Frequently Asked Questions:
1
What is a Colonoscopy?
A colonoscopy is an examination of the large intestine. During the procedure, a colonoscope, a long, flexible tube about the thickness of a finger is inserted through the rectum into the large intestine (colon). The colonoscope allows the physician to carefully examine the lining of the colon. If the doctor sees a suspicious area or needs to evaluate an area of inflammation in greater detail, he can pass an instrument through the colonoscope and take a sample of tissue (a “biopsy”) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. A small brush can be introduced as well to collect cells from an abnormal area for examination in the laboratory (a form of “pap test” or “cytology”). If small pre-cancerous polyps are found, they can be removed immediately during the same procedure preventing them from becoming cancer.
2
What is a polypectomy?
Sometimes during the course of the examination a polyp may be found. Polyps are abnormal growths of tissue, which vary in size from a tiny dot to several inches and can cause rectal bleeding or lead to cancer. They are usually benign (non-cancerous), however, some may be pre-cancerous. Generally, all polyps are removed immediately. Your doctor will pass a wire loop (snare) through the colonoscope and remove any polyps. You should feel no pain during removal of the polyp. Removal of colon polyps is important in the prevention of colon cancer.
3
How do I prepare for a colonoscopy?
For the best possible examination, the colon must be completely empty. You will be asked to temporarily discontinue the use of aspirin products, iron tablets and possibly other medications before the examination. Your doctor will give you detailed instructions to follow the day before your procedure, including the use of liquid laxatives or pills and fasting that will help ensure your colon is empty of all digested material on the day of your procedure. Be sure to let your doctor know if you are allergic to any drugs. Someone must accompany you to the office because you will be sedated and not allowed to drive after the screening. Even though you may not feel tired, your judgment and reflexes may not be normal.
4
What should I expect during the procedure?
When you arrive, you will be given an IV through which medication will make you relaxed and sleepy. After the medication takes effect, the colonoscope is inserted into the rectum and gradually moved through the colon while the lining is examined thoroughly. The procedure is usually very comfortable and rarely causes pain. In fact, most patients fall asleep during the examination and don't remember it at all. The actual procedure takes 15 to 30 minutes.
5
What happens after the colonoscopy?
You will be monitored until most of the effects of the medication have worn off. You may feel bloated and “gassy” right after the procedure because of the air that was introduced into the colon by the colonoscope. As soon as the procedure has been completed, you may resume your usual diet unless other instructions are given. If a polyp has been removed, your doctor may suggest a modified diet before returning your normal diet. It is advisable to avoid heavy lifting and exercise for several days if polyps are removed.
6
Are there any complications of colonoscopy and polypectomy?
Colonoscopy and polypectomy are safe and have minimal risks when performed by physicians who have been specially trained and are experienced in endoscopic procedures. One major possible complication is “perforation,” in which a tear through the wall may allow leakage of intestinal fluids. It may be managed with antibiotics and intravenous fluids, although surgery is usually required. Bleeding may occur from the site of biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of electrical current) through the colonoscope. Rarely, transfusions or surgery may be required. Localized irritation of the vein can occur at the site of medication injection. A tender lump develops which may remain for several weeks to several months but goes away eventually. Other risks include drug reactions and complications from unrelated diseases such as heart attack or stroke. Death is extremely rare but remains a remote possibility.
7
Why is a colonoscopy necessary?
Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by X-ray can be confirmed and studied in detail. Even when X-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found by colonoscopy. It is useful for the diagnosis and follow-up of patients with inflammatory bowel disease (IBD) as well. Colonoscopy's greatest impact is in its contribution to the control of colon cancer by polyp removal. Periodic colonoscopy is a valuable tool for follow-up of patients with previous polyps, colon cancer and family history of colon cancer. A Colonoscopy is a safe and extremely worthwhile procedure to help prevent colon cancer, in fact, thanks to colonoscopies, colon cancer is one of the most preventable cancers.
8
What is The Colon Cancer Prevention Network?
The Colon Cancer Prevention Network is a group of 12 CCPN centers with convenient online and over-the-phone scheduling and more than 115 independent outpatient surgery centers which collectively perform almost half a million colonoscopies per year. Each center is staffed by expert local gastroenterologists and nurses who are trained to deliver personalized, high quality digestive health care. All are affiliated with AmSurg Corp., America's leader in specialized outpatient surgery centers with a patient satisfaction rating over 99%. AmSurg is a publicly held health-care company which has specialized in the delivery of surgical services in the outpatient setting since 1993.
When you choose one of our outpatient surgery centers, you'll find that the process is much more convenient than at a hospital as well as more personal. Here, our environment is relaxed and inviting with individualized care. Our staff is specialized in their field and will make sure your visit goes as quickly and smoothly as possible.
As a patient of the Colon Cancer Prevention Network, colon cancer stops with you.
9
I hear there is a non-invasive “virtual” colonoscopy available. Why shouldn't I just wait for that?
Virtual colonoscopy is slowly becoming available, but it is still in the very early stages, so availability is very limited. In fact, AmSurg (The Colon Cancer Prevention Network's management partner) is very involved in testing this technology in some of its centers, in partnership with the renowned Cleveland Clinic and General Electric Corp. Based on the success of those tests, AmSurg and its more than 115 centers which offer colonoscopies will be among the first to offer the virtual option to their patients.
However, virtual colonoscopy has its limitations. To begin, it doesn't eliminate the colon-emptying preparation steps; you must still do that prep. But its primary limitation is that it can't remove any polyps found – it is not preventive. If polyps and other abnormalities are seen during a virtual colonoscopy, a traditional colonoscopy must be performed to remove them.
Since colon cancer is the second leading cause of cancer death in the U.S., our recommendation is not to wait to get your colonoscopy if you presently meet screening guidelines. If no polyps are found and if this technology progresses as planned, your next colonoscopy could very likely be virtual. (And The Colon Cancer Prevention Network will be among the first to offer it!) By acting now, as you wait you will enjoy the peace of mind in knowing you've done what you can do to prevent your colon cancer until then.