Colonoscopy of the intestine

When it is necessary to assess the condition of the large intestine in detail, tests and an ultrasound examination may be insufficient. Colonoscopy enables the doctor to directly examine the mucous membrane, see inflammatory changes, polyps, ulcers, and sources of bleeding. During the examination, it is also possible to take a tissue sample for analysis or immediately perform the necessary therapeutic manipulation.

At the «Oxford Medical» medical center, video colonoscopy is performed by experienced endoscopists using the modern Olympus Exera II system. For the patient’s maximum comfort, the examination can be undergone in a state of medication-induced sleep. To schedule the procedure, call the contact center — our administrators will help you choose a convenient time and location and will also provide guidance regarding the specifics of preparation.

Colonoscopy — is an endoscopic examination of the rectum and large intestine. For the examination, the colonoscope — a thin flexible tube with a video camera and lighting — is inserted into the rectum through the anal canal. The image of the mucous membrane is transmitted to the monitor in an enlarged form, which enables the doctor to assess its condition in detail.

Colonoscopy of the intestine can be diagnostic and therapeutic. During the procedure, the doctor, if necessary, takes a tissue sample for histological examination, removes polyps, or performs other endoscopic manipulations.

With the help of colonoscopy, it is possible to detect:

• inflammation, swelling, redness, and damage to the mucous membrane;
• erosions and ulcers;
• polyps and other benign neoplasms;
• diverticula — protrusions of the wall of the large intestine;
• narrowing and deformities of the intestinal lumen;
• sources of intestinal bleeding;
• changes characteristic of ulcerative colitis and Crohn’s disease;
• precancerous changes and rectal cancer.

The doctors of «Oxford Medical» note: the examination is of particular importance for the detection of colorectal cancer at an early stage. Most malignant tumors of the large intestine develop from polyps, therefore their timely detection and removal help reduce the risk of the disease. If during the examination the doctor sees a suspicious area, a biopsy followed by a histological examination of the tissue makes it possible to definitively determine the nature of the changes.

For a comprehensive assessment of the digestive tract, together with colonoscopy, the doctor may sometimes prescribe gastroscopy. It helps examine the esophagus, stomach, and duodenum and obtain additional information to clarify the diagnosis.

In some acute diseases and severe disorders of the general condition, colonoscopy is postponed or replaced with another examination method. Some contraindications are temporary, therefore, after treatment or stabilization of the condition, the procedure can be performed. The final decision is made by the doctor, taking into account the indications and planned manipulations.

The main contraindications include:

• suspected intestinal perforation;
• peritonitis — inflammation of the peritoneum;
• severe acute inflammation of the large intestine with its significant expansion;
• decompensated heart or respiratory failure;
• unstable condition after a heart attack or stroke;
• an acute infectious disease with a high temperature;
• severe blood clotting disorders;
• insufficient bowel cleansing, which does not allow a complete examination to be performed.

During pregnancy, colonoscopy is prescribed only for serious indications and after assessing the patient’s condition. If a person takes medications to reduce blood clotting, the doctor must be informed about this in advance. Their use must not be discontinued independently before the procedure.

The quality of the examination depends on how well the bowel is cleansed. If fecal matter remains in its lumen, the doctor may not notice small polyps or other changes in the mucous membrane. Therefore, preparation for colonoscopy includes a temporary change in diet and taking a special medication to cleanse the bowel.

Main stages:

• 6–7 days in advance or earlier. Inform the doctor about all medications that you take regularly, especially about agents that affect blood clotting. You must not discontinue them on your own.
• 3 days in advance. You should begin following a diet before colonoscopy with a restriction of foods rich in fiber. Vegetables, fruits, berries, greens, legumes, mushrooms, nuts, and seeds are temporarily excluded.
• 1 day in advance. A light breakfast and lunch until 15:00 are allowed. After that, only clear liquids may be consumed: water, tea, clear broth, and clarified juice without pulp. Milk, alcohol, red, and purple beverages are excluded.
• On the evening before and in the morning on the day of the procedure. The bowel is cleansed with the medication prescribed by the doctor. The solution is usually taken in two stages, and the exact time depends on the scheduled time of the examination.

The doctors of «Oxford Medical» note that each patient is provided with precise recommendations regarding nutrition, the choice of medication, and the time of its administration, taking into account the scheduled time of the procedure and the state of health. These recommendations must be followed, since the informativeness of the examination depends on the quality of bowel cleansing.

