Dr. Michael W. Goodman & Dr. Matthew E. Bagamery

Colonoscopy

What is a colonoscopy?

What preparation is required?

What about my current medications?

What can be expected during colonoscopy?

What if the colonoscopy shows something abnormal?

What are polyps and why are they removed?

How are polyps removed?

What happens after colonoscopy?

What are the possible complications of colonoscopy?

To the Patient


What is a colonoscopy?Back to top

Colonoscopy is a procedure that enables your physician to examine the lining of the colon (large bowel) for abnormalities by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.

Unless otherwise necessary, your colonoscopy will be performed in our Endoscopy Suite.

What preparation is required?Back to top

The colon must be completely clean for the procedure to be accurate and complete. Our nurses will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. In general, preparation consists of either consumption of a large volume of a special cleansing solution or several days of clear liquids, laxatives, and enemas prior to the examination. Follow your doctor's instructions carefully. If you do not, the procedure may have to be cancelled and repeated later.

We have provided a few of the most frequently asked questions (FAQs) about the Dulcolax and Colyte prep and the Fleet Phospho-soda prep.

What about my current medications?Back to top

Most medications may be continued as usual, but some medications can interfere with the preparation or the examination.

You may take your heart or blood pressure medications with a sip of water the morning of your procedure.

IMPORTANT: Please either bring a list of your current medications, including over the counter medications, or the bottles themselves to the facility where you are having your procedure. Also bring a list of your medication allergies with you to the procedure. Make sure our office also has this information.

- If you are diabetic: Contact your primary physician regarding medications for the day of your procedure.

- If you are on blood thinner (such as Coumadin and aspirin): Contact our office as soon as possible during business hours (9:00 am - 5:00 pm ) if you have not already informed our staff. These may need to be stopped prior to your procedure.

- If you have been told to take antibiotics prior to dental visits or diagnostic tests other than for hip /joint replacements: Contact our office as soon as possible during business hours ( 9:00 am - 5:00 pm ) if you have not already informed our staff.

What can be expected during colonoscopy? Back to top

Colonoscopy is usually well tolerated. There is often a feeling of pressure, bloating, or cramping at times during the procedure. Your doctor will give you medication through a vein to help you relax and better tolerate any discomfort from the procedure. Most patients sleep through the procedure. You will be lying on your side or on your back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the large intestine is examined. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The physician will decide if the limited examination is sufficient or if other examinations are necessary.

What if the colonoscopy shows something abnormal?Back to top

If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy ( a sample of the colon lining). This specimen is submitted to the pathology laboratory for analysis. If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulation (sealing off bleeding vessels with heat treatment). If polyps are found, they are generally removed. None of these additional procedures typically produce pain. Remember, the biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.

What are polyps and why are they removed?Back to top

Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. The majority of polyps are benign (noncancerous) but the doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis. Removal of a colon polyps is an important means of preventing colorectal cancer.

How are polyps removed?Back to top

Tiny polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. The physician passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon, which could require emergency surgery.

What happens after a colonoscopy?Back to top

After colonoscopy, your physician will explain the results to you. If you have been given medications during the procedure you will not be allowed to drive, take a taxi, or ride the bus. A responsible adult must drive and accompany you home from the procedure because of the sedation used during the examination. Even if you feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for you to drive or operate any machinery.

You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with passage of flatus (gas). Generally, you should be able to eat after discharge, but your doctor may restrict your diet and activities, especially after polypectomy.

What are the possible complications of colonoscopy?Back to top

Colonoscopy and polypectomy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures.

One possible complication is a perforation or tear through the bowel wall that could require surgery. Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the colonoscope. Rarely, blood transfusions or surgery may be required. Other potential risks include a reaction to the sedatives used and complications from heart or lung disease. Localized irritation of the vein where medications were injected may rarely cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve discomfort.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact your physician who performed the colonoscopy if you notice any of the following symptoms: severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Bleeding can occur several days after polypectomy.

To the Patient:Back to top

Because education is an important part of comprehensive medical care, you have been provided with this information to prepare you for this procedure. If you have questions about your need for colonoscopy, alternative tests, the cost of the procedure, methods of billing, or insurance coverage, do not hesitate to speak to your doctor or your doctor's office staff. Most endoscopists are highly trained specialists and welcome your questions regarding their credentials and training. If you have questions that have not been answered, please discuss them with the endoscopy nurse or your physician before the examination begins.

Erlanger Medical Mall
979 East Third Street
Suite C-0630
Chattanooga, TN 37403
423.267.5677