Colonoscopy: everything you need to know

A colonoscopy is a medical procedure which helps to detect and diagnose conditions such as polyps, inflammation, or colorectal cancer, and is crucial for preventive and diagnostic healthcare. Distinguished colorectal surgeon Mr Sebastian Smolarek provides guide to the procedure, answering everything that you need to know, including what to expect, and potential risks and complications.

What is a colonoscopy and why is it recommended for colon health?

A colonoscopy is a camera examination of entire colon, using a specially designed flexible camera with a light source. It allows for direct visualisation of the colon and help detects significant colonic pathologies, such as colorectal cancer, polyps, or other growth in the colon.

During a colonoscopy, benign colonic growths such as polyps can be removed, which will prevent further development of colorectal cancer.

How do I prepare for a colonoscopy and what are the dietary and medications restrictions?

Effective preparation for colonoscopy is essential to ensure a thorough, high quality examination and optimal mucosal visualisation. It is recommended that three to five days prior to procedure, the patient adheres to a low-residual diet, avoiding certain foods such as fruits, vegetables, whole grain products, breakfast cereal, red meat, nuts, seeds, as well as fruit and vegetable juices. In addition, 24 hours prior to the procedure, the patient should consume only clear fluids and follow the prescribed cleaning agent regimen according to the instructions provided by endoscopy units.

Is colonoscopy painful and what can I expect during the procedure?

Generally, a colonoscopy is not painful, however, it is an invasive examination. Some patients may encounter a degree of unease, and find the examination to be unpleasant. Since endoscopies involve introducing air into the colon to expand it for mucosal visualisation, individuals may experience bloating and sensations of the scope moving within the abdomen.  

Given the colon's curved nature, discomfort may arise, particularly near bends in the colon. The level of discomfort felt will vary from patient to patient on individual basis. To prevent discomfort and increase the compliance of colonoscopy, the patient can use Enthanox, also known as Gass and air, a short-acting analgesic, or intravenous sedation, which is a combination of fast-working analgesic with sedative agent. If selecting sedation, patients should arrange for someone to care for them for 24 hours and refrain from driving during this period.

What are the potential risks and complications associated with the colonoscopy?

Colonoscopy is generally safe examination, and the likelihood of risks and complications occurring is extremely rare.  Common side effects may include slight discomfort during the procedure, post-procedural bloating, minor bleeding if a biopsy or polypectomy is performed, and dehydration following the use of bowel cleansing agents. Severe complications are infrequent, and the most serious among being colonic perforation, which is estimated to occur in one out of a thousand procedures. Colonic perforation typically arises after polypectomies or more extensive procedures.

Other even more serious complications may include splenic perforation, in cases of severe adhesion between the colon and spleen, as well as potential hypotension.

What are the guidelines or recommendations for scheduling regular colonoscopies, and how often should I have one for free on this care?

A regular colonoscopy is an only offered for patients with genetic conditions, and is use for screening and preventing developing a colorectal cancers in conditions such as familiar colorectal polyposis. Generally, colonoscopy is indicated for patients who develop new colorectal symptoms, such as change in bowel habits, perineal (rectal) bleeding, weight loss, abdominal pain, iron deficiency anaemia. Additionally, a colonoscopy may be recommended for patients if they have long-standing symptoms of constipation or diarrhoea, which will require further diagnosis.

Furthermore, patients suffering from inflammatory bowel disease will require regular colonoscopies for disease assessment following treatment or after developing new symptoms.

If you require a colonoscopy, and would like to book a consultation with Mr Smolarek, do not hesitate to do so by visiting his Top Doctors profile today.