Complications Before, During, After Procedure

A colonoscopy lets your doctor check the insides of your colon and rectum for cancer and polyps — growths that can be early signs of cancer. It saves lives, so follow your doctor’s recommendations on when to have one.

They’ll give you a sedative to put you to sleep and use a long, flexible tube to look inside your colon. It has a light and a camera inside to help them see what’s going on.

It’s a fairly safe exam. On average, there are only two serious complications for every 1,000 procedures. The risks of a colonoscopy include:

Belly Pain or Discomfort

This is the most common side effect of colonoscopy. You might feel cramping or bloating afterward.

Your doctor may use air to inflate your colon so they can get a better view. They might use water or a suction device as well as certain surgical tools to take off a polyp. All these things can move and stretch your colon, so you might feel uncomfortable for 1 or 2 days afterward. The sedatives may also make you nauseated. If you have pain or vomiting, call your doctor right away.

Bleeding

You could notice blood from your rectum or in your poop after a colonoscopy. Most of the time, this happens because your doctor had to take a tissue sample or remove a polyp. Call them as soon as possible if the bleeding won’t stop or if there’s a lot of blood. Certain medications, such as vitamins and over-the-counter painkillers like aspirin, can raise your chance of bleeding. If you take them, be sure to tell your doctor before the test.

A Bad Reaction to Anesthesia

You may feel woozy or shaky when you wake up after the test. Some people can have serious reactions to the medications that put you to sleep, such as heart or breathing problems. Your medical team is trained to identify and treat these complications. Tell them before the test if you’re allergic to any medicines or have ever had a bad reaction to anesthesia.

Postpolypectomy Electrocoagulation Syndrome

If your doctor needs to cut off a polyp, they’ll use a tool with an electrical current to seal the area. It’s rare, but this current can go too deep, burning and inflaming the tissues. This might cause belly pain, fever, and a fast heart rate. Most people feel better after taking antibiotics for 2 or 3 days.

Infection

Colonoscopy tools can be hard to clean and disinfect. Rarely, they may carry bacteria such as E. coli, Klebsiella, or Enterobacter, or viruses like hepatitis B or C. 

Perforated Intestine

The tool that your doctor uses in a colonoscopy could push too hard against your colon. This can cause a small tear. Your doctor may need to repair it with surgery.

Colonoscopy Prep Risks

Before a colonoscopy, you’ll need to empty your colon so your doctor can get a clear picture. They’ll give you directions to use a strong laxative as bowel preparation or “prep.” Certain kinds of these medications can cause dehydration or electrolyte problems in some people:

• Older adults
• People who have heart, kidney, or liver problems
• People who have inflammatory bowel disease
• Pregnant women

Post-Colonoscopy Complications

Call your doctor right away if you have any of these symptoms after your test:

• Severe pain or cramping in your belly
• A hard belly
• Trouble passing gas or pooping
• Fever
• Dizziness
• Vomiting
• Frequent or severely bloody bowel movements
• Rectal bleeding that won’t stop, or bleeding more than a couple of tablespoons

Possible Side Effects of a Colonoscopy – OneWelbeck

What is a colonoscopy?

A colonoscopy is a camera examination where the lining of the colon is checked for abnormalities by inserting a tube through the bottom, usually under sedation. For more information on the treatment, we recommend reading our colonoscopy page, where we also provide information on bowel prep and what you would be expected to do to get ready for the procedure.

A colonoscopy is a straightforward procedure, but due to its sensitive nature, people may not feel comfortable enquiring about. You might wonder what a colonoscopy might feel like and what to expect after  the procedure, including what it and if there are any possible side effects. Let’s answer some of those commonly asked questions.

 How is colonoscopy different at OneWelbeck?

At OneWelbeck, all patients are provided with a personalised specialist app which is unique to OneWelbeck. All patients are provided with their own separate private cubical both before and after the procedure. All patients are offered sedation by an anaesthetist, who is present throughout the day in the unit.

How can I expect to feel after a colonoscopy?

If the colonoscopy were a purely investigative measure, you might expect some bloating and cramps as your body settles down again. Additionally, if biopsies are taken, or polyps are removed then you may experience a small amount of bleeding for a day or two.

Some colonoscopies are done using gas and air as a patient preference, which can make you feel dizzy or lightheaded for a short period.

After sedation, you may feel a little more tired for the rest of the day and will be advised to avoid driving for 24 hours, or operating any machinery and avoiding alcohol. Don’t forget that if you need to be sedated for the procedure, you will need to arrange to be picked up afterwards, to ensure you are able to get home safely. You can return to eating a normal diet straight away.

Following a colonoscopy, side effects are generally few and far between. In a small number of instances, side effects of a colonoscopy can include:

• Nausea (from the anaesthesia)
• Irritation around the rectum
• Feeling gassy for a few days
• Cramps, but nothing that would be deemed severe.

When can side effects be a warning sign of complications?

You should get in touch with their doctor after a colonoscopy if you start to experience persistent problems.

This can include:

• Continued bleeding, or bleeding which gets worse
• Severe pain in the abdomen
• An unexplained fever or chills

If any of these happen, they should not be ignored. 

Get in touch with us for expert advice

If you, or someone you know, needs to have a colonoscopy carried out and would like to have it done by leading gastroenterologists, please get in touch with OneWelbeck Digestive Health today.

You can get in touch any time of time by leaving a message on our contact form here.

You can also phone us during the day on 020 653 2004.

Recovery After Colonoscopy: What to Expect

A colonoscopy is a common procedure and comes with a fairly quick and easy recovery time. You may notice some side effects from the colonoscopy, but they usually pass on their own within a day or two. Depending on the result of your colonoscopy and whether abnormal tissue was discovered, your doctor may have some special instructions for you during your colonoscopy recovery period.

Immediately After a Colonoscopy

Colonoscopies are performed at a hospital or outpatient facility, where a nurse anesthetist or anesthesiologist will administer anesthesia or a sedative so you won’t feel pain during the procedure. It takes an hour or two to fully recover from the effects of the drug, so you will need to have someone drive you home. You shouldn’t go back to work that day.

You may notice some mild colonoscopy side effects in the first hour or so after the procedure, including cramping and bloating. This happens because the doctor introduces small amounts of air into your colon to open the passageway and allow a clear view of the colon wall. Walking around soon after your colonoscopy will help you pass gas and relieve the discomfort.  

It could take 2 to 3 days before you have a bowel movement after your colonoscopy because you completely emptied your colon and rectum ahead of the procedure. You may notice a little bit of blood in your first stool after your colonoscopy, especially if your doctor removed a polyp or took a biopsy of abnormal tissue. There’s no need to worry as long as it’s only a small amount and it doesn’t persist. If the bleeding becomes heavy or continues after many bowel movements, call your doctor. It could indicate a perforation, or tear in the colon wall. While this rarely happens—fewer than 10 patients in 10,000 will experience a perforation—it could require surgical repair.

If your colonoscopy result was negative, meaning your doctor found no abnormalities or polyps, you should be able to return to your regular diet the day after the procedure. However, if you had a biopsy or polyp removal (polypectomy), your doctor may give you specific diet instructions about what to eat after the colonoscopy.  

You should be able to resume your normal activities, such as driving and exercising, the day after the procedure. If you had polypectomy during the colonoscopy, ask your doctor before returning to your regular activities. Ask your doctor about other special instructions, such as avoiding aspirin or other drugs during your colonoscopy recovery. (Aspirin increases the risk of bleeding.)

Colonoscopy complications are rare. However, it is possible that a tear occurs in the colon or rectum during the procedure. If your doctor notices the tear right away, he or she will repair it before you leave the facility. Large holes may involve surgery in the hospital. If perforation is discovered after your procedure (see warning signs below), call your doctor immediately. You may need surgery to repair the tear.

Warning signs of a colonoscopy complication include:

• Persistent pain: Minor abdominal pain is expected after a colonoscopy as you recover, but severe or persistent pain should not be dismissed. Call your doctor and let him or her know your symptoms.

• Bleeding: Some bleeding is also normal after a colonoscopy, especially if you had tissue or a polyp removed. But, if you experience heavy bleeding or bleeding that doesn’t go away after a couple of bowel movements, call your doctor. This could indicate a perforation of the colon wall, which is a rare but serious complication.

• Fever: A fever is not expected after a colonoscopy, so if you experience a temperature higher than 100.4 degrees Fahrenheit in the next few days, call your doctor. Fever is one possible sign of infection.

• Nausea, weakness or shortness of breath: Call your doctor if you experience any of these symptoms, which can be due to an adverse reaction to the anesthetic.

If your doctor removed a polyp or abnormal tissue, the sample will be sent to a lab for analysis. Your doctor should receive results from the biopsy within a week. Follow up with your doctor to find out the next steps, if any are necessary. You may need another colonoscopy before the usual 10-year mark if the results showed precancerous tissue in your colon. 