To make the examination as comfortable as possible, at the «Oxford Medical» medical center it can be performed with sedation. Medication-induced sleep during colonoscopy helps avoid pain and pronounced discomfort: after the intravenous administration of the medication, the patient falls asleep, and their condition is monitored by an anesthesiologist throughout the entire procedure. At the patient’s request or if there are contraindications to sedation, the examination can also be undergone without it.

During the procedure, the doctor carefully inserts the colonoscope through the anal canal and gradually advances it through the sections of the large intestine. The image of the mucous membrane is transmitted to the monitor in an enlarged form, which makes it possible to examine the bowel sequentially and assess the detected changes in detail.

To expand the walls of the bowel, a small amount of carbon dioxide is introduced. This improves visualization and makes it possible to notice small polyps, erosions, ulcers, and neoplasms. If necessary, during the examination the doctor takes a tissue sample for analysis or performs a therapeutic manipulation.

The duration of colonoscopy is usually 20–40 minutes. If a biopsy or removal of a neoplasm is performed, the procedure may last longer.

During colonoscopy, the doctor can immediately perform removal of polyps in the bowel if their size, shape, and location make it possible to perform the manipulation safely. Removal is performed through a special channel of the colonoscope using an endoscopic snare or another instrument, without incisions in the skin. The removed neoplasm is sent for histological examination to determine its type and check for the presence of malignant changes.

Also during colonoscopy, the following may be performed:

• biopsy of a suspicious area of the mucous membrane;
• stopping minor intestinal bleeding;
• removal of a foreign body;
• dilation of individual narrowed areas of the bowel.

Colonoscopy with biopsy involves taking a small tissue sample for laboratory analysis. The examination helps clarify the nature of the inflammation, determine the type of detected changes, and establish an accurate diagnosis.

fter the procedure, the patient receives the endoscopist’s report and individual recommendations. If the examination was performed with sedation, it is necessary to remain at the clinic under the supervision of medical personnel for several hours.

During the first few hours, mild spasms, a feeling of fullness, and bowel bloating may occur due to the gas that was introduced during the examination. Usually, the discomfort gradually decreases during the day. Short walks, rest, and warm drinks are helpful for relieving the condition.

The main dietary rules after colonoscopy:

• if sedation was not used, drinking and eating are allowed immediately after the examination unless the doctor indicated otherwise;
• the first meal is usually allowed 1–2 hours after the procedure — soup, porridge, an omelet, yogurt, boiled meat, or fish are suitable;
• on the day of the procedure, fatty and spicy dishes, alcohol, legumes, and carbonated beverages should not be consumed.

After a biopsy or removal of polyps, the doctor may provide additional dietary recommendations.

It is important to know what must not be done after colonoscopy with sedation:

• you must not drive a car for 24 hours;
• consume alcohol;
• exercise intensively;
• take sleeping pills or sedative medications.

In case of severe abdominal pain, significant bleeding, elevated temperature, or pronounced weakness, it is necessary to seek medical assistance urgently.

Colonoscopy is considered a safe examination method, and serious complications occur quite rarely. To minimize possible risks, at «Oxford Medical» the procedure is performed by experienced endoscopists using modern equipment and in compliance with all safety requirements. Before the examination, the patient’s health condition and contraindications are taken into account, and during sedation, the anesthesiologist monitors breathing, pulse, blood pressure, and oxygen level.

Possible complications include:

• bleeding from the biopsy site or the site of the removed polyp;
• damage to the bowel wall;
• a decrease in blood pressure, breathing impairment, or another reaction of the body to sedation medications;
• infectious complications.

The doctors of «Oxford Medical» note: small traces of blood in the stool after a biopsy or polyp removal may appear during the first day. If the bleeding is significant or does not stop, severe or increasing abdominal pain occurs, the temperature rises, or pronounced weakness or dizziness appears, it is necessary to seek medical assistance immediately.

The price of colonoscopy depends on the scope of the procedure, the use of sedation, as well as the need to perform a biopsy or remove polyps. In particular, the price of colonoscopy under anesthesia, that is, under sedation, is somewhat higher because the procedure involves the participation of an anesthesiologist, the administration of medications for medication-induced sleep, and continuous monitoring of the patient’s condition. The cost of the examination without sedation is lower.

You can view the current cost of the procedure here. To undergo colonoscopy in Kyiv, leave a callback request on the website or call the «Oxford Medical» contact center. The administrator will help you choose a convenient time and provide all the necessary information.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• National Institute of Diabetes and Digestive and Kidney Diseases
• American Society for Gastrointestinal Endoscopy
• U.S. Preventive Services Task Force