The Ins and Outs of Colonoscopy
The Ins and Outs of Colonoscopy
If your doctor suspects you have either Colitis or Crohn's disease then sooner or later you will be scheduled for a Colonoscopy. But it is not only a necessary procedure for properly diagnosing diseases of the colon like IBD but also to screen the general population for cancers of the colon.
Technically a colonoscope is a long, flexible tube about as wide as your finger with a small fiber-optic light and a camera attached to its end. The ‘scope' is connected to a TV monitor that allows your doctor to see inside your colon. However, in order for your doctor to properly conduct the test your colon must be cleaned out, meaning no fecal matter or debris can be left inside your colon or it will hinder your doctor's ability to feed the scope into the colon and the procedure may have to be stopped and rescheduled. That said, it is the ‘bowel prep,' as it's called, that is the most important job you, the patient, has in guaranteeing a successful colonoscopy. There are a number of different ‘bowel preps' you can employ to properly clean out the bowel and your doctor will discuss which ‘prep' is right for you.
Most patients feel the ‘bowel prep' is the hardest and most uncomfortable part of a colonoscopy. Depending on the prep method used the patient may be on a strict liquid diet for 2 to 3 days before the procedure and use a laxative the night before the procedure; or, they may use a prep method that entails drinking a large volume of diarrhea-inducing liquid the evening before the procedure. Either way, you should be prepared to spend a good amount of time in the bathroom the night before your colonoscopy. I like to make sure I have plenty of reading material available, I make sure my iPod is charged and ready for use, and I usually ask my family to go out to dinner and a movie so that I can have at least a few hours of privacy to myself. How you deal with the purge part of the prep is up to you. Your doctor will discuss your prep options with you and help you determine which method is best for you.
On the day of your procedure you should plan to take off the whole day from work and find a family member or friend who will take you to the procedure and drive you home from the procedure. Trust me on this, after ‘cleansing' your system the night before you're going to feel tired and possibly even a bit woozy and you aren't going to feel like driving yourself to the hospital or outpatient clinic. And, since you will receive some sort of sedation during the procedure you will not be allowed to drive yourself home after the procedure.
Your colonoscopy will either take place at your local hospital or at an outpatient surgical unit - usually attached to your doctor's office. When you arrive you will be checked-in and you will be asked to change into a surgical gown. You will then be taken to the treatment room and asked to lie on your left side. In most cases you will be given a pain medication and a mild sedative either by mouth or by IV. You should discuss with your doctor prior to your procedure date what medications he or she plans to use. This is your opportunity to make sure you are comfortable with the types of medication you will be administered before and during the procedure.
When the procedure begins the colonoscope is inserted into the anus and slowly extended through the length of your colon. The doctor is able to gently introduce air through the scope to slightly inflate the colon to provide the best view possible - this can cause slight bloating and discomfort and will most likely cause you to have some gas for a few hours after the procedure. The scope is then slowly retracted and the doctor continues to look at the colon stopping to inspect areas of inflammation or to take biopsies (small tissue samples that are later viewed under a microscope) of abnormal looking tissue or to remove polyps.
The procedure should take at least 20 minutes and could last up to one hour in duration. After the procedure you will recover for at least one hour in the surgical unit's recovery room where your family member or friend will be able to sit with you until you are given the a-okay to go home. Once you get home, you should plan to rest for the remainder of the day giving your body time for any effects from the sedative you may have been given during the procedure to wear off.
I find that for the first day or two after a colonoscopy I have to treat my stomach nicely - mainly because it's hard for me to introduce food back into a completely empty gut. I tend to revert back to my B.R.A.T. (bananas, rice, applesauce, and toast) diet for the first day, then the second day I add foods like baked chicken, naked pasta, yogurt, and scrambled or poached eggs. I tend to eat like this until I have at least one bowel movement post-procedure. With that first bowel movement you may notice a small amount of blood and it is usually not a reason for concern. Most likely your bottom is just a little sensitive. However, if you experience prolonged bleeding, blood clots, abdominal cramping, or a fever after the procedure you should contact your doctor's office to report your symptoms.
Your first colonoscopy is bound to produce some anxiety and that's normal with any procedure. But if you can look at it as something that will help your doctor provide you with the best medical care it makes the procedure a little easier.