A Guide to Colonoscopy Indications

No man could be faithful on an empty stomach. This modified proverb tries to say that a person will not be able to think patiently or have faith in anything. This means you must eat at the right time to take care of yourself and your stomach.

Equally, it is important to take note of the treatments or medical procedures related to your stomach issues that come up unexpectedly. One such health condition related to the stomach is colonoscopy. Here’s a guide to the indications of colonoscopy.

What is colonoscopy?

A colonoscopy refers to a medical procedure that helps examine the large bowel for diarrhoea. The colonoscope comprises a long, firm, and flexible plastic tube fixed with a light and a small digital camera at one end. A colonoscopy serves as an exam that looks for changes like swelling, polyps, irritated tissues, or cancer in the rectum and large intestine (colon). They help diagnose symptoms like unexplained abdominal pain, diarrhoea, or blood in the stool. That’s why they help remove early cancers and polyps. This colonoscopy procedure involves inserting a long and flexible tube (a colonoscope) into the rectum. 

A guide to colonoscopies indications

The indications for colonoscopies mainly include the screening and surveillance of colon (colorectal) cancer. A colonoscopy helps to diagnose colon cancer (bowel cancer) or colon polyps. Colon polyps are growths on the colon lining that could be cancerous or might develop into cancer in some cases.

1) Colonoscopies indications

A colonoscopy may be performed to identify the cause of signs and symptoms, including:

• Bleeding from the rectum
• Blood in the stools
• Pus or mucus in the stools
• Unexplained abdominal pain
• Bowel habits change, such as unexplained and long-lasting diarrhoea
• Screening and surveillance for colorectal cancer.

A colonoscopy might help diagnose the following health conditions:

• Intestinal ischemia and ischemic colitis.
• Chronic colitis, including Crohn’s disease or ulcerative colitis. 
• Diverticulosis and diverticulitis.
• Colorectal polyps and colorectal cancer.
• Ulcers and perforations.
• Large bowel obstructions.

A colonoscopy helps to visually examine the whole large bowel (also called the colon or large intestine), starting from the distal rectum to the cecum. Colonoscopy is a very safe and effective method for evaluating the large bowel. The video camera piped to the end of the colonoscope helps generate a clear image of the mucosa. This camera, connected to a computer, stores and prints the colour images chosen at the time of the procedure.

2) Screening

The first colonoscopy is used for routine cancer screening in many people. As you age, the risk of developing colon cancer increases, even though you might not have reason to suspect the risk. Colon cancer often doesn’t show any symptoms until it becomes fully developed in a condition that is to be treated effectively. 

You might undergo a colonoscopy screening if you meet the following criteria:

• Above the age of 45 and haven’t done it at least once.
• You have a family history of colon or colorectal cancer.
• I haven’t done one for 10 years.
• You had tissue removed during your last colonoscopy.
• Affected by inflammatory bowel disease.
• Affected by an inherited disease that increases your risk, like Lynch syndrome or familial adenomatous polyposis.

3) Diagnosis

In case the symptoms of health problems have to be closely viewed, then a colonoscopy helps provide a proper image of your large intestine when compared to the other imaging tests that could not go inside your body. This better view helps find out the causes of the symptoms or confirm any health issue. In some cases during the colonoscopy, they might collect a tissue sample (biopsy) to analyse below a microscope for the diagnosis. 

Some symptoms which need a colonoscopy include:

• Unknown changes in the bowel functions like constipation, diarrhoea or incontinence. 
• Unexplained discharge or bleeding of the rectum. 
• Loss of weight or inability to gain weight in children without any reason. 
• Persistent abdominal pain without reason.

4) Treatment

If your endoscopist finds a problem during endoscopic procedures such as colonoscopy, then they might treat it at the same time. Endoscopists get training to do minor procedures using the special tools which they pass through the endoscope. At the time of a colonoscopy, polyps (abnormal growths) are removed after they are found, and then they are tested for cancer. Clearing off the polyps helps prevent the spread or development of possible cancer.