Because it’s a safe procedure for most healthy people, recovery after a colonoscopy usually is no more problematic than some cramps and a gassy feeling, which will soon pass. Your doctor will discuss all colonoscopy side effects with you before the procedure, and be sure to ask any questions you may have.

Colonoscopy Procedure | What to Expect Before and After

There is a lot of information floating around the internet about colonoscopies and what you should expect, but not all of it is accurate. The stories friends tell about theirs may have left you hesitant to schedule yours. But we’re here to ease
your mind, to arm you with knowledge, and to prepare you for what to expect when you do pick up the phone and schedule that colonoscopy. What happens during a colonoscopy may not be as bad as you’re expecting.

Colonoscopy Preparation: Before the Procedure

As you may have heard, the preparation is the most time-consuming part of a colonoscopy – and the most dreaded. But much of what you’ve heard may not be accurate. While colonoscopy prep does begin a day before the procedure, advances in preparation
practices have made it much more bearable.

Diet: During the 24 hours before your colonoscopy, you will have to be on a clear liquid diet. That means plain water, clear broth and soda, and plan coffee or tea (no milk, cream or other dairy or non-dairy creamers). You should avoid anything red because
the dye in red drinks can be mistaken for blood during the procedure.

The clear liquid diet is done so anything left in your digestive system during the procedure will not get in the way of the doctor seeing inside your rectum and colon. Your doctor may also recommend that you not drink anything at all after midnight the
day before your procedure.

In addition to making diet changes, you will also have to take a laxative that will help clear your intestines. The laxative is now easier to swallow, and you won’t have to take as much as people in recent past had to. Following instructions is
so important. If you do not, you may not be able to have the procedure, your doctor may not be able to visualize your colon well (leading to less-accurate results), or you may have to have an alternate procedure. You’ve probably heard that the
prep is the hardest part of the procedure, so you don’t want to have to do it twice.

Your doctor may also recommend that you avoid certain foods for a few days prior to the procedure. Things like seeds, stringy foods (like spaghetti squash), and foods with red dyes can make the test more difficult.

Medications: If you take medications, you may have to adjust them. Be sure to tell your doctor about all medications and supplements you take and when you take them. He or she will let you know what, if anything, you need to do to adjust
your medication schedule.

Other colonoscopy prep: In some cases, you may have to do an enema before the procedure. Your doctor will let you know if that is necessary.

During the Colonoscopy Procedure

When you arrive at the location of your procedure and have checked in, you will be asked to change into a gown. Most doctors will recommend a type of anesthesia called conscious sedation that will help you relax. You may be aware and able to respond if
your doctor wants you to do something, like hold your breath, but you should not feel pain, and the anesthesia should alleviate any anxiety related to the procedure. You may also be given some sort of pain medication. Doctors at Beaumont work hard
to ensure all our patients are comfortable throughout their procedures. If you have questions about the anesthesia we’ll use, talk with your doctor before the procedure.

The colonoscopy will take between 20 and 60 minutes. Once you are sedated, you will lie on your side, and your doctor will insert a scope into your rectum. This scope is a thin tube with a tiny video camera at the tip that allows your doctor to see inside
your rectum and colon to look for polyps or other abnormalities. Polyps are little clumps of cells that grow
inside the colon. Most of them are harmless and benign, but sometimes they can lead to colorectal cancer. If there
are polyps present, your doctor will remove them because they are not necessary and because most colon cancer grows from polyps. Therefore, if all polyps are removed, colon cancer is basically stopped before it starts.

If your doctor sees any potentially abnormal tissue, he or she can remove tissue samples for testing. When a doctor takes tissue samples, that is called a biopsy. Any polyps or tissue removed can then be tested to help diagnose abnormalities. Your doctor
will let you know when to expect the results of any tests or biopsies.

Colonoscopy Recovery: After the Procedure

After the procedure, you will stay in recovery until the sedation wears off enough for you to go home. You will probably feel a bit tired or groggy even then, so you cannot drive yourself home. Your doctor will not release you unless there is someone
there to bring you home. The effects of the sedation could last up to a day, so you should not drive or operate any machinery until the following day.

You may feel gassy or bloated for a while after the procedure because of the air that was injected into your intestine during the colonoscopy. As you release the air, the feeling should begin to subside. You should feel back to normal in that regard within
30 minutes to an hour.

If you had a biopsy or had polyps removed, your doctor may recommend a special diet for a day or so to allow your intestines time to heal. Your doctor will let you know what to expect and what you can and can’t eat or drink. 

You might not have a bowel movement for a couple days after the procedure. When you do have your first bowel movement, you may notice a bit of blood. This is likely normal and isn’t cause for concern. However, if you are passing large clumps or
clots of blood or the bleeding seems significant or lasts more than a day, contact your doctor. You should also call your doctor if you have severe abdominal pain, dizziness, or a fever over 100 degrees Fahrenheit.

The vast majority of people feel back to normal quickly and don’t suffer any pain or serious discomfort during or after a colonoscopy – and the test could save your life. If you’re over 50 (over 45 if you’re African American) or
you have a family history of colorectal cancer, talk to your doctor today about when you should schedule yours.

When You’ll Get Your Colonoscopy Results

If you had tissue removed for testing, your doctor will let you know right away. However, it will take some time to receive your test results from the lab that will confirm or rule out cancer. Your doctor may have some information for you prior to the
lab test results, but the official results will come from the lab within a couple weeks. If the doctor sees anything during the procedure that seemed to require immediate attention, he or she will let you know and will talk with you about recommendations
for next steps.

Don’t wait – talk to a Beaumont Doctor today to get a referral for a colonoscopy. Call 800-633-7377.

Colonoscopy | NIDDK

On this page:

What is colonoscopy?

Colonoscopy is a procedure in which a doctor uses a colonoscope or scope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.

How is virtual colonoscopy different from colonoscopy?

Virtual colonoscopy and colonoscopy are different in several ways:

• Virtual colonoscopy is an x-ray test, takes less time, and you don’t need anesthesia.
• With virtual colonoscopy, your doctor doesn’t view the entire length of your colon.
• Virtual colonoscopy may not find certain polyps as easily as a colonoscopy can.
• Doctors can’t remove polyps or treat certain other problems during a virtual colonoscopy.
• Your health insurance coverage may be different for the two procedures.

Why do doctors use colonoscopy?

A colonoscopy can help a doctor find the cause of symptoms, such as

• bleeding from your anus
• changes in your bowel activity, such as diarrhea
• pain in your abdomen
• unexplained weight loss

Doctors also use colonoscopy as a screening tool for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. Screening may find diseases at an early stage, when a doctor has a better chance of curing the disease.

Screening for Colon and Rectal Cancer

Your doctor will recommend screening for colon and rectal cancer —also called colorectal cancer—starting at age 45 if you don’t have health problems or risk factors that make you more likely to develop colon cancer.¹

You have risk factors for colorectal cancer if you²

If you are more likely to develop colorectal cancer, your doctor may recommend screening at a younger age, and more often.

If you are older than age 75, talk with your doctor about whether you should be screened. For more information, read the current colorectal cancer screening guidelines from the U.S. Preventive Services Task Force (USPSTF).

Government health insurance plans, such as Medicare, and private insurance plans sometimes change whether and how often they pay for cancer screening tests. Check with your insurance plan to find out how often your plan will cover a screening colonoscopy.

How do I prepare for a colonoscopy?

To prepare for a colonoscopy, you will need to talk with your doctor, change your diet for a few days, clean out your bowel, and arrange for a ride home after the procedure.

Talk with your doctor

You should talk with your doctor about any health problems you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including

Change your diet and clean out your bowel

A health care professional will give you written bowel prep instructions to follow at home before the procedure so that little or no stool remains in your intestine. A complete bowel prep lets you pass stool that is clear and liquid. Stool inside your intestine can prevent your doctor from clearly seeing the lining.

You may need to follow a clear liquid diet for 1 to 3 days before the procedure. You should avoid red and purple-colored drinks or gelatin. The instructions will include details about when to start and stop the clear liquid diet. In most cases, you may drink or eat the following:

• fat-free bouillon or broth
• gelatin in flavors such as lemon, lime, or orange
• plain coffee or tea, without cream or milk
• sports drinks in flavors such as lemon, lime, or orange
• strained fruit juice, such as apple or white grape—avoid orange juice
• water

Different bowel preps may contain different combinations of laxatives—pills that you swallow or powders that you dissolve in water or clear liquids. Some people will need to drink a large amount, often a gallon, of liquid laxative over a scheduled amount of time—most often the night before and the morning of the procedure. Your doctor may also prescribe an enema.

The bowel prep will cause diarrhea, so you should stay close to a bathroom. You may find this part of the bowel prep hard; however, finishing the prep is very important. Call a health care professional if you have side effects that keep you from finishing the prep.

