Hello! Today we are going to talk about a medical test that many people are a little afraid to ask about, but it is very important. That is called a colonoscopy. Maybe your doctor has advised you to get this done, or you have heard about it somewhere. So, let's see in simple terms what it is, why it is done, and how it is done. There is nothing to be afraid of, we will talk about everything clearly.
What is a colonoscopy?
Simply put, a colonoscopy is a test that looks inside your colon, rectum, and anus. It's like putting a camera in. Doctors call this an endoscopy. That means they insert a small, flexible tube into your body with a tiny camera and light on the end. It's called a colonoscope. The colonoscope is inserted through your anus and then moved up your colon. As it goes, the doctor can see on a screen that shows the camera. This will show you if there are any problems inside your colon.
Why do we need a colonoscopy?
There are many reasons why a colonoscopy may be performed. Sometimes it is preventive , other times it is diagnostic , or therapeutic . Often, it can be a combination of all three.
As a test to detect cancer early (Screening)
Many people have their first colonoscopy as a routine screening for colorectal cancer . We all have some risk of developing colon cancer as we age. That's why organizations like the American Cancer Society recommend that everyone over the age of 45 get this test. You may not have any symptoms, but statistically speaking, the risk is high, so it's wise to get tested early. Colorectal cancer often doesn't show symptoms, and when it does, it can be too late to treat it.
It may be time for you to have a colonoscopy as a cancer screening test, if:
- If you are over 45 years old and have not yet had this test.
- If it has been about 10 years since you last had a colonoscopy.
- If you had polyps removed during your last colonoscopy.
- If someone in your family has had colorectal cancer .
- If you have a hereditary disease such as Familial Adenomatous Polyposis (FAP) or Lynch syndrome (these increase the risk of cancer).
- If you have a condition like Inflammatory Bowel Disease (IBD) .
If you ask your family doctor or the doctor you are seeing, he or she can tell you when you should have this test based on your health condition. Tests like this save thousands of lives every year.
Diagnose a disease
Sometimes, your doctor may order a colonoscopy to look deeper into your symptoms because you have them. This is because it allows you to see the inside of your colon more clearly than other scans. This can help determine the cause of your symptoms or confirm a suspicion your doctor has. Sometimes, your doctor may want to take a piece of tissue (a biopsy) and look at it under a microscope. This can also be done during the colonoscopy.
Some symptoms that may prompt a colonoscopy include:
- If there is bleeding or other discharge from the anus for no reason.
- If your toilet habits have changed for no reason (e.g. diarrhea, constipation, incontinence).
- If you have a persistent stomach ache for no reason.
- If you are losing weight for no reason, or if you are not gaining weight in young children.
There are several conditions that can be diagnosed with a colonoscopy:
- Chronic colitis conditions, for example ulcerative colitis or Crohn's disease .
- Intestinal ischemia and ischemic colitis (conditions caused by reduced blood flow to the intestines).
- Diverticulosis and diverticulitis (the formation of small pouches in the wall of the intestine and their infection).
- Intestinal ulcers and perforations .
- Large bowel obstructions .
- Colorectal polyps and cancer .
As a treatment
One of the great advantages of endoscopy tests, such as colonoscopy, is that if the doctor finds any problems during the test, he can treat them at the same time . These doctors are trained to perform minor surgeries using special instruments that are passed through the endoscope. During a colonoscopy, polyps, which are often seen, are removed and sent to a lab to be tested for cancer. Removing these polyps also reduces the risk of developing cancer in the future.
During your colonoscopy, your doctor may do things like:
- Polypectomy .
- Cover the wounds.
- Take medications.
- Remove obstructions.
- Insert a stent (to widen narrow areas in the intestine).
- Get laser therapy .
How do you prepare for a colonoscopy?
This is very important . In order for the test to be successful, you need to be fully prepared. Your doctor will give you detailed instructions on what to do a few days in advance. The main purpose of this preparation is to keep your colon as clean and clear as possible during the colonoscopy. If you don't, the doctor won't be able to see properly. Then you may have to postpone the test or go through all of this preparation again. Imagine how inconvenient that is!
