Colonoscopy

A colonoscopy is a visual exam of the lining of the large intestine, also called the bowel or colon, with a colonoscope. A colonoscope is a flexible tube with a light and a viewing device. It allows the doctor to view the inside of the colon through a tiny video camera.

Parts of the body involved:

Large intestine (colon), rectum.

Reasons for the procedure:

A colonoscopy is performed to visualize, diagnose and sometimes treat problems inside the large intestine. The procedure is most often recommended for the following reasons:

• To locate the source of lower intestinal bleeding
• To diagnose changes in bowel habits
• To determine the cause of lower abdominal pain
• To detect early signs of colon cancers or pre-cancers (polyps) in individuals without symptoms but who are at increased risk for these conditions
• To obtain tissue samples for testing
• To remove a polyp (an abnormal growth on the inside lining of the intestine)
• To stop intestinal bleeding

Risk factors that may lead to complications:

• Active colitis, diverticulitis or other acute bowel diseases
• Previous treatment with radiation therapy
• Treatment with certain medications, including aspirin and other drugs with blood-thinning properties

What to expect before the procedure:

Your doctor will likely do the following:

• Physical exam
• Health history
• Review of medications
• Test to check for hidden blood, called "occult blood"

In the days leading up to your procedure:

• Your colon must be completely cleaned out before the procedure. Any stool left in the colon will block the doctor's view and limit the procedure's success. Several cleansing methods may be used, including enemas, laxatives and a clear-liquid diet. You may be asked to drink a large container of solution that aids in the complete emptying of the colon. This preparation may start several days before the procedure.
• Do not take bulk-forming laxatives or iron-containing medications or supplements for one week before the procedure unless told otherwise by your doctor.
• Do not take aspirin or other anti-inflammatory or blood-thinning drugs for one week before the procedure unless told otherwise by your doctor.
• Do not eat or drink anything for eight to 10 hours before the procedure.
• If you have insulin-dependent diabetes, ask your doctor about any adjustments to your insulin dose.
• Arrange for a ride to and from the procedure.

Anesthesia:

A pediatric anesthesiologist will give general anesthesia during the procedure. This ensures no discomfort during the procedure for our pediatric patients.

Description of the procedure:

Pediatric patients are generally positioned on their back with the knees brought up in a frog-legged position. Biopsies in pediatric patients can identify inflammation and possible allergies and diagnose various conditions, such as bleeding polyps and inflammatory bowel disease.

After the procedure:

Laboratory exam of removed fluid or tissue.

How long will it take?

The colonoscopy takes less than one hour. Expect to stay at the hospital or doctor's office for another hour or two or until the sedative wears off. Because of the anesthesia used, it is a good idea to have someone drive you home from the procedure.

Will it hurt?

There is no discomfort during the procedure since general anesthesia is used for pediatric patients.

Possible complications:

• Bleeding
• Perforation or puncture of the bowel

Average hospital stay:

None.

Postoperative care:

• Do not drive for at least eight hours.
• Rest for the remainder of the day.
• Feelings of bloating, gas or cramping may persist for 24 hours.
• Resume medications as instructed by your doctor.
• Resume your normal diet unless told otherwise by your doctor.

Outcome:

The doctor will usually give you a preliminary report after the medication wears off and you are more alert. The results from a biopsy can take as long as one to two weeks to be completed, so schedule a follow-up with your GI doctor to review the results and develop a treatment plan.

Call your doctor if any of the following occurs:

• Signs of infection, including fever and chills
• Bleeding (notify the doctor if you pass a teaspoon or more of blood)
• Black, tarry stools
• Severe abdominal pain
• Coughing, shortness of breath, chest pain, severe nausea or vomiting