COLONOSCOPY IS A MIRACULOUS, IF UNPLEASANT, PROCEDURE

ASK DOCTOR K by Anthony L. Komaroff, M.D.

DEAR DOCTOR K: My brother was recently diag­nosed with colon can­cer. Now my doc­tor wants me to have a colonoscopy. Can you tell me what will hap­pen dur­ing this procedure?

DEAR READER: Your brother’s diag­no­sis puts you at higher risk for colon can­cer, so I’m glad to hear your doc­tor has rec­om­mended that you get checked.

Colonoscopy is used to look at the lin­ing of your colon, or large intes­tine. The pro­ce­dure can detect colon can­cer, as well as abnor­mal growths (polyps), inflam­ma­tion, bleed­ing, weak­nesses in the wall of the intes­tine (diver­tic­u­lar dis­ease) and other prob­lems of the diges­tive tract.

Your bowel needs to be empty dur­ing the colonoscopy to give your doc­tor a clear view of your intes­tine. Your doc­tor may ask you to have a liq­uid diet the after­noon and evening before the test, and to eat noth­ing the night before the pro­ce­dure. To help empty your bowel, your doc­tor will ask you to drink a lot of fluid, with lax­a­tives in it, the day before the pro­ce­dure. This is the part of the pro­ce­dure that makes you “go” a lot.

Many peo­ple find “the cleanout” to be the unpleas­ant part of the pro­ce­dure. I’ve had two colono­scopies myself, and that’s surely my view. As far as I’m con­cerned, any­one who can invent a way of clean­ing out the bow­els with­out the use of lax­a­tives should get the Nobel Prize.

For the pro­ce­dure itself, you will be asked to lie on your side on an exam­i­na­tion table. The lower part of your body will be cov­ered by a sheet.

Your doc­tor will use an instru­ment called a colono­scope. This is a flex­i­ble view­ing tube with lenses, a small TV cam­era and a light on one end. The colono­scope scans the inside of your colon and trans­mits images to a video screen.

The colono­scope is lubri­cated and bends eas­ily. You will be given light doses of seda­tives to min­i­mize any dis­com­fort. The seda­tives can cre­ate a sort of “dreamy” feel­ing. In fact, you may not remem­ber much about the pro­ce­dure after it’s over.

Your doc­tor will insert the colono­scope into your rec­tum and, as nec­es­sary, pump a small amount of air through the colono­scope. The air will open up your intes­tine for a clearer view. You may be asked to raise one or both of your knees up to your chest.

If your doc­tor sees a sus­pi­cious area dur­ing colonoscopy, he can take a small tis­sue sam­ple to be exam­ined in a lab­o­ra­tory. If a polyp is found dur­ing colonoscopy, your doc­tor may remove it.

The pro­ce­dure can take up to an hour. After­ward, you may still feel drowsy from the med­ica­tion. You need to arrange for a friend or fam­ily mem­ber to help you get home: In most states, the doc­tor is not allowed to let you walk or drive your­self home, or even to take a taxi. Either the doc­tor per­form­ing the test or your pri­mary care doc­tor will tell you the results.

Even though it has its unpleas­ant aspects, a colonoscopy is a mirac­u­lous advance. It can see inside your colon, catch colon can­cer early and save your life.

(Dr. Komaroff is a physi­cian and pro­fes­sor at Har­vard Med­ical School. Go to his web­site to send ques­tions and get addi­tional infor­ma­tion: www.AskDoctorK.com.)

Posted by Guest 2 Columnist on Mar 7 2012. You can follow any responses to this entry through the RSS Feed. Both comments and pings are currently closed.