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What is Colonoscopy?

A colonoscopy is a procedure that lets a physician examine the large intestine and the rectum for any abnormalities or changes. During a colonoscopy, a flexible, long tube is placed into the rectum. The doctor can examine the inside of colon using a tiny video camera at the tip of the tube. 

Why is colonoscopy done?   

A surgeon may recommend colonoscopy to 

Investigate intestinal signs and symptoms - A colonoscopy can help the doctor determine the source of stomach pain, rectal bleeding, severe constipation, chronic diarrhoea, and other intestinal issues. 

Screening - If a patient is 50 or older, the doctor may suggest a colonoscopy every 10 years or even sooner to check for colon cancer. Colonoscopy is used for detecting colon cancer. 

Look out for polyps - If one previously had polyps, the doctor may recommennd a follow-up colonoscopy to search and remove any new ones. This is done to lower the chances of developing colon cancer.

What are the different types of colonoscopies?

Colonoscopies are classified as either screening or diagnostic. Before the treatment, talk to a doctor about which type the patient might require and what benefits they will get from each. 

1.Screening colonoscopy-

As colorectal cancer usually does not cause symptoms until the disease is advanced, it is important for people to start colorectal cancer screening earlier and/or undertake screening more frequently if they have any of the following colorectal cancer risk factors including:

• Personal history of chronic IBD
• Personal history of adenomatous polyps or colorectal cancer 
• Strong family history of polyps or colorectal cancer like polyps or cancer in a first-degree relative (parent, sibling, or child) below 60 years of age or in 2 first-degree relatives in any age group.
• Family history of hereditary colorectal cancer syndrome like Lynch syndrome, FAP, or other syndromes

2. Diagnostic colonoscopy -

A diagnostic colonoscopy may be required if the patient has symptoms or a strong family history of colon cancer. If they experience any of the following symptoms, they will require a diagnostic colonoscopy: 

• Anaemia
• An abdominal ache that doesn't go away 
• Blood in the stool
• A long-term alteration in bowel habits 
• Polyps or colon cancer in the family or personal history 

What can be expected during a colonoscopy? 

Before the procedure 

The patient will be asked to empty the colon before having a colonoscopy. During the exam, any residue in the colon may block the vision of the colon and rectum. To empty the colon, a doctor may suggest the following: 

·    The day before the exam, eat a particular diet. 

·    Take a laxative to help you get rid of the waste. 

During the procedure 

During a colonoscopy, in most cases, sedation is advised. The exam will begin with one laying on the left side of the exam table, with the knees drawn to the chest. A colonoscope is inserted into the rectum by the doctor.  

The scope has a light and a tube (channel) that enables the doctor to pump carbon dioxide into the colon. It is long enough to reach the whole length of the colon. The colon is inflated by air or carbon dioxide, which allows for a clearer view of the lining.

Stomach cramping may be experienced by the patient when the scope is moved or air is inserted. A tiny video camera is placed at the tip of the colonoscope. The camera transmits images to an external monitor, allowing the doctor to examine the inside of the colon. The doctor also uses the scope to insert devices to take tissue samples or remove polyps. A colonoscopy generally takes 30 to 60 minutes to be completed. 

After the procedure 

It takes roughly an hour for the sedation to wear off after the exam. Because the sedative's full effects can take up to a day to wear off, the patient  will need someone to drive them home. For the rest of the day, don't drive, make crucial decisions, or return to work. After the test, the patient may happen to see a small quantity of blood in the first bowel movement. Normally, this isn't a cause for concern. If it continues, it is recommended to consult a doctor. While unusual, this could happen right away or within a few days of the treatment. 

What are the benefits of colonoscopy?

The main advantage of having a colonoscopy is that it allows the doctor to discover early signs of cancer and remove polyps that can become cancerous over time. Colonoscopies can also reveal the source of symptoms such as abdominal pain, anal haemorrhage, unexpected weight loss, and bowel functional  abnormalities. If the test reveals the presence of cancer, more tests will be required. Blood samples, as well as biopsies of the colon and surrounding tissue, will be obtained.

What are the possible complications of colonoscopy?

A colonoscopy may result in the following complications: 

·    An allergic response to the sedative administered during the examination 

·    Bleeding at the site of a tissue sample (biopsy) or the removal of a polyp or other diseased tissue.

·    Perforation at  the colon or rectum wall  

Conclusion  

Colonoscopies with polypectomy can reduce the risk of colorectal cancer formation in people practically to the same level as patients who do not have a polyp.