At the time of your colonoscopy, the endoscopist can perform the below procedures:

• Remove polyps (polypectomy)
• Occlude wound
• Clear up blockages
• Inject medicines 
• Insert stents
• Treat tissues using laser therapy

Colonoscopy Procedure

Before beginning a colonoscopy procedure, you will be given the medications that make you relaxed and drowsy. These medicines are given by placing a soft and flexible tube called an intravenous line inside a vein, usually into the back of your hand or arm. Those provided medications will give you sedation, so you will not remember the procedure or feel the pain.

• At the time of screening, your gastroenterologist might collect the suspicious tissues for testing and further prevention.
• During the procedure, the patient will lie on the left-hand side with the knees tucked up to the chest. Then, the colonoscope is gently inserted through the anus and up into the colon. Meanwhile, the air, or carbon dioxide, is introduced to help with the colonoscope insertion.
• After the colonoscope reaches the point at which the colon joins the small intestine, the doctor slowly takes it out by carefully looking at the colon lining. Then, the images might be taken. The colonoscopy procedure needs a time of 15 to 30 minutes.
• Once the colon polyps are identified in this procedure, they are collected, and the tissue is sent for further analysis to check if the polyp is cancerous or non-cancerous.

Post Colonoscopy

After undergoing a colonoscopy procedure, there might be a possibility that you may have the following conditions:

• Bloating
• Mild cramping
• Gas

Your medical instructor might advise you to drink and eat something light only after one hour from the time you are fully awake. You could leave for home after four hours.

Complications of colonoscopy

Colonoscopy is an effective procedure, although complications may rarely occur. These include:

• More bleeding
• Colon Wall’s Perforation
• Taking care of yourself at home

Listen to the following advice from your doctor:

• Don’t drink alcohol, as it may affect the good effects of medications.
• Do not drive yourself home after a colonoscopy procedure because of the medication’s effects.
• Strictly follow all the dietary suggestions.
• Long-term outlook after colonoscopy.

The abdominal bloating, flatulence, and pain will be mitigated within a few days. The gas that is pumped into the colon during the colonoscopy procedure usually causes these symptoms. You must visit your doctor again to ask about the results of your colonoscopy.

What is the duration of a colonoscopy procedure? 

It takes 30–60 minutes for a colonoscopy procedure, but it depends on other requirements, like taking biopsies. However, it takes 2-3 hours total for the patients and carers at the hospital or endoscopy centre, including the preparation and recovery time.

It takes nearly 15 minutes to fix the colonoscope to the end of the patient’s large intestine. To take it out, it requires another 15 minutes. Through this, the doctor sees the whole large intestine twice. If they wish to remove or treat, this might need additional time. Colon polyps involve a standard method to remove them on sight, which may take another 15 minutes. 

What happens after the colonoscopy procedure?

After your colonoscopy procedure, you must rest for the first hour in the healthcare centre. This gives you time to recover from the anaesthesia that was given before the colonoscopy procedure. Your healthcare team will closely monitor you for signs and symptoms of health complications.

While you are awake, your gastroenterologist will pay attention to what they found during the exam and any methods they performed. You might receive a formal report by mail or electronically. If they collect a sample of tissue for biopsy, then you will obtain those test results later.

How long does it take to recover from a colonoscopy?

It takes nearly 24 hours to recover from the anaesthesia. This is the reason why healthcare providers strictly advise you not to drive, operate equipment, or make important decisions until the next day. But you might begin to feel more like yourself every hour. You might get some gas pain, bloating, or nausea in the first two hours, but this must pass quickly. You could resume your normal diet after you get completely cured. If your medical provider collects the tissue during the colonoscopy procedure, you may suffer from some rectal bleeding for a few days afterwards.

About Colonoscopy

• If you have a primary care provider or if you make a doctor checkup or treatment, then enquire them if you are eligible for your routine colonoscopy screening. After analysing your health history, they will tell you when you should have the screening, or they might refer you to some medical instructors who can make it for you.
• In a few developed countries, regular colonoscopy screenings are done. However, endoscopists must follow the guidelines while assigning the appropriate screening and surveillance intervals.
• A repeat colonoscopy should be performed every 3 years on all patients with advanced adenomas.
• If the colonoscopy screening patients are normal or very small hyperplastic polyps are present in them, then repeated examinations must not be made before 10 years. 
• This procedure helps detect small lesions (e.g., adenomas) that can develop into cancer when compared with other imaging modalities.
• After a colonoscopy, the treatment depends on the diagnosis. This procedure is performed in a unit that is only used for endoscopy procedures.
• A polyp removal or biopsy might result in bleeding. Clips or some other techniques will help stop the bleeding. If the bleeding is heavy, a blood transfusion or re-insertion of the colonoscope might be used to control the bleeding.

