Colonoscopy is a test that allows your doctor to look at the inner
lining of your
large intestine (rectum and colon). He or she uses a thin, flexible tube
called a colonoscope to look at the colon. A colonoscopy helps find
colon polyps, tumors, and areas of inflammation or
bleeding. During a colonoscopy, tissue samples can be collected (biopsy) and abnormal growths can be taken out.
Colonoscopy can also be used as a screening test to check for cancer or
precancerous growths in the colon or rectum (polyps).
colonoscope is a thin, flexible tube that ranges from
48 in. (122 cm) to
72 in. (183 cm) long. A small
video camera is attached to the colonoscope so that your doctor can take
pictures or video of the large intestine (colon). The colonoscope can be used
to look at the whole colon and the lower part of the small intestine. A test
sigmoidoscopy shows only the
rectum and the lower part of the colon.
Before this test, you will need to clean out your colon (colon prep).
Colon prep takes 1 to 2 days, depending on which type of prep your doctor
recommends. Some preps may be taken the evening before the test. For many
people, the prep for a colonoscopy is more trying than the actual test. Plan to
stay home during your prep time since you will need to use the bathroom often.
The colon prep causes loose, frequent stools and diarrhea so that your colon
will be empty for the test. The colon prep may be uncomfortable and you may
feel hungry on the clear liquid diet. If you need to drink a special solution
as part of your prep, be sure to have clear fruit juices or soft drinks to
drink after the prep because the solution tastes salty.
Colonoscopy is one of many tests that may be used to screen for colon cancer. Other tests include sigmoidoscopy, stool tests, and computed tomographic colonography. Which screening test you choose depends on your risk, your preference, and your doctor. Talk to your doctor about what puts you at risk and what test is best for you.
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Before you have a colonoscopy, tell
your doctor if you:
You may be asked to stop taking aspirin products or iron
supplements 7 to 14 days before the test. If you take blood-thinning medicines
regularly, discuss with your doctor how to manage your medicine.
You will be asked to sign a consent form that says you understand the
risks of the test and agree to have it done.
Talk to your doctor about
any concerns you have regarding the need for the test, its risks, how it will
be done, or what the results will mean. To help you understand the importance
of this test, fill out the
medical test information form(What is a PDF document?).
Arrange to have someone take you home after the test,
because you may be given a medicine (sedative) to
help you relax before the test.
Before this test, you will need to
clean out your colon. The following information gives you a general idea of the
preparation for a colonoscopy. Your doctor will give you specific instructions
before your test.
Colonoscopy may be done in a doctor's
office, clinic, or a hospital. The test is most often done by a doctor who
works with problems of the digestive system (gastroenterologist). The doctor may also have an
assistant. Some family doctors, internists, and surgeons are also trained to do
During the test, you may get a pain medicine and a
sedative put in a vein in your arm (IV). These
medicines help you relax and feel sleepy during the test. You may not remember
much about the test.
You will need to take off most of your
clothes. You will be given a gown to wear during the test.
may lie on your left side with your knees pulled up to your belly. The doctor
will gently put a gloved finger into your anus. Then he
or she will put the thin, flexible colonoscope in your anus and move it slowly
through your colon. The doctor can look at the lining of the colon through the
scope or on a computer screen hooked to the scope.
You may feel
the need to have a bowel movement while the scope is in your colon. You may
also feel some cramping. Breathe deeply and slowly through your mouth to relax
your belly muscles. This should help the cramping. You will likely feel and
hear some air escape around the scope. There is no need to be embarrassed about
it. The passing of air is expected. You may be asked to change your position
during the test.
Your doctor will look at the whole length of your
colon as the scope is gently moved in and then out of your colon.
The doctor may also
use tiny tools, such as forceps, loops, or swabs, through the scope to collect
tissue samples (biopsy) or take out growths. Usually, people do not feel
anything if a biopsy is done or if polyps are taken out.
scope is slowly pulled out of your anus and the air escapes. Your anal area
will be cleaned with tissues. If you are having cramps, passing gas may help
The test usually takes 30 to 45 minutes, but it may
take longer, depending upon what is found and what is done during the
After the test, you will be watched for 1 to 2 hours. When
you are fully awake, you can go home. You will not be able to drive or operate
machinery for 12 hours after the test. Your doctor will tell you when you can
eat your normal diet and do your normal activities. Drink a lot of fluid after
the test to replace the fluids you may have lost during the colon prep, but do
not drink alcohol.
If you received a
sedative during the test, do not drive, operate
machinery, or sign legal documents for 24 hours after the test. Arrange to have
someone drive you home after the test.
This test can be uncomfortable and you
may feel embarrassed. The colon prep will cause diarrhea and cramping which may
make you use the bathroom often.
During the test,
you may feel very sleepy and relaxed from the sedative and pain medicines. You
may have cramping or feel brief, sharp pain when the scope is moved or air is
blown into your colon. As the scope is moved up the colon, you may feel the
need to have a bowel movement and pass gas. If you are having pain, tell your
The suction machine used to remove stool (feces) and
secretions may be noisy but does not cause pain.
You will feel
sleepy after the test for a few hours. Many people say they do not remember
very much about the test because of the sedative.
After the test,
you may have bloating or crampy gas pains and may need to pass some gas. If a
biopsy was done or a polyp taken out, you may have traces of blood in your
stool (feces) for a few days. If polyps were taken out, your doctor may
instruct you to not take aspirin and
nonsteroidal anti-inflammatory drugs (NSAIDs) for 7 to
There is a small chance for problems from a
colonoscopy. The scope or a small tool may tear the lining of the colon or
After the test, call your doctor
immediately if you:
Colonoscopy is a test that allows your
doctor to look at the inner lining of your
large intestine (rectum and colon). If a sample of tissue (biopsy) was collected during the colonoscopy, it will
be sent to a lab for tests.
Your doctor may be able to tell you the results immediately
after the procedure. Other test results are ready in 2 to 4 days. Test results
for certain infections may be ready in several weeks.
The lining of the colon looks
smooth and pink, with a lot of normal folds. No growths, pouches, bleeding, or
inflammation are present.
Some common abnormal findings
of colonoscopy include
hemorrhoids (the most common cause of blood in the
polyps, cancer, one or more sores (ulcers), pouches in the wall of the colon (diverticulosis), or inflammation. A red, swollen
lining of the colon (colitis) may be caused by infection or
inflammatory bowel disease (IBD).
Reasons you may not be able to
have the test or why the results may not be helpful include:
Other Works ConsultedChernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.Levin B, et al. (2008). Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA: A Cancer Journal for Clinicians, 58(3): 130–160.Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.U.S. Preventive Services Task Force (2008). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm.
December 7, 2011
Adam Husney, MD - Family Medicine & Arvydas D. Vanagunas, MD - Gastroenterology
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