Colonoscopy

What is a colonoscopy?

Also known as a C-scope is an endoscopic examination of your lower gastrointestinal tract (rectum, sigmoid colon, dedcending colon, transverse colon and ascending colon). A flexible scoop with a camera is used for evaluation of the lower gastrointestinal tract.

What are the indications for the scope:

Rectal and intestinal bleeding,
Anaemia
Changes in bowel habit
Chronic constipation
Screening for colorectal polyps or cancer (advised for individuals 45 years or older)
Screening for colorectal polyps or cancer in patients with a family history of colon cancer or polyps

What the procedure entails:

The colonoscopy generally takes 30-60 minutes. You will be sedated by an anaesthetist for the procedure which means you will be asleep for the entire duration of the procedure. A flexible scope with a camera is inserted through the anus into the rectum and the colon is examined. Polyps may be removed, tissue samples may be taken and sent to the pathologist for further analysis.

Possible complications:

Side effects of the sedative medications used may include nausea, vomiting or allergic reactions.
You may have loose bowel actions for a day or two after the examination but are likely to return to normal within 24 hours after the colonoscopy.
Severe complications from a colonoscopy include perforation, heavy bleeding and death (the last occurring in 1 out of 100 000 patients).
During colonoscopies where a polyp is removed (a polypectomy), the overall risk for perforation is 1 in 1000 patients.
‘Post polypectomy syndrome’ is a rare but serious complication that may arise after a colonoscopy where polypectomy is performed. This occurs due to a burn to the bowel wall when the polyp is removed. Patients may experience fever and abdominal pain. The condition is treated with intravenous fluids and antibiotics in the hospital.
Severe dehydration caused by the laxatives taken during bowel preparation for the colonoscopy may occur. It is therefore advised that patients keep fluid intake up during the preparation stage before the procedure.

Before the procedure:

After your consultation:

Obtain authorization from your medical aid (whether the scope is done in consultation rooms/theatre)

The day before the procedure:

Prepare your colon with prescribed colon preparation and diet as provided by Dr Jaffer.
Only have clear fluids (apple juice, black tea or rooibos tea, energade)
Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).

Day of procedure:

Arrive for admission at the indicated time.
If your procedure will be done in the theatre, change into theatre attire and remove all valuable belongings.
If your procedure is in the consultation rooms, you will be asked to change into a gown.

After the procedure:

The surgeon will see you after the procedure to explain the findings of the colonoscopy.

Post-sedation:

A responsible adult should drive you home. Avoid driving, operating heavy machinery or taking any important decisions for 12 hours after the procedure.

Diet:

It is best to avoid alcohol consumption for 12 hours.
Unless otherwise directed you may resume your normal diet after the colonoscopy.

Activities:

Wait until the day after the procedure before resuming your normal exercise routine.

Back to work:

You can return to work the day after your procedure. A sick note will be provided for the day of the procedure unless agreed upon otherwise by the surgeon.

Medication use:

If polyps were removed or biopsies taken, avoid using Aspirin or anti-inflammatory drugs for 2 weeks.

Pain:

- It is normal to experience some abdominal discomfort after the procedure. This is due to the air that is used to inflate the bowel to ensure proper visualisation.