Usually, you will need to make some changes to your diet for two to three days before the test. You will be on a low-fiber diet for two to three days. On the last day, you will be told to drink only clear liquids . The evening or night before the test, you will be given a laxative formula to drink. After drinking it, you will need to go to the bathroom frequently for several hours. So be prepared for that, and stay comfortable. Then get a good night's sleep. The colonoscopy is usually done the next morning.
What happens on the day of the test?
When you go for the test, you need to have someone who can drive you home. Because it takes about a day for the anesthesia to wear off, some hospitals won't even let you in for the test without a responsible person. (The person who accompanies you will have to stay there for about two hours.) When you get to the hospital, you will be taken to a room and made to wear a hospital gown. Then a nurse will come in and put an IV line in a vein in your arm, through which you will start to receive sedatives and pain medication.
Do they put us to sleep during a colonoscopy?
Yes, you can have either general anesthesia (which puts you completely to sleep) or conscious sedation (which reduces your consciousness a bit, so you may fall asleep or wake up but have no memory of it). Your doctor will discuss the type of anesthesia you will be given with you in advance. This way, you will know in advance what to expect on the day of the test. Your doctor will help you choose the method that best suits your body and needs.
Is this a painful test?
Because you are under anesthesia, you will not feel any pain inside your colon. This is true for tissue removal and laser treatment. However, when the colonoscope is passed into your colon , you may feel a slight gassy sensation or a push. This is because the colonoscope inflates the colon with a small amount of carbon dioxide gas to allow a better view of the inside of your colon. However, this is usually not very noticeable. You will be placed on one side of the hospital bed with your knees pulled up to your chest (fetal position), and you may even fall asleep.
Who performs a colonoscopy?
Colonoscopy is usually performed by a gastroenterologist or a colorectal surgeon. Both of these doctors are experts in diseases of the digestive system and are specially trained to perform endoscopy. These doctors not only look inside the body, but they can also take tissue samples and perform minor treatments if necessary. They are also qualified to analyze the results of the test.
How exactly is a colonoscopy performed?
A colonoscope is a long, thin, flexible tube (also called a catheter ) with a small camera and light attached to the end.
- The doctor inserts this colonoscope through your anus and guides it up your large intestine, all the way to where it meets the small intestine.
- As you carry it, a little air is pumped in through the tube, inflating the intestine, allowing you to see inside clearly.
- The images from the camera are displayed on a monitor. The doctor watches the screen to see if there is anything unusual.
- Once you reach the end of the colon, the colonoscope is taken out again, so you can take a good look at it a second time.
Imagine, this is like taking a "tour" inside your intestines! The doctor looks in every nook and cranny.
How long does a colonoscopy take?
It usually takes about 15 minutes to insert the colonoscope into the end of the colon and another 15 minutes to pull it out. This means that the entire colon is examined twice. If something is found that needs to be removed or treated, it takes a little longer. Polyps are very common; they are found in about 30% of colonoscopies. Although most of them are not cancerous, the standard procedure is to remove them as soon as they are found. This can add another 15 minutes.
What happens after the test?
After the test, you will be kept under observation in the hospital for about an hour and a half . This is until you regain consciousness from the anesthesia. The medical team will continue to monitor your vital signs and watch for any signs of complications. After you regain consciousness, the doctor will come and tell you about what was seen during the test and the treatment that was given. You will receive a formal report later, either by mail or electronically. If a tissue sample (biopsy) was taken, the results will take a few days to come back.
How long does it take to recover?
It takes about 24 hours for the anesthesia to fully wear off. That's why doctors say you shouldn't drive, operate machinery, or make important decisions until the next day. But you'll feel much better in the hours that follow. You may experience some bloating, gas pain, or nausea for the first hour or two, but this will subside quickly. You can start eating normally as soon as you feel better. If the doctor removed tissue, you may have some bleeding from the anus for a few days. This is normal.
