Colonoscopy

Why is it performed?

• To assess bleeding, inflammation or polyps, and for preventive screening when appropriate. Biopsies may be taken or polyps removed.

If you encounter a problem

• Call the unit if you cannot finish the solution, keep vomiting, or still have dark or solid stool close to your appointment. Do not add laxatives yourself.
• Replace fluids with permitted drinks until the drinking cutoff. If you have a fluid restriction, ask for an appropriate plan. Do not ignore severe dizziness or reduced urine.

What happens during the examination?

• A flexible scope is inserted through the anus, and sedation may be used. Temporary mild bloating or cramps can follow. Bleeding, perforation and sedation complications are uncommon but possible, especially after treatment.

What happens on procedure day?

1. Check in at the endoscopy unit. The nurse reviews your preparation, fasting, medicines and allergies, checks your vital signs and places an IV line if needed for sedation or medicines.
2. The team explains the procedure and confirms your consent. The examination itself often takes around half an hour in this clinic. It may take longer if treatment is needed.
3. After sedation, expect about an hour in recovery. The team checks how you are doing and decides when it is safe to go home. Check-in and recovery add to the total time at the unit.

The doctor uses the scope to diagnose problems and can treat some of them during the same examination. Based on the findings and the agreed plan, the doctor may take small tissue samples (biopsies), stop bleeding, remove polyps, widen a narrowed area in selected cases, or perform another treatment if needed.

What to expect with moderate sedation

A sedative is usually given through a vein. You may feel relaxed and sleepy, and you can usually respond to your name or a simple request. You generally breathe on your own and may remember little of the examination. The team monitors breathing, oxygen level, pulse and blood pressure. Tell the team if you feel pain or discomfort. Your team will discuss whether an examination without sedation, moderate sedation, deeper sedation or another option is most suitable for you.

Possible complications

Serious complications of routine diagnostic endoscopy, such as perforation, are very rare. Serious complications from sedation are also very rare. The procedure can cause bleeding or a tear in the wall (perforation), and infection is possible. Sedation can lower oxygen or blood pressure, and stomach contents can enter the lungs (aspiration). The team monitors for these problems and treats them promptly. Risk varies with your health and what is done during the procedure. In screening colonoscopy, one evidence review estimated about 3 perforations and 15 bleeding events per 10,000 procedures. Risk can be higher when polyps are removed. In a large endoscopy registry using different sedation methods, serious sedation complications occurred in about 1 in 10,000 procedures. Brief drops in oxygen or blood pressure can be more frequent.