Colonoscopy

What is a colonoscopy?

Colonoscopy is the process where the interior part of the large intestine or the colon is inspected and evaluated. It involves the use of a long and flexible tube called the colonoscope that is inserted through the anus. The process is also able to enter and inspect the last section of the small intestine called the terminal ileum.

The method is used to study any changes or abnormalities inside the intestine including rectal or intestinal bleeding. In some cases, the process can be used to remove polyps or abnormal tissues and also to extract tissue samples for biopsy.

The process is often recommended for individuals with a past or family history of colorectal cancer or polyps, as they have greater risks. The device is attached with a camera that transmits an image which allows the doctor to inspect the interiors of the colon. The tube also bends to move around the curved surface of the colon and is also used to blow air to expand the colon, in order to improve visibility. In some cases, a process called virtual colonoscopy is followed which is basically a form of x-ray.

While this process does not use a colonoscope, it cannot be used for the detailed study of the colon. It has been estimated that around 76 to 90% of colon cancers can be detected and screened through the method of colonoscopy.

Why do I need to undergo a colonoscopy?

A doctor can recommend colonoscopy for the following reasons.

– Any prolonged bleeding from the large intestine.
– Prolonged diarrhea, chronic constipation or abrupt change in bowel habits.
– Abdominal pain and discomfort.
– Unexplained weight loss.
– To check for any symptom of the colon or rectal cancer.
– To look for polyps and remove them if necessary.
– To investigate any abnormality found in the abdomen through a CT scan or an x-ray.

It is suggested that anyone above the age of 50 and with an average risk for cancer, needs to get a colonoscopy done every ten years in consultation with the doctor. The doctor can also recommend this as a follow-up test after conducting a manual rectal examination, a fecal occult blood test or a barium enema.

How is the colonoscopy performed?

The colonoscope may be of various types which can include a high-definition or a wide-angle camera. It may also contain fold-flattening devices or some special tools for polyp removal. Modern methods also use special wavelengths of light that allows the doctors to study the tiny blood vessels below the surface of the colon. 

Some methods also use fluorescent chemicals that are injected intravenously and absorbed by the abnormal cells in more quantity. This enhances their visibility and provides a better chance of detection. The process of colonoscopy generally involves the following steps.

Before the process, the colon is cleaned thoroughly which can take a day. You will be given detailed instructions about the cleaning process, which involves drinking a special cleansing solution or laxatives.

Shifting to a liquid-only diet on the day before the test is necessary so that the wastes can be eliminated quickly from the body.

– You will be asked to change into a hospital gown and an IV will be attached.

– A pain reliever and a sedative will be pushed through the IV so that you feel relaxed and somewhat drowsy.

– The patients are generally made to lie on their left side with the knees drawn up towards the chest.

– The colonoscope is introduced through the anus and slowly advanced, allowing the doctor to check the details of the walls of the colon.

– Air may be passed through the scope to inflate the walls of the colon for a better view. This can lead to a sensation of bloating which will pass with time.

– You can be asked to change positions for better visualization.

– Once the colonoscope reaches the small intestine, it is slowly withdrawn.

– The whole process of examination can take anywhere between 30 minutes to an hour.

– After the process is over, you will have to spend some time in the recovery room until you are fit for discharge. You can return to your normal diet unless you are instructed otherwise.

What is the price of colonoscopy in India? 

The cost for the process of colonoscopy in India varies between INR 4000 to INR 15000 or higher, depending on the facilities provided in the center and the condition of the patient.

How many cases of colon cancer are reported in India every year?

The rate of prevalence of colon cancer in India is 7.2/100,000 in males and 5.1/100,000 among females. Though this number is smaller compared to that of other cancers such as breast cancer and lung cancer, the number of cases reported every year is growing steadily. Colonoscopy can be used to effectively screen colon cancer.

When will I get the test results?

The preliminary results of the procedure can be provided in the same day. If tissue samples have been collected, it might take a week for the process of biopsy.

What is the normal range for a colonoscopy?

The process is generally a visual exam and in case the doctor detects something abnormal, a sample can be collected for tests. The colonoscopy can be called negative when the doctor does not find any abnormalities during the test. The test is called positive in case polyps or abnormal tissue is found during the test.

What do the results mean?

The doctor will share the details of the test with you in the next appointment and if the results are positive, specific instructions will be given to monitor and treat the conditions. In case polyps have been found and removed, you will have to follow an examination scheduled to look out for more polyps in the future.

Although most polyps are benign, precaution needs to be taken to prevent the risk of cancer. In case certain polyps could not be removed during the process, the doctor can recommend you to a specialist who can remove larger polyps through surgery. If there is an infection, a biopsy will reveal the type of bacteria involved and treatment will follow. When biopsy has been done and has revealed the risk of cancer, specific methods of treatment will have to be followed.

Do I need to fast for a colonoscopy?

There will be some diet and fluid intake restrictions placed on you before the examination. Preparing and cleaning the colon in the right manner is necessary to get the process right and the doctor will share with you the steps that are needed for doing the same.

What else do I need to know before I appear for a colonoscopy?

The following factors are to be kept in mind before appearing for the process of colonoscopy.

– Since the process involves the use of sedatives you should be accompanied by someone who can guide you home after you are discharged. Give sufficient time for the sedative to wear off before you can get involved in activities like driving.

– The bowel preparation process may involve diarrhea and you may need to stay at home before the day of the exam. Discuss the details of the process with the doctor so that you can take the right steps.

– Some rectal bleeding may occur after the procedure which is normal and will get healed within a few days. There are minor chances of abdominal perforation during the procedure.

– In case of severe abdominal pain, heavy bleeding, fevers orbloody bowel movements that do not get better, you should report back to the doctor without delay.

– Some abdominal cramping or bloating is normal after the exam and will ease away with time.

– In case you are pregnant or have any special medical condition, you should discuss the same with the doctor of the same before the procedure. If you have heart conditions, diabetes or consume medicines that interfere with blood clotting, you need to inform the doctor about the same.

– Other potential complications can result from allergic reactions to the sedatives used and localized irritation or swelling in the vein through which sedatives were injected.

Can pregnant women undergo a colonoscopy?

Pregnant women can go through the process of colonoscopy as advised by the doctor.

Is colonoscopy possible for new-born babies?

Colonoscopy is conducted for new-borns after they are made to fall asleep with the use of general anesthesia.