Colonoscopy can be performed either in a physician's office or in an endoscopic procedure room of a hospital. An intravenous (IV) line is inserted into a vein in the patient's arm to administer, in most cases, a sedative and a pain-killer.
During the colonoscopy, patients are asked to lie on their sides with their knees drawn up towards the abdomen. The doctor begins the procedure by inserting a lubricated, gloved finger into the anus to check for any abnormal masses or blockage. A thin, well-lubricated colonoscope is then inserted into the anus and gently advanced through the colon. The lining of the intestine is examined through the colonoscope. Images are viewed by the physician on a television monitor, and the procedure can be documented using a video recorder. Still images can be recorded and saved on a computer disk or printed out. Occasionally air may be pumped through the colonoscope to help clear the path or open the colon. If excessive secretions, stool, or blood obstructs the viewing, they are suctioned out through the scope. The doctor may press on the abdomen or ask the patient to change position in order to advance the scope through the colon.
The entire length of the large intestine can be examined in this manner. If suspicious growths are observed, tiny biopsy forceps or brushes can be inserted through the colon and tissue samples can be obtained. Small polyps can also be removed through the colonoscope. For excising tumors or performing other types of surgery on the colon during colonoscopy, an electrosurgical device or laser system may be used in conjunction with the colono- scope. After the procedure, the colonoscope is slowly withdrawn and the instilled air is allowed to escape. The anal area is then cleansed with tissues.
The procedure may take anywhere from 30 minutes to two hours depending on how easy it is to advance the scope through the colon. Colonoscopy can be a long and uncomfortable procedure, and the bowel cleansing preparation may be tiring and can produce diarrhea and
cramping. During the colonoscopy, the sedative and the pain medications will keep the patient drowsy and relaxed. Some patients complain of minor discomfort and pressure from the colonoscope. However, the sedative and pain medication usually causes most patients to dose off during the procedure.
Jennifer E. Sisk M.A., The Gale Group Inc., Gale, Detroit,