Colonoscopy

Colonoscopy is the procedure used to examine the lining of the entire colon or large intestine. This is done for individuals with a history of constipation or diarrhea, persistent rectal bleeding, persistent abdominal pain, positive stools for occult blood, personal history of breast, uterine, or ovarian cancer, personal or family history of colon polyps or colon cancer, or persons with a long-standing history of inflammatory bowel disease involving the entire colon.

The endoscope (colonoscope) is a long black flexible tube, a little bigger around than a pencil. Light is transmitted through the scope and a picture appears on a screen much like a television. In most cases, the physician will take pictures of any abnormalities. These pictures become a permanent part of your hospital chart and your chart in the physician’s office. He/she will also have these pictures available to show you and your family after the procedure. In some cases, the physician will videotape your procedure.

You will be admitted to the Ambulatory Care area of the hospital approximately 1-1/2 to 2 hours before your procedure. It is in this area that your procedure will also be done. On admission, a nurse will do a nursing physical assessment and have you sign a Consent for Treatment Form. An I.V. line will be started. Through this you will receive medication to keep you relaxed and comfortable during the procedure. You may also feel a bit sleepy. This is normal.

For the procedure, you will be asked to lie on your left side. The procedure will take about 30 minutes depending on what the physician is finding. If several biopsies need to be taken or several polyps removed, it may take longer. If there is a possibility that polyps are going to be removed, a special pad that may be cold and sticky will be placed on your upper thigh.

Lubricating jelly is applied to the tube before it is inserted into the rectum. As the tube is advanced through the colon, you may experience a feeling of having to have a bowel movement. This is normal. You may also experience cramping and a feeling of fullness. This due to the physician inserting air into the colon to better visualize the area. Suction is also available to remove any retained liquid or stool in the colon. You will not feel this.

If you experience any severe discomfort, please let the nurse or physician know immediately. You will receive enough medication to keep you comfortable.

As the physician is inserting the endoscope into the colon, he/she is continually examining the lining of the colon. When the scope is inserted to satisfactory position, he/she will begin to slowly withdraw the scope. It is at this time when the most thorough examination is done. Biopsies are taken or polyps are removed at this time. Be assured, you will feel no discomfort when this is done.

After the procedure, the physician will give you a general idea of what was found. However, biopsy samples and polyps that are removed are sent to the laboratory for analysis. These results are sent to your physician. After careful review, your physician or nurse will call you or notify you by mail of your results. This may take a week to ten days..

Colonoscopy and biopsies are generally safe when performed by an experienced, trained physician. If biopsies are done or polyps removed, you may experience a small amount of bleeding for up to one week following. Serious complications are rare but can include perforation (tear in the wall of the bowel), and bleeding at the biopsy site. Notify your physician immediately if you develop heavy bleeding (more than one-half cup or more), if you begin to pass clots, have severe abdominal pain, chills or fever. Less severe side-effects may include redness or tenderness in the vein where the IV was started. A tender lump may develop in this site and may remain for several weeks. This will eventually disappear. Other risks include drugs reactions or complications from other diseases such as heart problems. This is only a remote possibility.

After your procedure, it is important that you have someone with you to speak with your physician. Someone needs to be available to drive you home. After the effects of the medicine have worn off and you are able to take fluid and foods, you will be discharged. If you have any questions in the meantime, please call the office at 563-557-9111.

TWO IMPORTANT REMINDERS:

1. HAVE SOMEONE AVAILABLE TO DRIVE YOU HOME.

2. CONTACT YOUR INSURANCE CARRIER REGARDING COVERAGE OF THE PROCEDURE. YOU MAY NEED AN INSURANCE PRECERTIFICATION NUMBER.

PREPARATION FOR COLONOSCOPY

Follow all the directions that are checked:

Begin a low residue diet two days before your procedure.

Begin a full liquid diet the day before your procedure.

Begin a clear liquid diet after starting your laxative the day before your procedure. A clear liquid diet includes any liquids you can see through. Examples include water, apple juice, plain tea, broth, plain gelatin, and popsicles. It is best to avoid any red liquids.

