Dos and Don'ts After Colonoscopy Procedure

What Is a Colonoscopy?

The colon is considered to be the terminal and the longest (5 feet) part of our digestive system. It is linked to the small intestine on one end and the anus on the other. The main function of the colon is to absorb water and prepare a solid stool. The rectum is the last few inches of the large intestine, from where the stool passes out via the anus.

Colonoscopy is a diagnostic test commonly done to examine the colon and rectum. It makes use of a specialized instrument known as a colonoscopy which has a camera and light to guide the procedure. Colonoscopy is most commonly recommended in cases of gastrointestinal bleeding, polyps or growths, abdominal pain, and any change in bowel habits. Colonoscopy is the most vital tool in colorectal cancer screening and diagnosis as it also helps to obtain a biopsy from the site.

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What Are the Uses of the Colonoscopy Procedure?

A colonoscopy procedure is indicated in the following conditions:

• Gastrointestinal bleeding.

• Sudden and persistent change in bowel habits (change in the color, consistency of the stool).

• Unexplained abdominal pain.

• Consistent weight loss without any medical history.

• Screening tool in colorectal cancer. Patients above the age of 45 with increased risk factors for colorectal cancer may be subjected to colonoscopy.

• Patients with a history of inflammatory bowel disease, Crohn’s disease, or ulcerative colitis should be subjected to colonoscopy as they have an increased risk of developing colorectal cancer.

• It can also be used to aid various surgical procedures related to the large intestine.

• Colonoscopy procedures can be used to remove polyps or biopsy abnormal tissue for pathological examination.

• It can be used along with a suction device to remove liquid stool.

• Colonoscopy can be used to treat diverticula and strictures.

• To remove any objects obstructed in the colon.

How Should the Patients Prepare for a Colonoscopy Procedure?

Patient preparation is of utmost importance for a successful colonoscopy. The preparations happen in three areas; diet modification, bowel cleaning, and general instructions.

1. Diet Modification:

• Patients are advised to consume only plain foods like clear soup, rice, pasta without sauce, or bread from 2 days before the scheduled procedure.

• A day before the procedure, the patient should refrain from any solid foods. They can consume a clear liquid diet such as plain broth, clear water, plain tea or coffee, and soda.

• Should avoid any colored food or food dye.

• Should avoid red-colored food as it could be mistaken for blood during the examination.

• The patient should avoid spaghetti or stringy foods, squash, nuts, corn, and seeds for at least three days before the scheduled procedure.

• Patients are required to fast for four hours before the colonoscopy.

• Patients should drink plenty of water.

• The liquid diet will help get a clear view of the colon and rectum as no solids will be present in the digestive system.

2. Bowel Cleansing:

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Bowel preparation is critical for colonoscopy as the colon should be devoid of any materials. A clear bowel will help the doctor get a clear view and facilitate the diagnosis. Bowel preparation usually involves laxatives which the patient will be advised to take the night before the procedure. They are usually pills or in liquid forms. Sometimes the patient may also have to take a laxative in the morning before the procedure. Some patients may also require an enema before the procedure. A clear bowel is vital to accurate results.

3. General Instructions:

• Patients should report to the doctor any history of allergy.

• Ladies who think they might be pregnant should inform their doctor regarding the same. Also, if they are doing a routine screening colonoscopy, it will be advisable to postpone the procedure.

• Patients who are on blood-thinning medications should inform the doctor as the dose may have to be adjusted, or the medicine may need to be stopped before the procedure to avoid unnecessary bleeding.

• The doctor should be well informed about the prescription medicines, supplements, and over-the-counter drugs taken by the patients.

• An antibiotic coverage may be needed for heart patients with valvular disease.

How Is Colonoscopy Done?

Colonoscopy is performed as an outpatient procedure. The entire procedure may take roughly 30 to 60 minutes or even longer if an intervention is required.

• The patient will be asked to wear a hospital gown and made to lie on the examination table. They would be made to lie on their side with knees approximated to their chest.

• An intravenous (I.V) line would be started on their arm, and mild sedatives will be given; for some patients, general anesthesia may be required.

• The vitals such as pulse, blood pressure, and heart rate will be monitored.

