Colonoscopy | Johns Hopkins Medicine

A colonoscopy is a procedure that lets your health care provider check the inside of your entire colon (large intestine).

The procedure is done using a long, flexible tube called a colonoscope. The tube has a light and a tiny camera on one end. It is put in your rectum and moved into your colon.

In addition to letting your provider see the inside of your colon, the tube can be used to:

• Clean the lining of your colon using irrigation (a water jet)
• Remove any liquid stool with a suction device
• Inject air into your bowel to make it easier to see inside
• Work inside your bowel with surgical tools

During a colonoscopy, your provider may remove tissue or polyps (abnormal growths) for further examination. He or she may also be able to treat problems that are found.

Anatomy of the Colon

The colon is the last section of your digestive system. It absorbs water to change waste from liquid to solid stool. The large intestine is about 5 feet long in adults. It has the following four sections:

• Ascending colon: extends upward on the right side of your belly
• Transverse colon: extends from the ascending colon across your body to the left side
• Descending colon: extends from the transverse colon downward on your left side
• Sigmoid colon: extends from the descending colon to your rectum

The rectum joins the anus, which is the opening where stool passes out of your body.

Why might I need a colonoscopy?

Colonoscopy can help your provider look for problems in your colon. These include any early signs of cancer, inflamed (red or swollen) tissue, ulcers (open sores) and bleeding.

Cancer Screening

Colonoscopy is also used to screen for colon cancer and rectal cancer. Screening involves looking for cancer in individuals who do not have any symptoms of the disease.

Colonoscopy can also be used to check the colon after cancer treatment.

Checking and Treating Problems

A colonoscopy may be used to check and, if needed, treat problems such as:

• Colon polyps
• Tumors
• Ulcerations
• Inflammation
• Diverticula (pouches) along the colon wall
• Narrowed areas (strictures) of the colon
• Any objects that might be in the colon

It may also be used to find the cause of unexplained, chronic (long-term) diarrhea or bleeding in the gastrointestinal (GI) tract.

Results of Other Tests

Colonoscopy may be used when other tests show the need for additional testing. These include the following:

• Barium enema
• Computed tomography (CT) colonography (also called virtual colonoscopy)
• Tests for blood in the stool
• Stool DNA tests
• Sigmoidoscopy

Your health care provider may have other reasons to recommend a colonoscopy.

What are the risks of a colonoscopy?

As with any invasive procedure, complications may occur. Complications related to colonoscopy include, but are not limited to, the following:

• Continued bleeding after biopsy (tissue sample) or polyp removal
• Nausea, vomiting, bloating or rectal irritation caused by the procedure or by the preparatory bowel cleansing
• A bad reaction to the pain medicine or the sedative (medicine used to provide a relaxing, calming effect)
• A perforation (hole) in the intestinal wall, which is a rare complication

You may have other risks related to your condition. Be sure to discuss any concerns with your provider before the procedure.

How do I get ready for a colonoscopy?

Your health care provider will fully explain the procedure and answer your questions. You will be asked to sign a consent form prior to the test. Read the form carefully and ask any questions you may have.

Dietary Instructions

You must not eat or drink for a specified amount of time before the procedure. This often means no food or drink after midnight or a restricted schedule with the laxative and water sips allowed until a couple hours before the colonoscopy. You may be given additional instructions about a special diet to follow for one or two days before the procedure. It is absolutely mandatory to follow your particular instructions carefully to avoid cancellation and to ensure a safe, effective test.

Notifications for Your Doctor

Before your colonoscopy, tell your provider:

• If you are sensitive or allergic to any medicines, latex, tape oranesthesia medicines (local and general)
• About all the medicines you take, including over-the-counter drugs, prescription medicines, vitamins, herbs and other supplements
• If you have a history of bleeding disorders
• If you are pregnant or think you may be pregnant

Bowel Preparation

Your health care provider will give you instructions on how to prepare your bowel for the test. You may be asked to take a laxative, an enema or a rectal laxative suppository. Or you may have to drink a special fluid that helps clean out your colon.

Medications Before and After the Procedure

If you are taking any blood-thinning medicines, aspirin, ibuprofen or other medicines that affect blood clotting, they may need to be stopped before the procedure. If you have a heart valve disease, you may be given disease-fighting antibiotics before the procedure.