If your colonoscopy is scheduled in the afternoon, you may have clear liquids the morning of your procedure.

Nothing to eat or drink after midnight.

Laxative preparation as marked below:

ColyteTM preparation. Chill one gallon of water. Dissolve one container of ColyteTM crystals in a gallon of water. Drink one or two glasses every 10-15 minutes until gone. If you become nauseated or feel sick to your stomach, drink laxative more slowly at a pace comfortable for you.

Fleet’s Phospha SodaTM--- 3ounces

Take 1½ ounces each at 4 P.M. and at 8 P.M. the day before your procedure.

Take 1½ ounces at 4 P.M. the day before your procedure and 1½ ounces at 6 A.M. the morning of your procedure.

Drink 8 ounces of water with each dose and follow with another 8 ounces of water.

Remember: Clear liquids only after starting the laxative preparation.

Low Residue Diet

Beverages: Carbonated beverages, coffee, tea, milk (limit of two glasses per day.

Bread: Enriched white bread, seedless, rye, cornbread, rusk, saltines, soda crackers, Zwieback.

Cereal: Cooked refined cereals as Cream of Wheat, Farina, strained oatmeal, grits; dry prepared cereal from corn, oat or rice.

Cheese: American processed, cottage, cream. Plain yogurt as part of milk allowance.

Desserts and sweets: Cakes--angel food, chiffon, plain, pound, sponge; plain cookies; gelatin; plain sherbets; fruit whip from pureed fruits; plain mild desserts; custard, ice cream, milk puddings prepared from milk allowance; whipped topping; sugar, clear jelly, honey, syrups; hard candies, milk chocolate, gumdrops, marshmallows.

Meat, fish, poultry, eggs: Soft, scrambled, fried or boiled eggs; baked broiled, creamed, or stewed meats; very tender beef, chicken, lamb, liver, fish, tuna, turkey, salmon, veal, lean pork, crisp bacon, canned ham; shellfish

Fruit: Ripe bananas, baked apple (without skin), cooled or canned fruits without skins or seeds, applesauce, peaches, pears, peeled apricots; jellied cranberry sauce; all strained juices.

Vegetables: Whole tender carrots, beets, asparagus tips; strained vegetables such as wax or green beans, green peas, spinach, yellow squash, tomatoes; vegetable juices.

Potatoes or substitutes: White potatoes--boiled, baked, creamed, escalloped, mashed; grits, macaroni, noodles, rice, spaghetti, strained sweet potatoes.

Salad: Gelatin; fruits and vegetables prepared from allowed foods.

Soup: Broth, bouillon; soups made from allowed foods; strained cream soups made from milk and vegetable allowances.

Fats: Butter, cream, cream substitutes, margarine, mild mayonnaise, gravies, vegetable oils.

Miscellaneous: Salt, cream sauce, catsup, flavorings, lemon juice, paprika, vinegar, smooth peanut butter.

Full Liquid Diet

1. Cream soups and clear soups--smooth without chunks of food.

2. Milk, milk shakes, ice cream that are smooth. Must not have bits of food or fruit. It is best to eliminate chocolate.

3. Fruit juices of all kinds except those with pieces of pulp such as orange juice with pulp.

4. Coffee and tea.

5. Any type of carbonated beverages. Alcoholic beverages are allowed but not advised.

As a general rule of thumb for a full liquid diet, you can have anything you can easily get through a straw.

Dietary listings are from the dietary department of the Finley Hospital, Dubuque, Iowa.

 Special Medication Instructions

1. If you are on medication, please check with the physician on how this medication should be taken before your procedure. Take your medications to the hospital with you.

2. If you are on insulin or medication for diabetes, these may need to be adjusted prior to the procedure. Check with you physician.

3. Do not take fiber supplements for three days prior to you colonoscopy.

4. Do not take iron for one week prior to your colonoscopy.

5. If you take aspirin, anti-inflammatory drugs, or blood thinners, be sure the physician is aware of this. The medication may need to be discontinued for up to one week prior to the scheduled procedure.