Your doctor will tell you how long before the procedure you should have nothing by mouth.

The instructions will include details
about when to start and stop the clear liquid diet.

Arrange for a ride home

For safety reasons, you can’t drive for 24 hours after the procedure, as the sedatives or anesthesia need time to wear off. You will need to make plans for getting a ride home after the procedure.

How do doctors perform a colonoscopy?

A doctor performs a colonoscopy in a hospital or an outpatient center. A colonoscopy usually takes 30 to 60 minutes.

A health care professional will place an intravenous (IV) needle in a vein in your arm or hand to give you sedatives, anesthesia, or pain medicine, so you won’t be aware or feel pain during the procedure. The health care staff will check your vital signs and keep you as comfortable as possible.

For the procedure, you’ll lie on a table while the doctor inserts a colonoscope through your anus and into your rectum and colon. The scope inflates your large intestine with air for a better view. The camera sends a video image to a monitor, allowing the doctor to examine your large intestine.

The doctor may move you several times on the table to adjust the scope for better viewing. Once the scope reaches the opening to your small intestine, the doctor slowly removes the scope and examines the lining of your large intestine again.

For the procedure, you will lie on a table while the doctor
inserts a colonoscope through your anus and into your rectum and colon.

During the procedure, the doctor may remove polyps and will send them to a lab for testing. You will not feel the polyp removal. Colon polyps are common in adults and are harmless in most cases. However, most colon cancer begins as a polyp, so removing polyps early helps to prevent cancer.

If your doctor finds abnormal tissue, he or she may perform a biopsy. You won’t feel the biopsy.

What should I expect after a colonoscopy?

After a colonoscopy, you can expect the following:

• The anesthesia takes time to wear off completely. You’ll stay at the hospital or outpatient center for 1 to 2 hours after the procedure.
• You may feel cramping in your abdomen or bloating during the first hour after the procedure.
• After the procedure, you—or a friend or family member—will receive instructions on how to care for yourself after the procedure. You should follow all instructions.
• You’ll need your pre-arranged ride home, since you won’t be able to drive after the procedure.
• You should expect a full recovery and return to your normal diet by the next day.

After the sedatives or anesthesia wear off, your doctor may share what was found during the procedure with you or, if you choose, with a friend or family member.

If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal. A pathologist will examine the biopsy tissue, and results take a few days or longer to come back. A health care professional will call you or schedule an appointment to go over the results.

After the procedure, you—or a friend or family member—will receive instructions
on how to care for yourself after the procedure. You should follow all instructions.

What are the risks of colonoscopy?

The risks of colonoscopy include

• bleeding
• perforation of the colon
• a reaction to the sedative, including breathing or heart problems
• severe pain in your abdomen
• death, although this risk is rare

A study of screening colonoscopies found roughly 4 to 8 serious complications for every 10,000 procedures.³

Bleeding and perforation are the most common complications from colonoscopy. Most cases of bleeding occur in patients who have polyps removed. The doctor can treat bleeding that happens during the colonoscopy right away.

You may have delayed bleeding up to 2 weeks after the procedure. The doctor can diagnose and treat delayed bleeding with a repeat colonoscopy. The doctor may need to treat perforation with surgery.

Seek Care Right Away

If you have any of the following symptoms after a colonoscopy, seek medical care right away:

• severe pain in your abdomen
• fever
• bloody bowel movements that do not get better
• bleeding from the anus that does not stop
• dizziness
• weakness

References

[1] Colorectal Cancer: Screening. U.S. Preventive Services Task Force. Updated May 18, 2021. Accessed May 25, 2021. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening#fullrecommendationstart

[2] National Cancer Institute. Colon cancer treatment (PDQ®)-patient version website. https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq#link/_93. Updated February 27, 2017. Accessed July 20, 2017.

[3] Lin JS, Piper MA, Perdue LA, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;315(23):2576–2594.

Colonoscopy Complications Occur at Surprisingly High Rate

When Harlan Krumholz, MD, saw a friend rushed to the hospital “with shaking and chills” one day after his colonoscopy a few years ago, he wondered how often this procedure results in such scary, adverse events.

“For about 12 hours he was very, very sick,” Krumholz recalled. And it seemed “a bit much to think the colonoscopy was unrelated; maybe there was a micro-perforation, or a contaminant in the IV” used to administer sedation during the procedure.

It struck Krumholz, director of the Yale Center for Outcomes Research and Evaluation (CORE), that the frequency and severity of harm from this common cancer screening, performed in roughly 14 million people each year, were poorly quantified. It probably varies widely among facilities, depending not just on the skill of their clinicians, but on many other factors related to how the facility functions, he thought.

So Krumholz, whose team has multiple Medicare contracts to develop pay for performance measures for healthcare settings, went to work.

“I came back to my group and said, ‘We need a measure for this,'” he said. “How often does this happen and how much does it vary among the outpatient centers? Probably the people who performed his colonoscopy didn’t even know he showed up in the emergency department. Because today, there’s no feedback to let them know.'”

The Yale team developed a risk-adjusted measure that now has been incorporated in two Centers for Medicare & Medicaid Services quality reporting programs. It provides a count of all healthy fee-for-service Medicare beneficiaries 65 and older who, for any reason, experienced an unplanned visit to the hospital within 7 days of their outpatient colonoscopy — regardless of whether a polyp was removed or biopsy performed.

As a kind of test, Krumholz and colleagues applied the measure, which factors in the patients’ procedures and conditions in the prior year, to Medicare claims databases in four states (New York, California, Florida, and Nebraska) that track unique patient identifiers. With that, they could see what care patients required within 7 days of their colonoscopies.

Two of Every 125 Patients

What they found might surprise many, although it’s not out of line with the literature: 1.6% of 325,000 otherwise low-risk healthy patients who had a colonoscopy in the year 2010 experienced a complication serious enough to send them to a hospital or emergency department within 7 days.

For some, “that 1.6% may not seem high,” Elizabeth Drye, MD, director of quality measurement programs at the Yale center, said in an phone interview. “But not when you think of how so many healthy people have these procedures. It’s important for us to know how many could be having a bad result.”

The Yale team’s results were published as the lead article in the January issue of the journal Gastroenterology, accompanied by a video interview with Drye.

What’s more, the team found wide variation in the rates of emergency visits and hospitalizations across facilities, from 8.4 per 1,000 up to 20, she said.

Extrapolating to a national population of 1.7 million Medicare fee for service beneficiaries undergoing colonoscopies each year, Drye and colleagues estimated about 27,000 would have an unplanned hospital visit within 7 days. That does not include Medicare Advantage enrollees or younger patients 50 to 64 who have an adverse reaction from their colonoscopy bad enough to send them to the hospital.

A lot of things can go wrong even after colonoscopy in an outpatient setting, such as a hospital outpatient department or an ambulatory surgery center.

Perforations or lacerations can cause bleeding and hemorrhage or even infections that don’t show up for a day or more; sedative drugs can cause reactions resulting in hypoxia, aspiration pneumonia, and cardiac arrhythmias. Abdominal pain or nausea can also result, possibly from preparation, Drye said.

As early as next year, all Medicare-approved outpatient facilities will have their scores for the measure — “ASC-12” or “OP-32” as it is now called — publicly reported on its website.

CMS said in its specifications manual that such transparency “will reduce adverse patient outcomes associated with preparation for colonoscopy, the procedure itself, and follow-up care by capturing and making more visible to providers and patients all unplanned hospital visits following the procedure.” Eventually the measure will probably be used to determine amount of Medicare reimbursement to those facilities.

It also will provide “transparency for patients on the rates and variation across facilities in unplanned hospital visits after colonoscopy,” CMS said in its rulemaking documents.

The intent is “not to put a label on a facility that looks better or worse,” she emphasized. “What we’re doing is making this visible to doctors, to gastroenterologists and surgeons and their facilities, so they know what is happening to the patient … something they don’t know now.”

When the data becomes public, it will also help physicians determine where to refer their patients.

Beyond 7 Days

Most colonoscopy adverse events occur within 7 days, but even more occur beyond the 7-day period. In a mid-2014 handout, the agency said: “Hospital visit rates after outpatient colonoscopy range from 0.8 to 1.0 percent at 7-14 days.” And in its rule establishing ASC-12 as a reporting requirement, it estimated the range of hospital visits is between “2.4 to 3.8% at 30 days post procedure.”

But Drye noted also that the risk is even higher on a per-person basis, because one must consider that patients who undergo colonoscopies at recommended intervals — every 10 years, or every 5 years if polyps are found — would have from three to six colonoscopies before age 76.

Additionally, the measure also only captures the risk for healthier patients; Those with conditions such as diverticulitis or inflammatory bowel disease, and those with serious chronic illnesses are more likely to experience complications from colonoscopy were excluded from this measure’s denominator.

