is used as a screening procedure for a full colonoscopy. In many instances a sigmoidoscopy is performed in conjunction with a fecal occult blood test (FOBT), which can detect the formation of cancerous cells throughout the colon.


From http://en.wikipedia.org/wiki/Colonoscopy

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