Which foods should I eat while preparing for the colonoscopy?

To get better prepared for the colonoscopy, you could include the following foods:  

Milk and milk products

• Evaporated or powdered milk
• Skim or low-fat milk
• Sherbet
• Custard
• Low-fat cheeses
• Buttermilk
• Low-fat ice cream
• Smooth nonfat or low-fat yoghurt without berries, rinds, or seeds. 
• Smooth nut butter (such as creamy peanut butter)
• Tofu

Vegetables

• Well-cooked vegetables (e.g., carrots, asparagus tips, green or wax beans, pumpkin, spinach, lima beans) but without seeds. 
• Lettuce
• Potatoes without skin
• Nicely cooked green or wax beans, pumpkin, spinach, lima beans( but without seeds) 
• Strained Vegetable juice

Non-vegetarian foods 

• Well-cooked meat, poultry and fish
• Meats and other protein foods
• Eggs

Cereals

• White rice
• Bread, pasta, and cereals made from white or refined flour
• Bagels, rolls, and crackers made from white or refined flour (e.g., crispy rice cereal and cornflakes)
• Cooked cereals (i.e. creamy rice)

Beverages

• Sports drinks (such as Gatorade)
• Water
• Coffee, tea

Fruits

• Pulpless Fruit juices (but avoid except prune juice)
• Smooth, canned, and pureed fruit without skin (except pineapple)
• Peeled apple
• Ripened bananas or melons.

Snacks and sweets

• Plain cake and plain cookies
• Plain pudding and custard
• Hard candy
• Jell-O
• Sherbet
• Popsicles
• Low-fat ice cream
• Pretzels

Condiments

• Ketchup 
• Plain gravies
• Margarine, sour cream, butter, oils, mayonnaise, and salad dressing
• Cooked herbs 
• Bouillon, broth, and soups made with allowed vegetables(with only powdered spices)
• Sugar, clear jelly, honey and syrup

What foods should I avoid for the colonoscopy procedure?

Make sure that you are away from the following foods for five days before your colonoscopy.

Milk and milk products

• Yoghurt with seeds, berries, rinds, or nuts

Vegetables

• Broccoli
• Greens (turnip, mustard and collards)
• Brussels sprouts
• Cabbage and sauerkraut
• Cauliflower
• Onions
• Corn
• Fried vegetables
• Winter squash
• Mushrooms
• Okra
• Peppers
• Potato skins

Non-vegetarian foods 

• Chewy cuts or tough parts of meat

Protein foods

• Chunky nut butter
• Canned, frozen or dried legumes (such as beans, lentils and peas)
• Nuts or seeds

Cereals

• Cereals made from whole grains
• Brown rice and wild rice
• Cereals foods made with seeds or nuts
• Whole-wheat or whole-grain breads
• Rolls, crackers or pasta

Fruits

• All kinds of raw fruits except ripe bananas, peeled apples, and melon
• Canned berries and canned cherries
• Dried fruits (even raisins)
• Prunes and prune juices
• Snacks, sweets, or condiments
• All desserts that have nuts, dried fruit, seeds, or coconut.
• Popcorn
• All desserts are made from bran or whole grain.
• Candy made with nuts or seeds
• Jam, preserves, or marmalade.
• Olives, pickles, relish, or horseradish

Conclusion

Many countries do not concentrate much on colon cancer and medical procedures like colonoscopy. Colonoscopy can capture 94% of all types of colorectal cancer. In the USA, colorectal cancer is the second most common cause of cancer death, though it is preventable. So, screening at the right time helps lower mortality at all ages. A colonoscopy is a simple medical procedure that uses a tube called a colonoscope along with a light and a digital camera. This procedure helps examine the bowel clearly. 

FAQs