“We were very conservative,” Drye said. Also, the 1.6% meshed more or less with what they found in medical literature, where a variety of studies using different time frames and definitions of “hospitalization” found rates of colonoscopy complications ranging from .8 to 3.8%.

Rates were somewhat different between hospital outpatient departments and ambulatory surgical centers, Drye added. Their study found that the ASC measure scores “ranged from a minimum of 6.5 per 1,000 procedures to a maximum of 13 per 1,000.” Hospital outpatient department averages were slightly higher “with a minimum of 7.3 and a maximum of 16.6 per 1,000.”

Public reporting will be a good thing, said Joel Brill, MD, a quality measurement expert referred by the American Gastroenterological Association.

“This forces, or at least helps to begin a dialogue of what percentage of the endoscopists’ (and facility’s) patients actually have an emergency department or hospital visit within the week,” said Brill, of Predictive Health LLC in Phoenix. “Ideally, it should be zero.”

And if it isn’t, he said, “you need to look at the root causes of why that would occur, and would you could do to bring it down.”

Providers should be asking, “what kind of preparation was used, what type of scope did you use, what were the comorbid conditions, what type of sedation or anesthesia – ask all those questions first to find out what’s going on. And if there’s something there, we need to modify or change our practices,” Brill said.

The measure is part of the movement toward value, Brill acknowledged. “We clearly have to move toward avoiding potentially avoidable complications, and that includes avoiding unnecessary services that could have been prevented up front. This could be tipping us off to that.”

CMS began collecting this data early last year, and in recent months outpatient surgical centers received their first confidential reports to show how they measure up. Those numbers are not being publicly reported, to give centers a chance to compare themselves and improve before the data go live next year with updates for 2016.

Gastroenterology groups seem comfortable with the new transparency, even though some proceduralists will need to change their practices.

Disbelief Common

Though still, some physicians expressed skepticism, saying they don’t see such high rates of complications. Brill thought the actual complication rates are much lower than what Drye found. “It’s still a very low risk procedure,” he said.

Some emergency room physicians concur.

“(It’s) very unusual in my practice at UCSD [University of California San Diego],” said James Dunford, MD, a long-time emergency room physician who now serves as medical director for the city’s fire and rescue department. “I know of one case in the past couple of years, and naturally it happened to an MD during a routine screening exam.”

Drye acknowledged widespread disbelief that complications are that common. “These outcomes really aren’t visible to anyone right now, just like hospital readmissions weren’t visible until we started reporting them.”

But others say those numbers are quite plausible. Ryan Stanton, MD, an emergency physician in Lexington, Ky., said he was “not surprised. The most common complications I see are perforations that are usually small, diverticulitis and bleeding.”

Lorrie Metzler, MD, an emergency physician in New Orleans, wrote that she has not seen “a lot” of patients in the ED with complications, although, she added, she has “seen some with massive GI bleeds after polypectomy.”

For Krumholz, the numbers will tell an important story about quality in outpatient settings that has for too long gone unreported. “It’s a big area of growth, but a largely invisible area with regard to performance. It’s important for us to have a sense of what is being achieved.”

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What to expect after a colonoscopy

Even though it’s a common cancer screening procedure, it’s completely normal to wonder about what will happen after you get a colonoscopy.

Find out why early detection is crucial for beating colon cancer

Most people between the ages of 50 and 75 will only need to get a colonoscopy once every five or ten years. Whether it’s your first time or it’s been a few years, here’s a primer on what to expect after a colonoscopy.

Colonoscopy aftercare FAQs

“What happens once the doctor finishes the colonoscopy?”

Colonoscopies are quick, generally taking around 20–30 minutes. Most patients “sleep” during the procedure because they are sedated to increase their comfort and aid in relaxation.

Unless you’ve chosen not to be sedated during your colonoscopy, the nursing staff will move you to a recovery area to rest comfortably until anesthesia medication you’ve been given wears off. This part of the recovery typically takes about a half-hour.

After this period, you’ll be free to go home under the care of a family member or a good friend for the first 24 hours.

Some patients report having only a vague memory of everything that happened during their colonoscopy because of the effects of conscious sedation. Once you start to “wake up” from sedation, you may find yourself feeling a little sluggish and bloated. For relief from your cramps during the first hours after your colonoscopy, you’ll be encouraged to pass gas, and—until you stop feeling groggy—your doctor may recommend you limit your activity.

The drugs will gradually wear off entirely during the rest of the day. You owe it to yourself to take it easy and give your body time to heal.

Learn more about what you can do to prevent colon cancer

“What happens if my doctor finds something?”

If your doctor sees any abnormalities during your colonoscopy, they will discuss their findings with you after the procedure. In some cases, your doctor may find and remove polyps to prevent cancer from developing or take tissue samples from your colon wall for cancer screening; you can expect to get results from those biopsies within three to five days.

“What can I eat after a colonoscopy?”

Before your colonoscopy, you will have to avoid eating and drinking certain things. You will also need to be mindful of abiding by certain restrictions for the first 24 hours after your procedure, including:

• Getting plenty of liquids, especially beverages with sorbitol—like prune juice—which can alleviate constipation by softening your stool
• Avoiding high-fiber foods or taking any over-the-counter fiber supplements)
• Not drinking any alcohol

If you had to stop taking medications as part of your colonoscopy prep, your doctor will give you advice on when you should restart taking those treatments.

“How will I feel the day after a colonoscopy?”

One day after your colonoscopy, you’ll finally start to feel more like yourself again. In fact, most patients feel up to returning to normal activities within 24 hours.

It’s highly recommended that patients take it easy with scheduled activities for the first week after to allow enough time to get back to normal, especially if your doctor found and removed polyps during the procedure.

Colonoscopy aftercare basics

Having complications after a colonoscopy is rare but not impossible, which is why it’s so important to follow all post-procedure self-care recommendations from your doctor.

You also need to be on alert for any warning signs of complications from a colonoscopy, such as:

• feeling extreme abdominal pain or severe bloating
• vomiting
• rectal bleeding
• experiencing irregular heartbeats
• having chills or a fever

If you notice any of these symptoms or feel unwell and like something isn’t right, don’t hesitate to go to the emergency room or call your doctor.

Colonoscopies at Logansport Memorial Hospital

Now that you know more about what to do after a colonoscopy (and what to expect), you’ll be better prepared to make the healing process go as smoothly as possible.

Have questions about screening for colon cancer and maintaining good colon health? Set up a time to meet with one of the LMPN Surgical Services general surgeons by calling (574) 753-2222.

You might also like:

90,000 colonoscopy as a way to solve many intestinal problems

Today we will talk about a delicate but very important procedure – colonoscopy. Most often, it is prescribed by gastroenterologists and proctologists when a patient complains about intestinal malfunction, abdominal pain, etc.

An important plus of colonoscopy is that it is the most accurate method that allows you to study the state of the intestine from the inside (its mucous membrane, lumen, tone and other indicators).Thanks to a colonoscopy, you can find out why the stomach hurts, what happens in the intestines. In addition, this study is indispensable in the diagnosis of colorectal cancer, a serious disease that can be cured if detected early thanks to colonoscopy. Previously, cancer could only be detected during X-ray examination, more often at a late stage of the disease. Endoscopy (including colonoscopy) made it possible to “catch” this insidious disease at the very beginning, when successful treatment is possible, and to prevent it.

Also, colonoscopy makes it possible to quickly and without abdominal operations on the abdominal cavity remove benign formations or take a biopsy of a suspicious area in order to find out the nature of a possible neoplasm and diagnose this or that disease as soon as possible.

Many, having learned about the details of the procedure, the details of its preparation, refuse to carry it out, postponing the diagnosis “on the back burner” in the hope that everything will pass by itself, and the procedure will not be required.Familiar situation? But in many cases it is absolutely impossible to postpone a colonoscopy! Especially in the case of a bad family history of bowel cancer.

Therefore, especially for you, we have prepared 5 important components that will make colonoscopy for you the most comfortable and painless procedure.

1. WITHOUT PAIN AND FEAR

At DIXION Clinic, colonoscopy can be performed under anesthesia.The patient sleeps during the procedure, the examination does not cause pain and passes almost imperceptibly, after the procedure the patient does not feel discomfort.

2.COMFORT

After the colonoscopy procedure under anesthesia, patients rest in comfortable wards of a day hospital with Wi-Fi, TV and an emergency call button for medical staff, are under the supervision of doctors (endoscopist, anesthesiologist).

3.LEADING SPECIALISTS

In the DIXION clinic, the colonoscopy procedure is performed by the endoscopist of the highest qualification category – Alla Valentinovna Milenko, whose professionalism is recognized both in Russia and abroad (in December 2018, Alla Valentinovna received an international certificate of The European Accreditation Council for CME (EACCME®) at the Amsterdam Live Endoscopy conference in the Netherlands).