• A colonoscope will be inserted through the anus into your colon. The colonoscope is a thin long flexible tube-like device that has a light and camera attached to it. The light guides the scope, and the camera helps to visualize the structures.

• As the scope is inserted, the patient will feel some pressure but no pain.

• Air or carbon dioxide would be pumped in to inflate the colon and get a better view inside. The patient might feel some cramps or the urge to pass motion.

• The scope helps the doctor to view the colon and rectum and to look for abnormalities. The scope, when attached to a monitor, can also send real-time images which can be observed on the screen.

• If any abnormal growth is observed, the scope can be used to biopsy the tissue at the same time.

• Once the procedure is complete, the scope is withdrawn, and the patient will be taken to the recovery room.

What Are the Instructions to Be Followed After the Colonoscopy Procedure?

Just as patient preparations are essential for successful colonoscopy, recovery instructions should also be carefully followed for fast recovery. The instructions can be categorized as below:

1. General Instruction:

• After the procedure is completed, the patient will be monitored in the recovery room for 2 to 3 hours.

• Cramping and bloating are normal in the first few hours after the procedure, which is due to the air pumped in during colonoscopy. Walking helps to relieve the air, and the patient feels better.

• Patients are not expected to drive or lift any heavy objects. No physical strain or exertion for the next 24 hours.

• If surgical intervention is done, the patients are advised to rest for a week.

• Avoid consuming alcohol for the next 24 hours.

• Post colonoscopy, especially if a biopsy is performed, patients could be anxious about the reports. It will be better to keep yourself engaged in your favorite activities till the reports come. Also, it should be kept in mind that early detection would result in a better outcome.

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2. Diet modification:

• The patient can return to their normal diet, however, with minor modifications for a few days.

• Patients should drink plenty of liquids to rehydrate themselves for the first 24 hours.

• Electrolytes, tea, vegetable, and fruit juice are suggested as they would rehydrate as well as provide essential nutrients.

• Patients are suggested to start with light meals such as crackers, toast, cooked vegetables, chicken, or fish with mild seasoning as they are easy to digest.

• Patients should avoid spicy and fiber-rich food for a day or so after the procedure as they are hard to digest.

• Heavy, fatty foods should also be avoided as they can cause nausea and vomiting.

• If polyp removal is done, patients might be asked to avoid seeds, nuts, and kernels as they could get lodged in the wound and hinder the healing process, and may also result in infection.

• Carbonated and aerated drinks should also be avoided as they can make the patient feel more bloated.

3. Bowel Movement:

Bowel movement may not happen for a few days; also, the first bowel movement may have a tinge of blood which is normal. Unless there are huge blood clots or lumps, or uncontrolled bleeding from the anus, the patient need not be worried. Most of the patients make a complete recovery within 24 – 48 hours. However, it is advisable to take a rest till they feel absolutely normal.

What Are the Benefits of This Procedure?

• A minimally invasive technique.

• Best screening tool for colorectal cancer.

What Are the Complications of This Procedure?

• Uncontrolled bleeding.

• Colon perforation.

• Abdominal pain.

• Bleeding and tearing of colon tissue may be associated with biopsy.

• Allergic reaction to the sedative. This is extremely rare.

When to Seek Medical Advice?

• Severe abdominal pain.

• Uncontrolled fever.

• Bleeding from the anus or persistent bloody stool.

• Nausea, dizziness, and uncontrolled vomiting.

What Is Virtual Colonoscopy?

A virtual colonoscopy is an X-ray imaging test used to view the rectum and colon. No colonoscope is used in virtual colonoscopy. The patient is asked to consume a contrast material, and X-ray images are obtained of the large intestine. A virtual colonoscopy is less effective than a regular colonoscopic procedure as it does not give a complete picture of the colon. It is also not possible to remove a polyp or biopsy a tissue through virtual colonoscopy. Hence it is not much recommended.

Conclusion:

Colonoscopy is a relatively safe and very important diagnostic procedure in identifying gastrointestinal problems. Though the procedure requires tedious preparations, the recovery is easy and quick. People with high-risk factors or with a family history of colorectal cancers should get themselves regularly screened with a colonoscopic procedure. Regular screening will enable early detection of any abnormality, thus facilitating prompt treatment.

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