Prior to the procedure, you will be given pain medicine and a sedative. After the procedure, someone must drive you home.

The Importance of Good Bowel Preparation During Colonoscopy

In this video, learn why the bowel preparation for a colonoscopy is so important to the results of the procedure.

What happens during a colonoscopy?

You may have a colonoscopy in an outpatient setting or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your health care provider’s practices.

Generally, the colonoscopy follows this process:

1. You will be asked to remove any jewelry or other objects that mightget in the way during the procedure.
2. You may be asked to remove your clothing and put on a hospital gown.
3. An intravenous (IV) line will be inserted into your arm or hand. A sedative or a pain medicine will be injected into the IV.
4. You will be given oxygen to breathe.
5. Your heart rate, blood pressure, respiratory rate and oxygen level will be checked during the procedure.
6. You will be asked to lie on your left side with your knees pulled up towards your chest.
7. A lubricated tube will be put into your anus and moved into your rectum and colon. You may feel mild pain, pressure or cramping during the procedure. A sedative is used to reduce your discomfort.
8. Depending on the type of anesthesia used, you may be completely asleep during the procedure. If awake, you may be asked to take slow, deep breaths while the tube is being inserted. This helps to relax your abdominal muscles and decrease the discomfort. You may also be asked to change your position to help the tube pass through.
9. Air may be injected into your bowel. This may make it easier to see the inside surfaces. A water jet may also be used to clean the lining of your colon. A suction device may be used to remove any liquid stool.
10. The health care provider will check your colon and may take photos. If a polyp is seen, it may be taken out. Or it may be left in the colon until a future procedure is performed.
11. After the procedure is over, the tube will be taken out.

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What happens after a colonoscopy?

After the procedure, you will be taken to the recovery room to be monitored. Your recovery process will depend on the type of sedative you were given. Once your blood pressure, pulse and breathing are stable and you are awake and alert, you will be taken to your hospital room. Or you may be discharged to your home.

You can usually eat whatever you can tolerate after the procedure. Some people start with small, bland meals.

It is normal to be flatulent (pass gas) and experience gas pains after the procedure. Walking and moving around may help to ease any mild pain.

You should not drink alcohol for at least 24 hours. You may be asked to drink extra fluids to make up for the water you lost as you got ready for the procedure.

Tell your provider if you experience any of the following:

• Fever or chills
• Frequent, bloody stools
• Belly pain or swelling
• A hardened belly
• The inability to pass gas

Your health care provider may give you other instructions depending on your situation.

Complications Before, During, After Procedure

Written by WebMD Editorial Contributors

• Belly Pain or Discomfort
• Bleeding
• A Bad Reaction to Anesthesia
• Postpolypectomy Electrocoagulation Syndrome
• Infection
• Perforated Intestine
• Colonoscopy Prep Risks
• Post-Colonoscopy Complications
• More

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:

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.

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.

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.

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.

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. 

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.

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

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

Top Picks

Colonoscopy — Veresaeva Hospital

Colonoscopy is an invasive type of examination that provides the maximum amount of information about the presence or absence of various neoplasms – malignant or benign, inflammatory changes in the colon mucosa, vascular pathology, etc. During the examination, the doctor uses a specialized device – a colonoscope, which allows you to examine the rectum, large intestine and the outlet section of the small intestine. During the study, a biopsy can be performed to confirm the diagnosis, removal of the identified neoplasm, and stop bleeding.

• What is a virtual colonoscopy?
• Why do doctors use colonoscopy?
• Colon and rectal cancer screening
• How do I prepare for a colonoscopy?
• How do doctors perform a colonoscopy?
• What can I expect after a colonoscopy?
• What are the risks of colonoscopy?
• Make an appointment with an endoscopist

What is a virtual colonoscopy?

Virtual colonoscopy is an x-ray examination that takes less time and does not require manipulation of the colonoscope.

Virtual colonoscopy cannot examine the entire length of the colon. Virtual colonoscopy may not detect all polyps. Doctors cannot remove polyps or fix some other problems during a virtual colonoscopy.

Why do doctors use colonoscopy?

A colonoscopy can help your doctor find the cause of symptoms such as anal bleeding, unexplained weight loss, bowel problems such as diarrhea and abdominal pain.