Are there any risks involved?
Complications and risks are very rare , but they can occur. They include:
- Damage to your intestinal wall , such as a tear.
- Uncontrollable bleeding when tissue is removed.
- A different type of infection that requires antibiotics .
- An abnormal response to anesthesia .
Things like this happen very rarely, but it's good to be aware.
When do reports come out?
You will get most of your results the same day . The doctor will be able to tell you what he or she saw, what treatments were given, and whether they were successful. If a biopsy was taken and sent to a lab, the results will take a few days or weeks to come back. Just because a biopsy is taken and sent to a lab doesn't mean the doctor suspects cancer. It may be just a precaution, or it may be looking for something else, like microscopic colitis . The doctor will tell you what to expect.
What are abnormal results?
Abnormal results may include:
- Uncontrolled gastrointestinal bleeding .
- Polyps can be benign, precancerous, or cancerous .
- Inflammation (colitis) caused by infection, ischemia, or autoimmune disease.
- Permanent tissue damage such as scarring.
- Intestinal obstruction or stenosis .
- Abnormal pouches in the wall of the intestine (diverticulosis) .
Your doctor will talk to you about these results and what they mean.
Are there other ways to detect colorectal cancer?
Yes, there are several other screening tests for colorectal cancer. However, colonoscopy is the most sensitive test. That is, it has the highest chance of detecting cancer or a precancerous condition at its earliest stage. Detecting cancer as early as possible is very important for preventing and treating it successfully. Also, colonoscopy is the only test that can diagnose and treat the disease at the same time. If doctors find suspicious tissue during a colonoscopy, they can remove it during the test.
Some other screening methods for cancer:
- Fecal occult blood tests (FOBT): This involves taking a sample of your stool and looking for signs of cancer. There are several ways to look for blood in your stool. One type even analyzes the DNA in your stool to see if there are any changes that could indicate cancer. These tests should be done every one to three years . If a positive result is found from this test, the next step is a colonoscopy and a biopsy .
- Virtual colonoscopy: This is a type of CT scan . It can take very clear, three-dimensional (3D) pictures of your colon. It's "virtual" because it looks at the inside of your colon using pictures taken from outside your body. Like a regular colonoscopy, it also requires a bowel prep. But it doesn't require anesthesia. Doctors recommend having this test every five years .
So what are the benefits of colonoscopy?
The advantages of a traditional colonoscopy are:
- Higher sensitivity: There is a greater chance of detecting cancerous changes sooner.
- All-in-one diagnosis, treatment and prevention: If other tests come back positive, a traditional colonoscopy is still required to confirm and treat cancer.
- Only needs to be done once every 10 years: If your results are normal, you won't need to get tested again for a while.
A colonoscopy can diagnose, treat, and prevent disease all at once. This may not seem like a big deal if you don't have it, but if you do, it can make a big difference. Colorectal cancer is a common cancer in Sri Lanka. It can be prevented, but it needs to be detected early. With a colonoscopy, doctors can detect and treat cancer before it grows, spreads, or causes symptoms. If your results are good, you may only need to have it done every 10 years.
Finally, the most important things you need to remember (Take-Home Message)
So, if you've ever been scared of a colonoscopy, I hope you've now got a better understanding of it. While it may seem a little uncomfortable, it can be a very valuable, life-saving test for your health .
- Early detection is best: especially in diseases like colorectal cancer.
- Prepare as the doctor says: it is essential for the test to be successful.
- Don't worry: you won't feel any pain because of the anesthesia.
- Ask your doctor if you have any questions: Clear any doubts you may have.
If you are over 45 years old, or if someone in your family has had colon cancer, definitely talk to your doctor and consider having a colonoscopy. Your health is in your hands!
` Colonoscopy, colon cancer, endoscopy, bowel examination, cancer tests, digestive system, medical tests
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