What is a colonoscopy? Colonoscopy is an outpatient procedure that examines the rectum and the inside of the large intestine (colon).

What happens during a colonoscopy? During a colonoscopy, a physician uses a colonoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the colon. The colonoscope is inserted through the rectum and advanced through the large intestine.

1. Tell the physician/nurse practitioner if you are pregnant, have a lung or heart condition, or if you are allergic to any medications.
2. Tell the physician/nurse practitioner if you have an artificial heart valve or if you have ever been told you need to take antibiotics before a dental or surgical procedure. If you have any of these conditions, you may need to take antibiotics before the colonoscopy.
3. Tell the physician/nurse practitioner if you are on any blood thinners or anticoagulants. These may need to he held for a period of time before and after the examination.

Medications

1. If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. We will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
2. Tell the gastroenterology provider if you are taking anti inflammatory medications (such as ibuprofen including Advil, Motrin, and Nuprin; Naprosyn or Indocin) or blood thinning medications such as aspirin, Coumadin (warfarin), Persantine (dipyridamole), Plavix (clopidogrel), Aggrenox (aspirin plus dipyridamole) or Ticlid (ticlopidine hydrochloride). We may ask you to stop these medications or prescribe an alternate method for thinning your blood before the procedure.
3. Medications for high blood pressure, heart condition or thyroid disease may be taken with water the day of the procedure.

* Please note: Do not discontinue any medication without first consulting with the gastroenterology physician/nurse practitioner or your primary or referring physician.

1. The bowel must be clean in order for colonoscopy to be successful. It is very important that you read and follow the instructions given to you for your bowel preparation well in advance of the test.
2. You will need to purchase your bowel preparation medications within 1 week after your telephone consultation (since a pharmacy may discard the prescription 1 week after it is written).
3. Your gastroenterologist will prescribe a bowel preparation that is appropriate for your overall health and age. You can find instructions for Half-lytely preparation here.

Transportation You will need to bring a responsible adult to accompany you after the procedure. Often, pain reliever and sedative medication is given during the procedure that may cause prolonged drowsiness. If you receive these medications for the procedure, you should not drive, operate machinery, or make important decisions for at least 12 hours after the procedure is completed.

On the day of the procedure On the day of the procedure, the physician will introduce him(her)self and address any last minute questions that you may have regarding colonoscopy.

1. The procedure is performed by a physician experienced in colonoscopy.
2. You are asked to wear a hospital gown and remove eyeglasses.
3. You may be given a pain reliever and a sedative intravenously (in your vein). You will feel relaxed and drowsy.
4. You will lie on your left side, with your knees drawn up.
5. The colonoscope is inserted through the rectum and advanced to the large intestine.
6. A small amount of air is used to expand the colon so the physician can see the colon walls.
7. You may feel mild cramping during the procedure. Cramping can be reduced by taking slow, deep breaths.
8. The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
9. The procedure lasts from 30 minutes to 1 hour.

1. You will stay in a recovery room for about 30-45 minutes for observation.
2. You may feel some cramping or a sensation of having gas, but this usually passes quickly.
3. If you received medications, a responsible adult must accompany you home. Do not drive or operate machinery for at least 12 hours after the procedure.
4. You may resume your normal diet.
5. If polyps were removed, your physician may ask you to avoid taking blood thinning medications containing aspirin or anti inflammatory medications such as ibuprofen including Advil, Nuprin, Naprosyn, Indocin or Motrin) for several days after the procedure to help decrease the risk of bleeding. You may take acetaminophen (such as Tylenol) if needed.
6. If a biopsy was taken, you may notice light rectal bleeding for 1 to 2 days after the procedure. This is normal.

As with all medical procedures, there are risks associated with a colonoscopy.  One very common after-effect from the colonoscopy procedure is a bout of flatulence and minor wind pain caused by air used to help open the colon during the procedure. During colonoscopy a very small proportion of patients may experience perforation of the bowel. Most of the time, it is a small perforation that may be managed conservatively by letting the colon to heal on its own. However if it is a big perforation, this is a medical emergency and will require immediate surgery. Bleeding, infection, and sedation reactions are also possible side effects during and after colonoscopy. Sedation used during colonoscopy has a low (0.2%) risk of serious complications such as an allergic reaction or breathing difficulties. However a colonoscopy is performed under a controlled environment so these possibilities can be managed and quickly corrected by an experienced medical team.

1. Rectal bleeding greater than 1 tsp. at any time within 2 weeks after the procedure;
2. Black stools at any time within 2 weeks after the procedure;
3. Severe abdominal pain, fever or chills;