4.QUALITY EQUIPMENT

At the DIXION clinic, studies are carried out with modern video colonoscopes, which allow a detailed examination of the large intestine for early detection of even the smallest disorders in the mucous membrane and eliminate them in time.

5. STERILITY

In case of poor-quality disinfection of the colonoscope, the patient may be infected with serious diseases, including hepatitis and HIV.Therefore, when choosing a place for a colonoscopy, make sure that the medical institution processes colonoscopes with high quality after each patient.

At the DIXION clinic, you are guaranteed to be protected from such unpleasant consequences, since we pay special attention to the disinfection of instruments and the observance of antiseptics. Colonoscopes are cleaned using disposable instruments. The Bandeq washer for disinfection of flexible endoscopes and instruments for them takes place at the highest level of disinfection.

Disinfected and washed endoscopes and instruments for them are stored, taking into account the recommendations of the Ministry of Health of the Russian Federation, in a special cabinet that ensures cleanliness and sterility.

All this guarantees the sterility of the instruments and the protection of the patient from bacteriological contamination during the examination.

A delicate approach, safety and efficiency – all this is a colonoscopy at the DIXION clinic.

You can sign up for the procedure by calling 44-00-00.

Be healthy!

After colonoscopy of the intestine, stomach ache, pain in the lower abdomen

Full text of the article:

Causes of abdominal pain after colonoscopy

Pain after colonoscopy is quite common, usually patients notice that it hurts in the lower abdomen, unpleasant sensations, not too intense, are bursting and pulling in nature.

Pain syndrome occurs as a result of the influence of several factors:

• Bloating resulting from the overflow of the colon with gases supplied during the procedure to improve visibility.
• Irritation of the mucous membrane as a result of exposure to the colonoscope.
• The occurrence of damage to the mucous membrane after medical procedures (taking a biopsy, removing polyps).

Often, the appearance of pain syndrome is facilitated by impaired motility of the smooth muscles of the intestine. They occur in a small proportion of patients and usually resolve quickly. Usually, muscle spasm develops, which leads to cramping pains of low intensity.

Signs of serious complications

Severe pain may indicate the development of severe complications, such as perforation of the intestinal wall. There are three main punching mechanisms:

1. Mechanical damage by the colonoscope.
2. Barotrauma due to excessive air supply.
3. Direct injury from biopsy or polypectomy (removal of polyps).

In addition to acute pain, perforation is evidenced by a number of concomitant symptoms: decreased blood pressure, rapid pulse, cold clammy sweat.Perforation symptoms usually appear immediately and are easily diagnosed by nursing staff. Rarely, perforation can occur on the first day after the procedure, most often if the patient does not follow medical recommendations.

It is important to remember that perforation is an extremely dangerous complication that requires immediate medical attention. It is fraught with the development of peritonitis and sepsis, which can quickly be fatal.

The appearance of other severe disorders is evidenced by profuse bleeding from the rectum, accompanied by pain in the lower abdomen.If at the same time the patient’s blood pressure drops (especially the upper-systal), there is an increase in temperature, weakness – an urgent need to consult a doctor, since only a specialist can provide the necessary assistance in a timely manner.

How to avoid negative consequences of colonoscopy

What to do after colonoscopy to prevent pain, stool disturbances, and other bowel disturbances and dysfunction is a concern for many patients who have colon endoscopy.The most important task is to follow a gentle diet for 5-7 days after the examination. To be excluded from the diet:

• Fatty meats, fish.
• Fresh vegetables and fruits.
• Legumes, nuts, baked goods.

You can eat boiled, lean meat, vegetable broths. It is strongly not recommended to use hot spices, you need to reduce salt intake.

It is important to drink enough liquid – at least 2-3 liters per day.You can drink plain water, weak green tea. You can not drink coffee, alcoholic drinks, fruit drinks and fruit juices.

It is necessary to refrain from physical and mental stress, which can aggravate the negative consequences of the procedure, lead to a deterioration in the patient’s condition. With full compliance with these recommendations, all negative consequences of colonoscopy, including pain, will quickly disappear.

Colonoscopy – “the consequences after a colonoscopy under sedation: pinched nerve during the procedure, a month of anguish”

A procedure was ordered by the proctologist to confirm colitis or diverticulitis.

Since the procedure is not pleasant, I signed up with sedation (intravenous propofol).

Preparation was excellent with Moviprep, the evening before the procedure and the second stage in the morning 4 hours before the trip to the clinic.

The diet that was given to me in the clinic for preparation was stricter than in the description of the drug.

Then I realized that the clinic is reinsured, as there are cases when the moviprep does not clean up to the end.

Before the procedure, the endoscopist still could not put me down comfortably, then he asked me to move the upper body forward, then the lower – back, then press my legs to the body.

The first thing I felt when I woke up was numbness in my leg, as if I had been lying down very hard. The doctor said that the procedure could not be completed, because I have dolichosigma (additional bowel bend) – a non-standard bowel structure, in which the risks of colonoscopy greatly increase and in my case the procedure can only be done in a hospital. As a result, a third of the intestines were examined.

I tried to get up, but my left leg did not obey me, my foot simply hung, I could not move it.

A neurologist was immediately called to me, she examined me and said that during the procedure, due to an uncomfortable position, my peroneal nerve was pinched.

Gradually, in a couple of days, the leg moved a little, and I was able to walk, but numbness in the leg is still present after 2 weeks, plus lower back pain was added.

Such a bad experience, and the study was not completed, and got a sore.

Update six months later.After a month, everything went away, the pills, the physio and the neurologist did not help, but the osteopath helped, although I never believed in their treatment, and went to him out of despair.

Colonoscopy | Kamsky doctor

What is a colonoscopy?

During a medical examination, almost every third patient is diagnosed with abnormalities in the digestive system. If a patient complains of pain in the abdomen and anorectal region, persistent constipation, bleeding from the rectum, he has weight loss, unfavorable blood counts (low hemoglobin, high ESR), then an experienced doctor will definitely prescribe a colonoscopy examination of the intestines .

Colonoscopy is a modern method of instrumental research used to diagnose pathological conditions of the colon and rectum. This procedure is carried out using a special device – a colonoscope, and allows for a short time to visually assess the state of the large intestine along its entire length. The
Colonoscope is a flexible long probe, the end of which is equipped with a special illuminated eyepiece and a miniature video camera capable of transmitting an image to a monitor.The kit includes a tube for supplying air and water to the intestine and forceps intended for biopsy (collection of histological material). With the help of a video camera, the device is able to shoot video and photograph those parts of the intestine through which the probe passes, and display an enlarged image on the monitor screen.
This allows the specialist to examine the intestinal mucosa in detail and see the smallest pathological changes. Colonoscopy is indispensable for the timely detection and treatment of intestinal diseases, this procedure has many possibilities, which is why specialists prefer this study to other diagnostic methods.

Colonoscopy Capabilities.

What are the possibilities of examination with a colonoscope?
• During the procedure, the doctor can visually assess the condition of the mucous membrane, intestinal motility, and identify inflammatory changes.
• There is an opportunity to clarify the diameter of the intestinal lumen and, if necessary, to expand the area of ​​the intestine narrowed due to cicatricial changes.
• On the monitor screen, the specialist sees the smallest changes in the walls of the intestine and pathological formations (cracks, polyps of the rectum and colon, hemorrhoids, ulcers, diverticula, tumors or foreign bodies).
• During the procedure, you can remove the detected foreign body or take a piece of tissue for histological examination (biopsy).
• If small benign tumors or polyps are found, it is possible to remove these neoplasms during the examination, thereby saving the patient from surgery.
• During the examination, it is possible to identify the causes of intestinal bleeding and eliminate them by thermocoagulation (exposure to high temperatures).
• During the procedure, the doctor gets the opportunity to take pictures of the inner surface of the intestines.
The above possibilities make the colonoscopy procedure the most informative diagnostic method. According to the recommendation of the WHO (World Health Organization), as a preventive measure, colonoscopy is recommended to be performed once every five years for each patient over 40 years of age. If a person comes to the doctor with characteristic complaints, the study is prescribed without fail.

Indications for colonoscopy.

Colonoscopy examination of the intestines is prescribed in the following cases:
• Complaints of abdominal pain in the large intestine
• Pathological discharge from the rectum (mucus, pus)
• Intestinal bleeding
• Intestinal motility disorders (persistent constipation or diarrhea)
• Weight loss, high-grade anemia, low-grade fever, family history of cancer
• Presence of a foreign body in one of the intestines
sigmoidoscope).
In addition, colonoscopy is performed on suspicion of intestinal obstruction, Crohn’s disease, ulcerative colitis, and the presence of malignant tumors. The examination will help to identify manifestations of diseases (ulceration of the mucous membrane), and if a tumor is detected, take a piece of tissue for a biopsy.

