Colonoscopy is a diagnostic procedure used to examine the colon for structural abnormalities such as polyps or malignancies.

What Are the Indications for Colonoscopy?

Indications for colonoscopy include gastrointestinal hemorrhage, unexplained changes in bowel habits or suspicion of malignancy. Colonoscopies are often used to diagnose or rule out colon cancer, but are also frequently used to diagnose inflammatory bowel disease. In older patients (sometimes even younger ones) an unexplained drop in hematocrit (one sign of anemia) is an indication to do a colonoscopy.

Colonoscopy is now recommended as a routine screening test for people 50 years of age or older. Subsequent rescreenings are then scheduled based on the initial results found, with a five- or ten-year recall being common for colonoscopies with negative results.

Am I a Candidate for Colonoscopy?

If you have gastrointestinal bleeding (as evidenced by blood in the stool, which can be seen more easily with a hemoccult test), any changes in bowel habits, and/or a family history of polyps (familial adenomatous polyposis or FAP) or colorectal cancer, you should make an appointment with your physician to schedule a colonoscopy.
Anyone 50 years of age or older should also receive a colonoscopy as routine screening with appropriate follow-up as described above.

What Does Colonoscopy Involve?

Preparation: The colon must be free of solid matter for the test to be performed properly. For one to three days, the patient is required to follow a low fiber or clear fluid-only diet. Then, on the day before the colonoscopy, the patient is given a laxative preparation (such as bisacodyl, sodium phosphate solution, or a solution of polyethylene glycol and electrolytes) and large quantities of fluid.

Procedure: The first step is usually a digital rectal examination, to examine the tone of the sphincter and to determine if preparation has been adequate. The endoscope is then passed though the anus up the rectum, the colon (sigmoid, descending, transverse and ascending colon, the cecum), and ultimately the terminal ileum. The endoscope has a movable tip and multiple channels for instrumentation, air, suction and light. The bowel is occasionally insufflated with air to maximize visibility. Biopsies are frequently taken for histology.

Suspicious lesions may be cauterized, treated with lasers, or cut with an electric wire for purposes of biopsy or complete removal (polypectomy). Medication can be injected, e.g. to control bleeding lesions.

What Are The Advantages Of Colonoscopy?

A significant advantage of colonoscopy over X-ray or other, less invasive tests, is the ability to perform therapeutic interventions during the test. If a polyp is found, for example, it can be removed by one of several techniques. A snare can be placed around a polyp for removal. Even if the polyp appears flat, it can often be removed.

How Long Does It Take?

The procedure typically takes about 30-45 minutes, although it may take longer depending on what is found and what actions are taken during the test.

How Many Colonoscopy Procedures Are Required?

Usually only one procedure is required, except if there is an incomplete examination due to “looping” of the endoscope through tight turns of the colon.

However, patients should be followed up with periodic rescreening, with frequency of rescreening depending on the results of the initial exam.

When Will I See Results?

You as the patient will not necessarily “see results,” although the doctor will be able to view the interior of the colon during the procedure and biopsy any lesions that are seen and interpret those findings immediately.

What Are My Alternatives to Colonoscopy?

Flexible sigmoidoscopy is sometimes performed in lieu of colonoscopy, but this procedure does not afford the diagnostician a complete and thorough view of the colon in its entirety.

Hemoccult is a useful tool to detect hidden, or “occult” blood in the stool, which may be a sign of malignancy or other disorders. However, the hemoccult is not meant to substitute for colonoscopy.

Will I Have Pain?

Pain should be minimal to nonexistent, as narcotic analgesics are normally used during the procedure.

When Can I Go Back To Work Or School?

You can usually return to work or school the same day.

Who Will Perform My Treatment?

A physician experienced in the methods of endoscopy and gastroenterology will perform the procedure.

How Much Does It Cost?

Please call TopSurgeons at 800-506-8084 for more information.

Will My Insurance Cover Colonoscopy?

Insurance should cover the procedure subject to individual policy limitations on payments for routine diagnostic procedures.