Doctors also use colonoscopy to screen for colon polyps and early cancer. Screening is a set of measures that allows you to detect pathological changes in the early stages, when you do not have symptoms, thereby increasing the chances of a complete cure.

Colon and rectal cancer screening

If you do not have health problems or risk factors that increase your chance of developing colon cancer, screening is recommended starting at age 50.

Colorectal cancer risk factors:

• Gender – male;
• Family history – someone in your family had polyps or colon cancer;
• Previously diagnosed ulcerative colitis or Crohn’s disease;
• Lynch syndrome or other genetic disorder that increases the risk of colorectal cancer;
• Overweight;
• Tobacco use;
• Frequent drinking;
• Unhealthy diet;
• Sedentary lifestyle.

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

How do I prepare for a colonoscopy?

To prepare for a colonoscopy, you need to consult with your doctor and follow his instructions.

Tell your doctor about any health problems and any medications, vitamins, and supplements you take, especially:

• Arthritis medications;
• Aspirin and medicines containing aspirin;
• Blood thinners;
• Medicines for diabetes;
• Non-steroidal anti-inflammatory drugs;
• Vitamins containing iron.

Colonoscopy Diet

Your healthcare provider will give you a written guide to prepare for your procedure. You need to cleanse your intestines. Remaining contents in the intestinal lumen may prevent your doctor from fully examining the mucosa.

You will have to follow a diet for 2-3 days before the procedure. You should avoid red and purple drinks or gelatin. The instructions will include details on when to start and stop the diet. In most cases, you can drink or eat the following:

1. Low-fat broth or light broth;
2. Regular coffee or tea, without cream or milk;
3. Sports drinks lemon or lime flavored ;
4. Fruit juice without pulp, such as apple or white grapes – avoid orange juice;
5. Water.

Powder and tablet formulations may contain various combinations of laxatives. Some people need to drink large amounts of laxatives, most often the night before and the morning before the procedure. Your doctor may also prescribe an enema.

Bowel preparation will cause diarrhea, so you must be near a toilet and bath. You may find this part redundant, however, completing the preparation is very important. Tell your healthcare professional if you have any side effects that prevent you from completing your preparation.

Your doctor will also tell you how long before your procedure you should not take anything by mouth.

Driving home after the procedure

If the test was performed under medicated sleep or sedation, for safety reasons you may not drive for 24 hours after the procedure as there is no guarantee that the sedative or anesthetic has completely worn off.

How do doctors perform a colonoscopy?

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

Your healthcare provider will administer intravenous sedatives and/or painkillers so you don’t feel uncomfortable or panic during the procedure. The medical staff will check your vital signs and ensure you are as comfortable as possible.

For this procedure, you will lie on a table while the doctor inserts the colonoscope through your anus and into your rectum and colon. The device inflates the colon with gas for a better view. The camera sends a video image to a monitor, allowing the doctor to examine the colon.

Your doctor may change your position on the table several times to position the colonoscope for a better view. Once the colonoscope reaches the opening in the small intestine, the doctor slowly withdraws the colonoscope and examines the lining of the colon again.

During the procedure, the doctor may remove polyps and send them to a laboratory for examination. You will not feel the removal of the polyp. Colon polyps are common in adults and are harmless in most cases. However, most colon cancers start with a polyp, so removing polyps early helps prevent cancer.

If your doctor finds abnormal tissue, they may perform a biopsy. You will not feel the moment of biomaterial sampling.

What can I expect after a colonoscopy?

After your colonoscopy, you can expect the following:

• You will stay in the hospital or outpatient center for 1-2 hours after the procedure for observation;
• You may experience abdominal cramps or bloating for the first hour after your procedure;
• After the procedure, you or your caregiver will receive instructions on how to care for yourself after the procedure;
• You will need a pre-arranged trip home because you will not be able to drive after the procedure;
• You can return to your normal diet the next day.

If your doctor removes polyps or takes a biopsy, you may have some bleeding from your anus. This bleeding is normal. Biopsy results are prepared for several days or longer. Your health care provider will schedule an appointment with you to discuss the results.

What are the risks of a colonoscopy?