Contraindications for colonoscopy.

There are conditions in which a colonoscopy is undesirable, as the procedure can lead to serious complications.Colonoscopy is not done in the following cases:
• Acute infectious processes, accompanied by fever and intoxication of the body.
• Pathologies of the cardiovascular system (heart failure, myocardial infarction, the presence of artificial heart valves).
• A sharp drop in blood pressure.
• Pulmonary insufficiency.
• Peritonitis, intestinal perforation with the release of its contents into the peritoneal cavity.
• Acute inflammation in ulcerative colitis.
• Massive intestinal bleeding.
• Umbilical or inguinal hernia.
• Pregnancy period.
• Pathologies leading to bleeding disorders.
In such conditions, the risk to the patient’s health during the procedure is too high, therefore, the colonoscopy is replaced by other, alternative methods of examination. In any case, if there are contraindications described above, you should consult with a specialist doctor to determine the possibility of a colonoscopy.

What is the difference between fiber and video colonoscopy?

The only difference is in what apparatus the research is carried out. A distinction is made between video colonoscopes and conventional ocular endoscopes. At first glance, these colonoscopes do not differ much or even do not differ at all. But this is only at first and unaided glance …
Video colonoscopy is an informative diagnostic method that ensures high accuracy of examination (the camera transmits images in HD or HD + quality). The tube has a small diameter, so it does not cause any particular discomfort during the examination.This diagnostic method is often used to detect cancer at an early stage, thanks to the microscopic accuracy of the device.
The advantages of VIDEO colonoscopy are obvious: improved image quality, enlarged picture, enhanced image clarity, the ability to save pictures and videos on a computer, the use of dynamic observation recording and other features. This is the latest technology!
The endoscope controls allow you to “steer” its distal end, and the light transmitted through the fibers allows you to see on the monitor the state of the mucous membrane of the organ being examined.

How do I prepare for my colonoscopy?

For the procedure to pass without difficulties and complications, preliminary preparation is necessary. Preparation for colonoscopy of the intestine includes two important points:
1. adherence to the diet,
2. high-quality bowel cleansing.

Diet before colonoscopy (correct menu)
It is clear that the procedure requires a thorough and complete cleaning of the digestive tract. This is necessary in order to free the intestinal walls from toxins and remove feces, which will obstruct the advancement of the diagnostic probe.Preparatory activities should begin 2-3 days before the procedure. In this case, you do not need to starve, you just need to follow the instructions of the doctor and adhere to a special diet.

The following should be excluded from the diet (prohibited foods):
• All fruits and vegetables
• Greens
• Berries, legumes, nuts
• Fatty meat, fish, sausages
• Porridge (barley, millet, oat), pasta
• Carbonated drinks with artificial colors
• Black bread
• Whole milk, coffee, colored juices
• Alcohol

All of these foods are difficult to digest or cause excessive flatulence in the intestines.

Recommended (permitted products) for consumption:
• Wheat bread made from wholemeal flour (in small quantities)
• Lean boiled meat (beef, poultry) or fish
• Diet broths
• Dry biscuits (biscuits)
• Low-fat fermented milk drinks (kefir, yogurt, natural yogurt)
• Compotes without berries, uncolored juices without pulp
• Water
• Egg (no more than 1 per day)

On the eve of the procedure, the last meal is allowed no later than 12.00 hours. Further, during the day, you can drink liquid (water, tea). The last meal should be 20 hours before the start of the examination. On the day of the examination, food is prohibited, you can only drink weak tea or drinking water.

Further preparation for colonoscopy of the intestine is to cleanse it.
To do this, you can use one of the following methods:

Cleansing with an enema
For the preparation to be of high quality, a cleansing enema must be given twice before the procedure and twice immediately before the examination.
On the eve, it is better to cleanse the intestines in the evening, with an interval of one hour, for example, at 20.00 and 21.00. For a cleansing enema, use 1.5 liters of distilled warm water. That is, during the evening, 3 liters of liquid are injected into the intestines and washed until “pure” water comes out. In the morning, the intestines are also cleansed with an enema twice, with an interval of one hour. Mild laxatives or castor oil can be used to facilitate cleansing the day before your procedure.
Cleansing with enemas very often does not give the necessary “cleanliness” of the intestine, which greatly complicates, and sometimes makes it impossible to examine the mucous membrane of the large intestine.

Cleansing with modern preparations
In many cases, it is rather difficult to independently perform high-quality intestinal cleansing with enemas, and sometimes it is very painful, especially in the presence of anal fissures or inflamed hemorrhoids. Special drugs come to the rescue to facilitate and stimulate bowel movement. You need to take them one day before the procedure.

Bowel cleansing before colonoscopy can be performed with Fortrans , which is specially designed to prepare for diagnostic examinations.
The dosage of Fortance will be individually calculated by the doctor, based on the patient’s body weight. The calculation is based on the ratio: one bag per 20 kg of weight. So, if a patient weighs 80 kg, then for a complete bowel cleansing, he needs 4 Fortrans sachets. For one package, you need to take one liter of warm boiled water. Dissolve all 4 bags in this way. The solution should be taken two hours after the last meal.
The entire prepared solution must be drunk, but this does not mean that you need to take 4 liters of solution at a time.It is recommended to pour the liquid with the dissolved drug into a glass and drink it in small sips, at intervals of 10-20 minutes. Thus, taking breaks between glasses of solution, you should drink the entire volume of liquid in about 2-4 hours. It turns out that the intake rate will be approximately one hour per liter of solution.
If you cannot drink the entire volume of liquid, because a gag reflex may occur due to an unpleasant taste, you can divide it and drink 2 liters in the evening and two more liters in the morning.To facilitate the intake, doctors advise you to drink the solution in small sips, without holding it in your mouth, so as not to feel the taste. Immediately after taking the next glass, you can take a sip of lemon juice or suck on a slice of lemon, this will eliminate nausea.
After the last dose of Fortrans, defecation may continue for another 2-3 hours. Therefore, the time of application should be calculated correctly, and if you finish the rest of the drug in the morning, then the last glass of the solution should be drunk 3-4 hours before the start of the colonoscopy procedure.The drug Fortance is not absorbed into the bloodstream and is excreted unchanged, so there is no need to fear an overdose.
In some cases, when Fortrans is used, adverse reactions occur in the form of flatulence, abdominal discomfort or allergic manifestations.

Another drug specially created for preparation for diagnostic procedures – MOVIPREP . The drug provides excellent preparation of the intestines for colonoscopy.

How to prepare a solution of the drug MOVIPREP:
1. To prepare the first liter of the drug:
Dilute the contents of one sachet A and one sachet B in a small amount of still drinking water at room temperature until completely dissolved, bring to 1 liter with water and stir …
2. To prepare the second liter of the preparation:
Repeat the algorithm from point 1 (see above), using the remaining sachet A and sachet B.

The solution of the drug should be taken in fractional doses of 250 ml every 15 minutes.

Additional recommendations:
Each liter of drug solution requires an average of 2 hours to act. While taking the drug, it is recommended to perform light physical exercises: circular rotation of the pelvis, bending to the sides, back and forth, squats. You should not eat solid food from the beginning of the drug until the end of the colonoscopy.Stop taking the drug and other liquids 2 hours before the study. The criterion for the patient’s readiness for colonoscopy is the appearance of a liquid transparent or almost transparent lightly colored stool. Patients should consider the appropriate travel time to the clinic for the procedure.

Recommendations for concomitant diseases.

Constantly taken drugs.
Accelerated transit of intestinal contents leads to a sharp decrease or complete absence of the therapeutic effect of drugs taken before or in preparation for colonoscopy.This should be taken into account if you are constantly taking hormonal, cardiological, antihypertensive and other vital drugs, which should not be interrupted. Iron preparations are recommended to be canceled 2-3 days before the colonoscopy.
Diabetes mellitus.
If you are taking oral hypoglycemic drugs, it is recommended that you refrain from taking them in preparation for your colonoscopy and return to taking them after starting a normal diet. There is no need to fast (especially if you have diabetes) on the day of your colonoscopy.Immediately before the start of the study, a light meal (tea or coffee with sugar / honey) is acceptable, which will not interfere with the study and will make it easier to transfer the colonoscopy.
Chronic constipation.
If you have chronic constipation or have a barium suspension in the intestinal lumen, you should start your diet 5 days before your colonoscopy. During this period, you need to continue taking your usual laxatives. For constipation up to 6-10 days, it is required to double the dose of the laxative.
If you have concomitant diseases, be sure to consult your doctor!

How is the colonoscopy procedure performed?

