Colonoscopy is one of the most important examinations that are performed to detect diseases and abnormal changes that affect the colon. It is used for diagnostic or therapeutic reasons, depending on the case.
An overview of the colon
The colon is divided anatomically according to its location into four sections:
- ascending colon
- transverse colon
- descending colon
- sigmoid colon
colon sections
What is a colonoscopy?
The endoscope is connected to a screen where what the camera captures is displayed on the screen, enabling the examiner to see the colon and examine it and identify pathological changes, if present.
During the endoscopy, the patient is anesthetized so that no pain is felt.
Endoscopy can be used for therapeutic reasons, meaning that if a mass within the colon is suspected, a biopsy can be taken through endoscopy, and healthy masses and polyps can also be removed.
colonoscopy
Why is a colonoscopy used?
- Gastrointestinal symptoms such as bleeding, abdominal pain, and chronic constipation or diarrhea
- revealing of colorectal cancer The presence of polyps in the colon
- Suspicion of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease
- Colonoscopy is done periodically in patients who have a high risk of developing colorectal cancer such as a family history of infection or advanced age.
Preparation before a colonoscopy
There are some instructions that the patient must follow before performing the endoscopy in order to clean the colon from the stool that obstructs the entry of the endoscope so that the examining doctor obtains a clear view of the colon.
Diet before the endoscopy
The most important thing is to follow your doctor's instructions regarding diet.
drink laxatives
It is recommended to take laxatives the night before the endoscopy or in the morning of the day when the endoscopy will be performed.
Modify some medications
During a colonoscopy
During the procedure, the patient is wearing a special gown and is lying on his left side with his knees raised towards his chest (fetal position).
The patient is anesthetized either with regional anesthesia, which means the patient remains awake without feeling any pain, or general anesthesia is used in some cases.
The examining doctor inserts the colonoscope through the anus. The endoscope is equipped with a camera and is long enough to reach all parts of the colon. The endoscope contains a small lamp and a channel that enables the doctor to release air through which the air expands the colon and gives the doctor a clearer view.
The doctor looks for any abnormal changes in the colon and may take a biopsy of the colon if he suspects the presence of a cancerous mass, and if a polyp is found, the doctor will remove it.
After the examination is completed, the doctor gently pulls the endoscope out. The patient may feel cramps during the withdrawal. The cramps can be relieved by resting and taking a deep breath.
After colonoscopy
The recovery period depends on the type of anesthetic the patient received during the endoscopy.
The patient may feel temporary cramps or abdominal cramps that go away quickly.
The patient may not have a bowel movement for several days after the endoscopy due to complete emptying of the colon. If the doctor removed the polyp during the endoscopy, the patient may notice slight rectal bleeding for a day or two after the colonoscopy.
The examiner determines the need to stop taking diluents or adjust medications after the endoscopy.
Colonoscopy results
Endoscopy results are either:
Endoscopy results are negative
- 10 years in the absence of a risk factor for colon cancer
- 5 years if there were previous polyps that were removed
- Annually if there is a high risk factor for developing cancer, such as familial polyposis, which increases the risk of colon cancer significantly.
Endoscopy results are positive
In most cases, the polyps are not malignant, but there is a risk that the polyp will turn into a cancerous lesion, so the doctor will remove the polyp as soon as it is discovered.
The doctor may ask the patient to repeat the endoscopy soon if:
- Presence of one or more polybins
- Large polyp larger than 1 cm
- The polyp has a shape that is close to a cancerous lesion
In the event that the doctor is unable to remove the polyps through laparoscopy, the patient may be referred to a surgical procedure to remove them.
No results
In this case, the doctor asks the patient to repeat the colonoscopy within a short period with good preparation.
Colonoscopy risks
- Bleeding following a biopsy or laparoscopic polypectomy
- A tear in the wall of the colon or rectum
- Anesthesia related problems
- Sepsis if the endoscope used is contaminated
- Some complications occur before the endoscopy, such as excessive use of laxatives, which causes irritation to the skin around the anus due to continuous defecation.
Colonoscopy Instructions
Colonoscopy is the best way to reduce the risk of developing colorectal cancer and detect it early if it occurs. In some cases, colonoscopy should be started periodically at an earlier age, i.e. before 45, in one of the following cases:
- Having a first-degree relative with colorectal cancer
- Inflammatory colon diseases such as ulcerative colitis or Crohn's disease
- Having genetic diseases that increase the risk of cancer, such as familial polyposis and Lynch syndrome
Tests alternative to colonoscopy for cancer screening
sigmoid colonoscopy
That is, the sigmoidoscope cannot examine all sections of the colon.
Virtual colonoscopy
Also called computed tomography of the colon, it is a less invasive procedure than colonoscopy. This technique relies on shining several sources of x-rays that are controlled by a computer. The computer combines the images with each other and gives a three-dimensional image of the rectum and colon.
Swallow a capsule containing a camera
fecal transplant
The relationship between colorectal cancer and colonoscopy
- Cancer mortality decreased due to periodic colonoscopy
- Endoscopic excision of polyps reduced the risk of polyps turning into cancer
Frequently asked questions about colonoscopy in Turkey
Is a colonoscopy painful?
Colonoscopy is often not painful because the patient is sedated during the colonoscopy with either local or general anesthesia.
What should be done before a colonoscopy?
Before the colonoscopy, you must adhere to a diet prescribed by the doctor to empty the colon of waste, in addition to the possibility of taking laxatives the day before the endoscopy to completely empty the colon.
When should a colonoscopy be done?
In normal cases, colonoscopy should be done periodically once every ten years at the age of 45 in order to exclude colorectal cancer and detect it early, and colonoscopy is done in pathological cases when there are symptoms of colon problems such as chronic constipation or suspicion of infections at the colon level or to remove polyps intact.