What is colonoscopy?

By Cristiano Antonino On Mar 1, 2023

Colonoscopy is a diagnostic test that allows you to examine the surface of the colon and rectum by inserting, through the anus, a thin and flexible tube that is slowly advanced while introducing air to stretch the walls of the intestine

In recent years, to ensure better patient comfort, there is a tendency to replace air with carbon dioxide (CO2), which has the ability to be rapidly reabsorbed by the tissues, or alternatively with water, which allows for less relaxation of the intestine and, consequently, a reduced sensation of abdominal distension for the patient.

The colon consists of the last 130-150 centimeters of intestine, ending in the rectum and anus.

Colonoscopy, what is the preparation required?

The colon must be completely cleansed for an accurate and complete procedure, therefore the instructions must be strictly followed.

The preparations available vary in composition and in the volume of liquids to be taken.

Recently, preparations have been marketed that require the intake of low volumes, up to a single liter of solution, which in the same way guarantee adequate preparation for the exam, causing less discomfort to the patient.

Can I continue to take my medicines?

The patient should continue to take their usual medications, even on the morning of the procedure.

An exception is iron supplements, which must be stopped one week before the procedure.

Furthermore, while aspirin should not be suspended, if you are taking anticoagulants or other antiplatelet agents (such as pradaxa, xarelto, eliquis, lixiana, persantin, coumadin, sintrom, plavix or iscover), you will need to contact your doctor to define the modality of suspension in the days preceding the procedure.

What happens during a colonoscopy?

To make the procedure more comfortable, the patient is given an intravenous sedative.

The colonoscopy has an average duration of about 15-20 minutes and is generally well tolerated, but during the procedure it is possible to experience transient meteorism or cramps.

If the doctor thinks an area needs further evaluation, a biopsy (taking a sample of the lining of the colon) will be done for microscopic analysis.

These procedures are usually not painful.

What are polyps and why are they removed?

Polyps are bumps, mostly benign, on the surface of the colon. Their size can vary from a few millimeters to several centimetres.

Since tumors generally begin with a polyp, their removal, known as “polypectomy”, is an important means of preventing colorectal cancer.

Then, any polyps discovered during the colonoscopy will be removed by the doctor during the exam.

However, the external appearance does not always allow to distinguish a polyp from a malignant formation (tumor), therefore after removal they must be analyzed under a microscope.

Although colonoscopy is the most accurate method for identifying colon polyps and cancer, no test is foolproof and there is always a small chance that major lesions will go undetected.

This is especially true in the case of an inadequately cleansed bowel.

What happens after the colonoscopy?

The patient will have to be accompanied home and will not have to drive or make important decisions for the next twelve hours, as the faculty of judgment and reflexes may be slowed down due to the sedative drug administered.

There may be cramps or meteorism due to the air introduced during the exam.

All of this should quickly end with the gas escaping.

After the exam it will be possible to eat something.

What are the possible complications of colonoscopy?

Colonoscopy and polypectomy are generally safe procedures. A possible complication is given by the perforation or laceration of the intestinal wall, which in this case could require surgery in the most serious cases.

This complication is very rare (1/1000).

Bleeding may occur at the site of the biopsy or polypectomy, but it is often a non-significant phenomenon that can be treated endoscopically and only in very rare casecs may it require the need for blood transfusions and more invasive treatments (e.g. surgery).

Some patients may have cardio-respiratory problems following the administration of sedatives, or complications due to heart or lung disease.

Death is an extremely rare event in endoscopic procedures.