The technique of the procedure is simple.Let’s talk about the main nuances so that the patient can imagine how a colonoscopy is done.
1. The patient is placed on a couch on his left side, with his knees pressed to his stomach.
2. The specialist treats the anal area with an antiseptic and gently inserts the colonoscope probe into the rectum. In patients with hypersensitivity, before manipulation, anesthetic gels or ointments may be used to lubricate the anus.
3. Then the endoscopist slowly and carefully begins to move the device deep into the intestine, examining its walls on the monitor screen.In order to straighten the folds of the intestine, air is pumped into it during the examination.
Thus, the colon is visually examined along its entire length. If no serious pathologies are detected, then the procedure takes about 15-30 minutes; when carrying out diagnostic or therapeutic actions, it may take more time.
If a biopsy is necessary, a small piece of tissue is cut off with special forceps through a special channel of the endoscopic device and removed.
During colonoscopy, polyps or small benign lesions can be removed by using a special loop to capture the growths at the base, cut them off and remove them from the intestine.

How painful is the procedure?

Many patients are concerned about the painfulness of the upcoming manipulations. Before starting the procedure, the doctor must explain how the colonoscopy of the intestines is done and decide on the issue of pain relief. In many specialized clinics, the procedure is performed without anesthesia, since usually the manipulation does not cause severe pain.
The patient may feel some discomfort when pumping air to straighten the folds of the large intestine or when a diagnostic probe passes some anatomical bows of the intestine.These moments are usually easily tolerated, doctors recommend listening to your body and, if severe pain occurs, immediately inform the specialist performing the manipulation. This will help avoid complications such as damage to the intestinal wall. Sometimes during the procedure, there may be an urge to defecate; at such moments, doctors recommend breathing correctly and deeply.
In special cases, when the patient has adhesive disease or acute inflammatory processes in the rectum, severe painful sensations are possible during the procedure.In such a situation, colonoscopy of the intestines is done under anesthesia. Usually, the anesthesia is short-term, since the procedure itself does not take more than 30 minutes.

Alternative research methods

There are several alternative research methods, these are:
• Sigmoidoscopy. It is carried out with a special device – a sigmoidoscope, which allows examining the rectum to a shallow depth (25-30 cm).
• Irrigoscopy. X-ray method for studying pathological changes in the intestinal walls using a contrast agent.This method is good for detecting defects of the colon, but it cannot detect tumor processes in the initial stages, it is impossible to examine the wall and take a biopsy.
• MRI of the intestine. The most modern and informative method. It is also called virtual colonoscopy. Many patients are interested in which study is better: an MRI of the intestine or a colonoscopy? The new research method is definitely a more comfortable and gentle procedure. It is performed using a special scanner that takes pictures of the abdominal cavity from the back and front, and then from this material forms a three-dimensional image of the large intestine.In this model, the doctor can see foci of lesions and bleeding, examine the intestinal walls and identify pathological changes and tumors. At the same time, the patient does not experience stress, uncomfortable and painful sensations. But this procedure is still in many ways inferior to the classical colonoscopy. It does not allow detecting pathological formations, the size of which is less than 10 mm. Therefore, in many cases, such an examination is preliminary and after it, a classical colonoscopy procedure is necessary.

After the procedure: possible complications

During examination, air is pumped into the intestinal cavity. When the procedure is over, it is removed by suction with a colonoscope. But in some cases, an unpleasant feeling of discomfort and bloating remains. To eliminate these sensations, the patient is recommended to drink activated charcoal, which is previously dissolved in a glass of water. The patient is allowed to eat and drink immediately after the end of the examination.
The procedure must be carried out in a specialized institution by a competent and experienced specialist.If you carry out the manipulation according to all the rules, then this method is completely harmless and does not entail adverse consequences. However, as with any medical intervention, there is a risk of complications:
• Perforation of the intestinal walls. It is noted extremely rarely and most often occurs as a result of ulceration of the mucous membrane or purulent processes in the intestinal walls. In such cases, an urgent surgical intervention is performed to restore the integrity of the damaged area.
• Bleeding in the intestines. Such a complication is quite rare and can occur both during the procedure and after it. It is eliminated by cauterization or the introduction of vasoconstrictor and hemostatic drugs.
• Abdominal pain after the procedure. Most often appear after removal of polyps, are eliminated by analgesics.
The patient should see a doctor if, after the colonoscopy procedure, he has a fever, vomiting, nausea, dizziness, weakness.With the development of complications, loss of consciousness, bleeding from the rectum or bloody diarrhea may occur. All these manifestations require immediate medical attention. But such complications are rare, usually the procedure is successful and does not entail adverse consequences.
Colonoscopy examination of the intestine is recommended for persons over 40 years of age. This makes it possible to detect colorectal cancer at an early stage of development and gives a chance to defeat the disease at its very beginning.

90,000 The patient is afraid of having a repeat colonoscopy due to pain. Find out what the doctor replied to her

Colonoscopy is a safe and highly informative method for examining the rectum and colon using an endoscope. That being said, this is one of those medical examinations that people are afraid of and try to avoid. It is not only a matter of bashfulness, but also of unpleasant sensations.

A TV viewer called on a live medical program.She said that a few years ago she had a very difficult colonoscopy and was afraid of its repetition. The woman asked if it was possible to do anesthesia with this examination?

This is what the coloproctologist of the Novgorod Regional Clinical Hospital replied Alexander Malyshev :

“Now, if the patient wishes, colonoscopy can be done with anesthesia (under general anesthesia). But today, anesthetic drugs and the work of an anesthesiologist are not included in the compulsory medical insurance standards during this examination, this is not spelled out in the law.You can undergo a study on compulsory medical insurance, it is paid for by the state, but anesthesia is a paid service. ”

Presenter of the program Svetlana Sterligova asked: “Doctors suggest to undergo anesthesia, or should the patient himself be asked about it before the procedure?”.

“If the patient has not had any operations or adhesions in the abdominal cavity, then the person can normally undergo a colonoscopy without anesthesia. This is a normal, bearable procedure. But if there were abdominal surgeries, then it is better to do it with anesthesia.Everything here is individual. ”

Also, one of the viewers complained that she could not get training for a colonoscopy. Drinking four liters of water with the recommended preparation for cleansing the intestines proved to be an overwhelming task for her.

According to Alexander Malyshev , a woman needs to see a doctor who will recommend other drugs. Now there are a lot of such drugs. You will have to finish the liquid with them, but not in such a volume.

“But if you don’t get ready at all with the help of saline laxatives, then stick to a slag-free diet for several days, and prepare in the morning and evening with enemas,” the specialist added.

The doctor explained what the slag-free diet is:

“It is necessary to exclude fresh bread, legumes, seeds, confectionery, poppy … Everything that will settle on the walls of the intestine. It is preferable at this time to eat light chicken broth, vegetable soups, heat-treated vegetables without small seeds (like, for example, peppers). ”

More useful questions and answers from the coloproctologist in the program “Tell me, doctor” of the Novgorod regional television:

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Colonoscopy (FKS)

Video colonoscopy – a method of examining the colon from the inside, from the side of its mucosa.Colonoscopy, depending on the indications, we perform on a planned or emergency basis.

Diagnostic FCC:

• with sampling of biopsy material; chromoscopy with vital dyes (staining the mucous membrane with special dyes)

Medicinal FKS:

• Electro excision of benign colon tumors
• endoscopic polypectomy
• endoscopic mucosal resection
• stop bleeding
• removal of ligatures, foreign bodies

Indications are determined by doctors of the following specialties: gastroenterologist, coloproctologist, therapist, surgeon, oncologist, gynecologist.

Diagnostic colonoscopy is aimed at detecting inflammatory changes, diverticula, colon polyps, oncological processes, to exclude diseases of the terminal ileum. For a more accurate diagnosis of diseases during colonoscopy, chromoscopy (staining the mucous membrane with special dyes) and biopsy are performed. A biopsy is a collection of tissue fragments from the colon for subsequent examination of their structure under a microscope. A biopsy is performed using a thin instrument (forceps) through the endoscope channel: this procedure is painless.

Colonoscopy for therapeutic purposes is performed to remove polypoid formations (endoscopic polypectomy), submucosal formations (endoscopic mucosal resection), removal of ligatures, determination of the source of bleeding, and endoscopic hemostasis methods.

Identified polyps are removed using special instruments (diathermic loop), then the removed polyps are removed from the intestinal lumen and sent for histological examination.

In case of bleeding, the source of blood loss is eliminated using the methods of endoscopic hemostasis (electrocoagulation, chemical coagulation).

Preparation:

Proper preparation for colonoscopy is essential and essential to a successful study.

Preparation for the study must begin in a few days (strict adherence to a slag-free diet, taking medications for a complete cleansing of the colon). Taking an antifoam agent (espumisan) will lead to a decrease in foaming in the intestines, this will improve the well-being and the quality of the colonoscopy examination of the intestine.

