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    Colonoscopy and Sigmoidoscopy

    Colonoscopy is a procedure, usually done on out-patient basis. It involves the examination of the large bowel and the distal part of the small bowel from inside, with the help of a thin, long and flexible tube passed through the anus.

    Q. Why Colonoscopy is done? Indications of Colonoscopy.

    Colonoscopy is required to evaluate gastrointestinal symptoms, such as bleeding, abdominal pain or changes in bowel habits. Some Specific indications are:
    • Screening for colon cancer,
    • Unexplained changes in bowel habits (eg. Chronic constipation, diarrhoea)
    • Unexplained weight loss
    • Bleeding per rectum
    • Unexplained anemia
    • Abdominal pain
    • Inflammatory bowel disease
    • Hemorrhoids
    • Polyp removal/ diverticulitis
    American Cancer Society recommends that people at average risk of colorectal cancer should start regular screening at age 45. Screening options include Stool-based tests and colonoscopy.

    How Colonoscopy is done?

    It is usually done under sedation to evaluate inner lining of gut, mainly large intestine and adjoining part of small intestine also. The patient lies to one of the sides and colonoscope instrument is passed through the anus, into rectum and ascended upwards slowly. The scope is flexible and can bend according to curves of intestines.
    In order to see clearly, air is blown into the intestine, which distends it. The patient can feel some cramping at this time; which can be minimised by relaxing and taking deep breaths at that time. Once the procedure is done, colonoscope will be slowly removed from intestine.

    Steps For colonoscopy preparation / What to do before colonoscopy?

    1. Start soft diet 2 days before colonoscopy and shift to liquids only one day (24 hours before).
    2. Take the laxatives as prescribed by your doctor throughout the day before colonoscopy. After taking laxative, you may feel cramping in your stomach and intestines. Do not worry, this is being done to push out the waste contents off your intestines; so that whole bowel is empty and clear the following morning for better evaluation.
    3. Take plenty of liquids the day before to stay hydrated.
    4. Avoid eating anything atleast 4 hours before colonoscopy. This is to avoid any side effects related to sedation/ anaesthesia. If you believe that the bowel has not cleared, inform nurse and request for enema. It is important to tell the doctor beforehand if you are on any bloodthinners or have allergy to any medicine.

    IMPORTANT Frequently Asked Questions

    Q. Is colonoscopy painful?

    A. Colonoscopy is not a painful procedure, as mostly it is done under sedation. Some people may feel discomfort due to the inflated gas. This discomfort is short – lasted and can be reduced by being relaxed and taking long – deep breaths.

    Q. What are the side-effects of colonoscopy?

    A. It is a safe procedure. Following are common-
    • Feeling of bloating and gaseous distension
    • Abdominal cramps
    • Minimal bleeding (IMP- If more in amount, kindly report to your physician)
    • Anesthesia related effects

    Q. Complications/ Risks of Colonoscopy –

    A. Complications are rare after Colonoscopy. A few mentioned are as below
    • Intestinal/ bowel perforation
    • Heavy / persistent bleeding
    • Abdominal distension/ pain
    • Bowel Obstruction

    Q. Are you asleep during colonoscopy?
    A. Mostly the patient is under sedation while performing colonoscopy. Hence, the patient is asleep.

    Q. How long does it take to complete colonoscopy?
    A. Usually 30-60 minutes, including biopsy time. If polyps are to be removed, extra time may be expected according to the number of polyps.

    Q. What can one have after colonoscopy? When can I eat after Colonoscopy?
    A. It is advised to take liquids and light diet for 24 hours post- procedure. However, in case of bleeding, or and complication, you need to remain nil by mouth, till it is settled.

    SIGMOIDOSCOPY

    Flexible sigmoidoscopy is a procedure that allows to examine the rectum and the lower (sigmoid) colon. In case of suspicious lesion a biopsy (small sample of tissue) is taken and sent for pathological evaluation.
    What is sigmoidoscopy? How is sigmoidoscopy done?
    During sigmoidoscopy, a thin tube with distal end camera is passed through anus, for a short distance uptil the distal part of large intestine and its lumen evaluated. During this time, it can be used to remove and polyps, hemorrhoids and take biopsy too.
    Why sigmoidoscopy is done?
    It is done in cases with pathology involving anus, rectum and lower bowel.

    1. Anal bleeding
    2. Inflammatory bowel disease
    3. Painful hemorrhoids
    4. Anal polyps/ mass
    5. Screening for colorectal polyp

    How to prepare for sigmoidoscopy?
    Simply take soft diet on the prior day. If you have difficulty in clearing bowels, then take laxatives to clear off the bowels the day before.

    IMPORTANT Frequently Asked Questions

    Q. How is sigmoidoscopy done? Is sigmoidoscopy painful? How long does it take to do sigmoidoscopy?
    A. Patient lies to either of the side, sigmoidoscope is inserted in the anal canal and evaluated. This is usually done within 10 minutes and is not painful. Patient may experience a bit of discomfort, which is short lasting and responds to pain killers.

    Q. What can we eat after sigmoidoscopy?
    A. There are no dietary restrictions post- sigmoidoscopy.

    Q. Can we drive after sigmoidoscopy?
    A. Yes, driving is allowed.

    IMPORTANT REMINDER:
    This information is intended only to provide general guidance and not an alternative for formal doctor advice.. It is very important that you consult your doctor about your specific condition.