Coloscopy

Information leaflet about endoscopic examination of the large intestine  

Introduction
A coloscopy is an internal examination (endoscopy), in which the inside of the entire large intestine (colon) is examined. This is done by using an endoscope, a flexible and steerable tube with a camera. The camera is connected to a screen on which the doctor can monitor the examination. A coloscopy is used to detect any abnormalities in the large intestine, such as inflammations, ulcers, bleedings, strictures, diverticula (protrusions), polyps and tumours. It is also possible to take a biopsy (obtaining tissue samples for examination), to remove polyps and to treat strictures and bleedings. The examination will be carried out under light anaesthetic. Through an IV needle, you are given a sedative, as a result of which you will hardly notice anything during the examination. The examination is carried out in the Endoscopy Department by a specialised doctor, assisted by two endoscopy nurses.

Preparations at home
Prior to the examination, the entire large intestine must be completely empty. Only then will it be possible to make a good assessment of the intestinal mucosa. You have to follow a diet and take laxatives. More information about this can be found in the leaflet ‘Bowel Preparation’. Your local pharmacy may also provide you with a schedule and/or patient information leaflet on the laxative prescribed. However, we ask you to follow the schedule that Bronovo Hospital has given you.

If, during the examination, it appears that the large intestine is not clean enough, it may be that the examination will have to be repeated at a later date after a renewed bowel preparation.

If you are a diabetic, please contact the doctor treating you or the diabetes nurse about your medication use during the bowel preparation and on the day of the examination itself.

The laxative prescribed causes repeated diarrhoea. It would be best if you take this into account when planning your appointments. If you use oral contraception (the ‘pill’), you need to bear in mind that its reliability may be reduced when using the laxative.

Important
If you take bloodthinners, such as Acenocoumarol (Sintromitis), Fenprocoumon (Marcoumar), Ascal or Plavix, please ask the doctor who requested the examination for you if you should temporarily stop taking anticoagulants and also report this to the thrombosis intensive care department [trombosedienst], if you are registered there.  

If you take iron supplements, you need to stop taking them 7 days before the examination. After the examination, you may start taking them again.  

As a result of the light anaesthetic, your ability to react will be reduced for the rest of the day. You may therefore not drive a car or ride a bicycle yourself, or travel alone by public transport/taxi. You may only be given a light anaesthetic if the following conditions have been met:

• An adult will pick you up from the Day Treatment ward and will accompany you home.
• The telephone number of the person accompanying you must be given to the nurse at the start of the examination. The person accompanying you must be within telephone contact during the time you are in the hospital.

How long does the examination take?
The examination will take about 30 minutes. We ask you to report to the desk of the Endoscopy Department, third floor, 15 minutes before the scheduled time of the examination. After the examination, you will be taken to the Beatrix ward on the 4th floor, where you will sleep for about 90 minutes.

The examination

• You will be fetched from the waiting room of the Endoscopy department.
  If you brought someone with you, the nurse will ask you if the doctor may give this person the (preliminary) results after the examination. The nurse will also ask you for the telephone number of a contact person.
• In the dressing room, you need to take off your trousers or skirt, your underpants and your shoes.
  After the examination, your clothes will be laid on your bed and taken with you to the nursing ward.
• You lay down on the bed on your left side, with your knees drawn up as much as possible.
• The nurse will partially cover your lower body with a sheet. A pulse oximeter will be put on your finger which is used to measure your heartbeat and the oxygen levels in your blood. If necessary, you may be given extra oxygen through a small tube in your nose.
• The light anaesthetic and the course of the examination will be explained to you.
• The doctor will insert an IV needle and will administer the sedative through this needle.
• The endoscope is lubricated and inserted through the anus.
• Through the endoscope, air is blown into the intestines in order to properly unfold them.This may cause intestinal cramps. It may help to pass wind.
• During the examination, you may be asked to lie on your back or on your right side. It may also be necessary for the nurse to place his/her hands on your abdomen to apply pressure in certain areas.

After the examination
After the examination, you will be fetched by the nurses of the Day Treatment ward. You will be brought to a quiet room where you can sleep. The IV needle will be removed before you go home. After about 90 minutes, you are allowed to go home only if you are accompanied. You may be bothered by intestinal cramps. These usually disappear within a few hours.

The results
The doctor who carried out the examination may, if you wish so, discuss the (preliminary) results with a person designated by you immediately after the examination. This person needs to be present in the waiting room of the Endoscopy Department the moment the examination has been completed. If this is not possible, because you came alone and will only be fetched after you have woken up, you will be informed of the results during the appointment you have with the doctor who requested the examination for you. Your Family Doctor (G.P.) will be sent a detailed report of the examination within a few days.

Complications
A coloscopy is a safe examination but complications may arise. The doctor who requested the examination will discuss this with you prior to the examination. An intestinal perforation is a rare but serious complication. This is a hole or a tear in the intestinal wall.
Should you, after the examination, experience

• increasing abdominal pain
• fever
• significant blood loss

or any other symptoms you do not trust, please immediately contact your G.P. or the Accident & Emergency Department (Spoedeisende Hulp) of our hospital on telephone number 070 - 312 44 45.

Finally
If you have any questions after reading this information, please contact the Endoscopy Department during office hours on telephone number 070 - 312 46 88.

Edition: August 2010/477