Slag-free diet. Permitted:

• white bread, noodles or premium flour noodles, biscuit, pastry, white rice
• low-fat soups with meat broth
• low-fat types of fish (perch, pike perch, cod)
• low-fat cottage cheese, cheeses, natural yoghurt without additives, skim milk (up to two glasses)
• vegetable broths, peeled potatoes
• honey and sugar
• jelly, juices without pulp, berries and grains)
• half banana

Forbidden:

• Grain products (whole grains, products containing crushed nuts, grains, coconut, etc.)etc.)
• borscht and cabbage soup
• fresh and dried vegetables and fruits, berries, greens
• milk soups, cream soups, okroshka
• fatty meat, goose and duck meat
• canned food
• smoked meats and pickles, sausages
• mushrooms, legumes, peas, lentils
• black bread

It is necessary to drink more fluids, at least 1 liter per day.

Before the study, do not have breakfast, you can drink sweet strong tea.

Take only liquids and do not eat solid food 1 day before the study.

Taking medications:

• A few days before the study do not take: herbal laxatives, castor oil, iron preparations, antispasmodics !!!
• 3-4 hours before the start of the study, it is possible to take constantly used drugs (hormones, cardiovascular, antihypertensive, hypoglycemic)
• after consultation with a doctor, it is possible to take painkillers before the procedure

Preparation of one of the listed preparations is mandatory, regardless of the presence or absence of constipation, the name of the preparation for preparation:

Oral lavage method using one of the drugs (consult a specialist):

1. Fortrans (1 pack – 4 bags) or 2. Moviprep (1 pack – 2 sachets, A and 2 sachets B) or 3. Lavacol (1 pack – 15 bags) or 4. Kolokit ( 32 pills).

Preparations are taken 1 day before the study. During preparation, physical activity (walking, etc.) is recommended. Be sure to drink water between taking the drug !!!

Research Procedure:

The procedure is performed by inserting an endoscope (a flexible, thin apparatus equipped with a light guide) through the anus.Passing the endoscope usually does not cause severe pain, but a feeling of bloating and discomfort is possible. The following sections of the large intestine are examined: rectum, sigmoid, descending, transverse, ascending and cecum, as well as the terminal ileum.

Colonoscopy is performed under local anesthesia, if necessary, with preliminary drug preparation or under sedanalgesia.

Colonoscopy is first performed with the patient lying on the left side.In the future, it is possible to change the position of the body – turn to the back, stomach, to the right side. As the colonoscope is inserted, the colon mucosa is examined. During the study, unpleasant painful sensations may occur due to a number of reasons (previous operations on the abdominal cavity, adhesions, anatomical features of the colon – the presence of bends, additional loops, bowel lengthening).

The duration of the procedure for a simple diagnostic study is from 30 to 60 minutes, but may increase due to additional therapeutic interventions.

After the end of the study, a feeling of bloating may persist for some time. You can drink and eat, as a rule, 30 minutes after the procedure. In the case of a biopsy, physical activity during the day is excluded.

If, after the examination, unusual disturbing symptoms appear, the doctor should be informed.

Colonoscopy risks and safety:

The risk of complications is small (less than 0.4%).

Possible undesirable consequences – organ perforation, bleeding, gas filling the peritoneal cavity, allergic reactions, cardiovascular or respiratory disorder, exacerbation of a chronic disease.

These complications may require hospitalization and urgent surgical treatment.

Colonoscopy is a reliable diagnostic method, but it is not always possible to complete it in full. In such cases, radiation methods of research (radiological in the first place) are a possible alternative.

Registration for research:

It is necessary to agree in advance on the day and time of the study by phone: 268-78-36

If you are unable to appear at the appointed time, please call the department in advance!

Colonoscopy can be performed under intravenous sedanalgesia.

Registration for FKS with anesthetic aid – in the gastroenterology department by phone: 268−65−29; 268-65-77

!!! FCC with anesthetic aid (without clinical trials) includes:

• 2 bed / day of inpatient treatment in the gastroenterology department;
• diagnostic colonoscopy under intravenous medanalgesia;
• collection of morphological material for research;
• histological examination of biopsy material.

List of tests required for hospitalization for the purpose of endoscopic examination under intravenous sedation:

General blood test, general urine analysis, blood glucose
Wasserman reaction
Total bilirubin, direct bilirubin, AST, ALT, creatinine
total protein, potassium, sodium
FOG, ECG, examination by therapist

rapid test for Covid-19!

FCC with anesthetic aid (with clinical trials):

• 2 bed / day of inpatient treatment in the gastroenterology department;
• diagnostic colonoscopy under intravenous sedanalgesia;
• collection of morphological material for research;
• histological examination of biopsy material;
• clinical studies of blood, urine, ECG;
• rapid test for Covid-19.

WHAT IS IT WHY IT IS NECESSARY HOW IT IS PRODUCED

Colonoscopy – diagnostics of the large intestine, which allows you to detect polyps and flat growths in it. These formations must be removed, as over time they can develop into cancerous tumors. World medicine has recognized adenomas, polyps and other growths in the intestinal mucosa as a precancerous condition.

During a comprehensive colonoscopy, experienced doctors cut out and remove all formations using the latest equipment directly during the diagnosis.It is not necessary to specially prepare for the resection; it is enough to prepare the patient for the colonoscopy.

Manipulations last from 15 minutes to an hour. The duration depends on the severity of the disease and the number of formations. The main objective of the study is to study the colon at the exit and advance the flexible colonoscope to the caecal sac in a few minutes. When diagnosing, all the growths found are immediately cut out. After that, their cells are sent for biopsy to confirm or deny the presence of malignant cells.

In a medical center, a colonoscopy should be performed safely for the patient and maximum examination of the colon and cecum and the simultaneous removal of all excess. In this case, the manipulations should be carried out under anesthesia, when a person is immersed in a drug-induced sleep. This is the standard in this procedure in Europe and the USA.

When the anesthesia is fully effective, the device is inserted into the intestines, while the patient does not feel discomfort. To do this, clinics use drugs that do not give side effects.

Colonoscopy, what is it?

Patient Information

Colonoscopy is a medical procedure during which the doctor examines changes in the mucous membrane of the colon and cecum. The session is carried out exclusively in the endoscopist’s doctor’s office. A soft flexible probe 1-1.5 cm in diameter is inserted through the anus, moving it gently along the intestines. At the end there is a camera that displays the image on the monitor screen.

Why do you need a procedure

The examination allows you to quickly determine the presence of the disease.He is appointed for such complaints:

90,079 90,080 diarrhea;

The doctor can detect and confirm the presence of an inflammatory process, polyps, which can develop into cancer. After their removal, a second session is also carried out to look at the condition of the mucous membrane and make sure that everything has healed well.

People over 50 years of age whose relatives have had bowel cancer are recommended to have such an examination every 2 years, even if they have no complaints about their health.

Conducting a survey

What Happens in Session

Colonoscopy rarely causes pain in the patient and most often goes without problems. The person may feel pressure in the intestines and bloating. If it is difficult to endure, anesthesia is administered intravenously, due to which all muscles are relaxed.

A doctor performs a colonoscopy in a hospital or outpatient clinic. Typically, manipulations take 15 to 60 minutes.

The doctor inserts the colonoscope through the anus into the intestines.The sphere inflates it with air for a better view. The camera transmits the video image to the monitor. Sometimes the large intestine is not visible for a number of reasons, including poor preparation. Then the patient is sent for an irrigoscopy with a barium enema.

If pathology is detected

If a place with a pathology is found, a piece of tissue is pinched off and sent for a biopsy, which will show, if so, the presence of malignant cells.

If there are polyps, they are immediately dissected through a colonoscope.If there are many formations, the operation will have to be repeated several times with a certain period of time.

Having found a place on the mucous membrane that is bleeding, the doctor will determine how to stop and heal it.

Do not be alarmed if the tissue is sent for biopsy. This does not indicate the presence of colorectal cancer, but it helps to prevent it.

After procedure

At the end of the session, the doctor tells the patient what he found, but an accurate diagnosis will be made after the biopsy results come, that is, after about 7-10 days.

You may feel cramping or bloating during the first hour after the procedure. This is due to the introduction of a small amount of air. It will come out through the pores very soon, and the patient will feel relief. On the same day, you can return to your usual lifestyle and diet.

If anesthesia has been administered, it takes time to disappear completely. Then you need to stay in the hospital or outpatient center for 1 to 2 hours after the procedure. However, it will be possible to drive a car and play sports only the next day in order to avoid negative consequences under the weak effect of anesthesia.

If polyps are found, the doctor will discuss the date of their removal and prescribe a second procedure.

Possible complications

This is a safe procedure, as long as it is performed by an experienced endoscopist with special training.

Risks of colonoscopy include:

• bleeding from the site of intervention, then it is necessary to restore the integrity of the intestinal walls;
• a reaction to a sedative, including breathing or heart problems;
• abdominal pain.