COLONOSCOPY EXAM Colonoscopy is the visual examination of the large intestine (colon) using a lighted, flexible fiberoptic or video endoscope. The colon begins in the right lower abdomen and looks like a big question mark as it moves up and around the abdomen, ending in the rectum. The procedure is performed with you lying on your left side. After the administration of a mild sedative, the endoscope is gently inserted through the anus and moved around the bends of the colon. PREPARATION The key to an accurate diagnosis of your problem is proper preparation. The bowel needs to be flushed completely free of waste material to give the clearest possible view. You will receive instructions on how to do this from your physician. Diet You should drink only clear liquids and eat no solid foods for the day before the exam. Seeds and nuts frequently take longer to pass through the bowel than other foods, you should try to avoid these during the week preceding your examination. You should not eat or drink anything after midnight the night before your procedure except those liquids included in your preparation. You may have clear liquids up to five (5) hours before your scheduled arrival time. Medications If you take heart, blood pressure or respiratory medications, take them one hour before your appointment with a small amount of water. Please notify your doctor if you are taking anticoagulants or blood thinners such as Coumadin, Plavix, Persantine (dipyridamole), Ticlid or aspirin regularly. It is important that these medications are discontinued at least one week prior to your procedure. Special instructions may be necessary. Medications containing iron can interfere with your doctor's view of the colon. Do not take oral iron for at least one week before the exam. What to wear Wear loose fitting, comfortable clothes. Do not wear heavy or bulky sweaters. Avoid girdles, pantyhose, or tight-fitting garments. You will be required to change into a pair of loose fitting shorts for the procedure. Prior to the procedure you will be asked to remove your eye glasses. Contact lenses will not need to be removed. Dentures need to be removed only if they fit loosely. Tongue rings need to be removed rior to the procedure. Monitoring Before the procedure begins, your temperature, pulse, blood pressure and blood oxygen will be measured. During the procedure and recovery period, monitoring of blood pressure, pulse and blood oxygen level is continued. You will receive supplemental oxygen during the procedure using a small tube which fits under your nose. During the procedure, your EKG (heart rhythm) will be monitored also. Transportation Bring a driver since you can not drive yourself home. Because of the effects of the sedation you will be receiving, you will not be able to drive for at least 12 hours after your procedure. If possible, your driver should be someone with whom your doctor can freely discuss the results of your procedure, since you may be a little forgetful afterwards. We request that your driver remain at the center during your test. You should plan on being at the West Shore Endoscopy Center approximately 1 to 2 hours. Your Permission If you have any questions or concerns about this test, do not hesitate to ask your doctor about them. To signify that you completely understand what this test involves and that you are giving permission for the doctor to perform this test, you will be asked to sign a written consent form before the test begins. Your doctor will discuss the exam with you and answer any questions. DISCHARGE INSTRUCTIONS While you will soon be resuming your normal activities, there are several directions and precautions that you should be aware of to insure your safety. Because you have been sedated for the procedure, you are not to drive a motor vehicle, operate dangerous machinery, or perform potentially hazardous tasks for at least twelve hours or until you have completely recovered from the effects of the medication. Since you have been fasting and your lower intestinal tract has been investigated, it is wise to slowly resume your eating. A light snack as your first food is advisable. During the procedure, the doctor uses carbon dioxide (CO2) to inflate the colon to help him visualize this organ. While he removes as much as possible, some CO2 may remain and be passed normally. You may feel slightly bloated and gaseous. This is normal and will go away within a few hours. An intravenous needle is used to administer the medication for the procedure. Rarely, the medication may irritate the vein with symptoms of redness and soreness along the vein. This will usually disappear over several days though it may last as long as two weeks. Warm soaks to the area will help. If it persists, please call your doctor. Because your colon has been completely cleaned out for the procedure, do not expect to have a normal bowel movement for at least 24 to 48 hours after the procedure. Your first bowel movement may be diarrhea or loose stool. Rarely, complications can occur. While every caution is taken to prevent any problems, complications can occur and sometimes these may not become evident for several hours. If, in the next 24 hours you experience any of the following, contact your doctor immediately. If he is unavailable, go to the Emergency Department. Passage of a large amount of blood or black, coffee ground material. (Spotty bleeding may be noted for 2-3 days after the procedure, especially if biopsies or polyps were taken. This is normal). Severe or new onset of abdominal pain. Severe dizziness or fainting. Sweating, severe nausea or high fever. These symptoms may indicate a complication of the procedure. Your doctor will want to discuss these symptoms with you. PROCEDURE: Colonoscopy
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