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Colonoscopy

WHAT IS COLONOSCOPY?

It is a test done to visually examine the inside lining of the whole of the large bowel.  Using a flexible tubular fibre optic instrument and a camera, diseases of the bowel are identified.  It also allows biopsies to be taken and small colorectal polyps to be removed.

It is a safe test most often performed with sedation and pain killer injections.  Many people forget the experience completely.  It is a procedure which is carried out in an operating theatre or special endoscopy unit.  There is usually no need for admission to hospital over night.  The picture shows the flexible telescope within the large bowel, and most of the time the patient is lying on the left side.  Some times the patient is asked to roll over to make the procedure easier to perform.



WHO SHOULD HAVE A COLONOSCOPY?

A surgeon or doctor may recommend a colonoscopy examination if you have a change in bowel habit or bleeding, indicating a possible problem in the colon and rectum.

Colonoscopy is also the key test used in screening for bowel cancer.

Patients with a high risk family history of bowel cancer or polyps may be recommended for colonoscopy.

Monitoring of response to treatment in inflammatory bowel disease such as Crohns disease or Ulcerative Colitis may also need colonoscopy.

Investigation of abnormal findings on a barium enema X ray or CT Scans may warrant a closer bowel examination making a colonoscopy a necessary examination.

Patients under going follow up of bowel cancer or previous polyps also require colonoscopic check examinations.

HOW IS COLONOSCOPY PERFORMED?

The bowel must first be thoroughly cleared of all residues of stool before a colonoscopy. It is important that the preparation be done carefully so that the exam may be completed successfully. The preparation is in the form of a strong laxative medication taken the day before the procedure. It is important that patients follow the instructions regarding diet and drinking that are provided for the bowel preparation. Often the steps to take differ if the patient has a morning or afternoon appointment for their colonoscopy examination.

The colonoscope is inserted into the bowel through the anus (or back passage) and air is used to inflate the bowel.  This inflation allows an adequate view of the bowel as well as allowing the instrument to be advanced.  Where possible the last portion of the small bowel can also be examined. This is called the terminal ileum.  When necessary biopsies can be taken or polyps completely removed.  This is often using electro-cautery to prevent bleeding.

Inflation of the bowel and manipulation of the scope around corners can give patients mild discomfort.  To prevent and relieve discomfort and anxiety an injection of mild sedation and a pain killing injection is most often given. Following the colonoscopy, there may be slight discomfort, which quickly improves with the expelling of gas.  Patients can resume their regular diet later that day. The entire procedure usually takes less than an hour.  If patients receive sedation it is recommended they do not drive or operate machinery until the next day.

WHO PERFORMS COLONOSCOPY EXAMINATIONS?

Only specially trained doctors or surgeons perform this test who have expertise in the diagnosis and treatment of bowel disease.  Some specialist nurses however are now trained to perform this procedure.

It is always performed in special endoscopy units equipped with the necessary instruments and nursing staff trained to look after and care for patient in this specialised area of medical investigation.

WHAT ARE THE BENEFITS AND POTENTIAL RISKS OF COLONOSCOPY?

Colonoscopy is the Gold Standard in the diagnosis and treatment of large bowel disease.  Colonoscopy is more accurate than an X-ray or CT examinations of the colon to detect polyps or early cancer.  Frequently, polyps can be removed at the same time.  This is a major step towards the screening and prevention of colon cancer. Many other disorders of the colon may also be identified including diverticular disease and inflammation in the large bowel and the rectum. Biopsy may be taken at the time of the procedure to confirm a diagnosis. This involves taking a small pinch of tissue from the bowel lining. It is painless. The tissue taken is then examined in the laboratory with a microscope by a pathology doctor.

Colonoscopy is an invasive procedure and therefore there are potential risks. The two most significant are bleeding and perforation. These are rare complications that are usually recognized at the time of the procedure. The test is safe and major problems occur less then 1:1000 times, however in the worse cases may lead to a major operation to correct the problem.

 

If you wish to arrange an appointment with Dr. Rob Church at Al Zahra Hospital Dubai

Contact Al Zahra Call Center on +971 4-378-6666