SERVICES - GASTROENTEROLOGY(procedure - colonoscopy)
Endoscopy Procedure (Upper GI) | Colonoscopy Procedure (Lower GI) | Flexible Sigmoidoscopy Procedure (Lower GI)
Colonoscopy OverviewWhat is a colonoscopy?
A colonoscopy allows a doctor to look inside the entire large intestine. The procedure enables the physician to see things such as inflamed tissue, abnormal growths, and ulcers. It is most often used to look for early signs of cancer in the colon and rectum. It is also used to look for causes of unexplained changes in bowel habits and to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss.
What is the colon?The colon, or large bowel, is the last portion of your digestive tract, or gastrointestinal tract. The colon is a hollow tube that starts at the end of the small intestine and ends at the rectum and anus. The colon is about 6 feet long, and its main function is to store unabsorbed food waste and absorb water and other body fluids before the waste is eliminated as stool.
Preparation
You will be given instructions in advance that will explain what you need to do to prepare for your colonoscopy. Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure you will have to follow a low fiber diet 2 days before the procedure, and then a clear liquid diet on the day before. Thorough cleansing of the bowel is necessary before a colonoscopy. You will need to take a preparation, as prescribed by your physician, on the night before the procedure. Be sure to inform your doctor of any medical conditions you have or medications you take on a regular basis such as aspirin, blood thinners, diabetes medication, or vitamins that contain iron. This information will help the physician decide which preparation prescription will be the best, and safest for you. The medical staff will also want to know if you have heart disease, lung disease, or any medical condition that may need special attention. You must also arrange for someone to take you home afterward, because you will not be allowed to drive after being sedated.
Procedure
For the colonoscopy, you will lie on your left side on the examining table. You will be given pain medication and a moderate sedative to keep you comfortable and help you relax during the exam. The doctor and a nurse will monitor your vital signs, look for any signs of discomfort, and make adjustments as needed. The doctor will then insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The scope transmits an image of the inside of the colon onto a video screen so the doctor can carefully examine the lining of the colon. The scope bends so the doctor can move it around the curves of your colon. You may be asked to change positions at times so the doctor can more easily move the scope to better see the different parts of your colon. The scope blows air into your colon and inflates it, which helps give the doctor a better view. During the procedure you may feel mild cramping. You can reduce the cramping by taking several slow, deep breaths. When the doctor has reached the junction of the large and small bowel, the scope is slowly withdrawn while the lining of your bowel is carefully examined. The doctor can remove most abnormal growths in your colon, like a polyp, which is a growth in the lining of the bowel. Most polyps are not cancerous, but they could turn into cancer. The polyps are sent to a lab for testing. The doctor can also remove tissue samples to test in the lab for diseases of the colon (biopsy). In addition, if any bleeding occurs in the colon, the doctor can pass an electrical probe, or special medicines through the scope to stop the bleeding. In many cases, a colonoscopy allows for accurate diagnosis and treatment of colon abnormalities without the need for a major operation. A colonoscopy usually takes 30 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You may feel some cramping or the sensation of having gas after the procedure is completed, but it usually stops within an hour. You will need to remain at the office for 30 to 60 minutes after the procedure so the sedative can wear off. You will receive instructions for activiy, diet resumption, and who to call if you have nausea, vomiting, pain, or bleeding after you get home. Full recovery by the next day is normal and expected and you may return to your regular activities.
For additional information you may visit the American College of Gastroenterology website at www.acg.gi.org. Click the "Patient Information" section.
Instructions for Colonoscopy
At Least One Week Before Your Procedure
Medical History Pre-Procedure Review
If You Receive A Sedative For Your Procedure
Low Fiber Diet - Food Choices
About the gastroenterologists:
Dr. Mort Malkin received his undergraduate degree from the University of California at San Diego and received his Medical Degree from the Chicago Medical School. He received his training in Internal Medicine at the University of Connecticut and in Gastroenterology and Hepatology at the University of Rochester. He was an Attending Physician in the GI and Hepatology Departments at the University of Rochester. He was in private practice in Ohio prior to coming to Chapel Hill Internal Medicine in 2000. Dr. Malkin is board certified in Internal Medicine and Gastroenterology, and is listed by the Consumers’ Research Council of America as one of “America’s Top Physicians.” He is an active member in the American College of Physicians, the American College of Gastroenterology, American Society for Gastrointestinal Endoscopy, and the American Gastroenterological Association. Dr. Malkin is accepting new gastroenterology patients by referral.
Dr. Julia Tang received both her Baccalaureate and Medical Degrees from UNC-Chapel Hill. She joined the staff of Chapel Hill Internal Medicine in 2006, after completing her Fellowship in Gastroenterology at UNC–Chapel Hill. She is board certified in Internal Medicine and Gastroenterology. Dr. Tang was born in Hong Kong, and since she was seven years old, has lived in North Carolina. Dr. Tang is an active member of the American Society of Gastrointestinal Endoscopy and the American College of Gastroenterology. She is accepting new gastroenterology patients by referral.