Colonoscopy risks include:

• Bleeding;
• Colon perforation;
• Reaction to sedation, including respiratory or cardiac problems;
• Severe abdominal pain;

A static study of screening colonoscopies revealed 4 to 8 major complications in every 10,000 procedures.

Bleeding and perforation are the most common complications of colonoscopy. Most cases of bleeding occur in patients who have polyps removed. Your doctor can stop bleeding during a colonoscopy.

If bleeding occurs after the procedure, the Doctor can diagnose and treat delayed bleeding with a repeat colonoscopy.

Perforations can also be repaired during a colonoscopy, but in some cases they can be treated with surgery.

If you have any of the following symptoms after a colonoscopy, seek medical attention immediately:

• Severe abdominal pain;
• Fever;
• Blood content in the stool two weeks after the procedure;
• Bleeding from the anus that does not stop;
• Dizziness;
• Weakness.

Make an appointment with an endoscopist

Colonoscopy | Kamsky doctor

During a medical examination, almost every third patient has abnormalities in the digestive system. If the 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 examination of the bowel by colonoscopy .

Colonoscopy is a modern method of instrumental examination used to diagnose pathological conditions of the colon and rectum. This procedure is carried out using a special device – a colonoscope, and allows you to visually assess the condition of the large intestine throughout its entire length in a short time.
The colonoscope is a long, flexible tube with a special illuminated eyepiece and a miniature video camera capable of transmitting images to a monitor. The kit includes a tube for supplying air and water to the intestine and forceps designed for biopsy (taking histological material). Using 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 experts prefer this study to other diagnostic methods.

Colonoscopy options.

What are the benefits of a colonoscopy examination?
• During the procedure, the doctor can visually assess the condition of the mucous membrane, intestinal motility, and identify inflammatory changes.
• It becomes possible to specify the diameter of the intestinal lumen and, if necessary, expand the section 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 (fissures, 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 tumors during the examination, thus saving the patient from surgical intervention.
• During the examination, it is possible to identify the causes of intestinal bleeding and eliminate them by thermocoagulation (high temperatures).
• During the procedure, the doctor is able to take pictures of the inside of the bowel.
The above features make colonoscopy the most informative diagnostic method. According to the recommendation of the WHO (World Health Organization), as a preventive measure, it is recommended to undergo a colonoscopy once every five years for every patient after 40 years of age. If a person comes to the doctor with characteristic complaints, the study is prescribed without fail.

Indications for colonoscopy.

Intestinal examination by colonoscopy is prescribed in the following cases:
• Complaints of pain in the abdomen in the large intestine
• Abnormal discharge from the rectum (mucus, pus)
• Intestinal bleeding
• Impaired intestinal motility (stubborn constipation or diarrhea)
• Weight loss, high degree anemia, sub febrile temperature, family history of oncological diseases
• Presence of a foreign body in one of the intestinal sections
• Benign tumors or polyps detected during sigmoidoscopy (in these cases, colonoscopy is necessary to examine the upper parts of the large intestine, inaccessible to the sigmoidoscope).
In addition, colonoscopy is performed for suspected ileus, Crohn’s disease, ulcerative colitis, and malignancy. The examination will help to identify manifestations of diseases (mucosal ulceration), and if a tumor is detected, take a piece of tissue for a biopsy.

Contraindications for colonoscopy.

There are some conditions in which a colonoscopy is undesirable because 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).
• Sudden drop in blood pressure.
• Pulmonary insufficiency.
• Peritonitis, perforation of the intestine 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.
Under such conditions, the risk to the patient’s health during the procedure is too high, so colonoscopy is replaced by other, alternative methods of examination. In any case, if there are contraindications described above, it is necessary to consult a specialist doctor to determine the possibility of performing a colonoscopy.

What is the difference between fibro and video colonoscopy?

The only difference is the devices used for the examination. There are 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 glance and with the naked eye…
Videocolonoscopy is an informative diagnostic method that provides high accuracy of examination (the camera transmits an image in HD or HD+ quality). The tube has a small diameter, so it does not cause much discomfort during the examination. This diagnostic method is often used to detect cancer at an early stage, due to the microscopic precision of the device.
The advantages of VIDEO-colonoscopy are obvious: improved image quality, enlarged picture, increased image clarity, the ability to save pictures and videos on a computer, the use of recording during dynamic monitoring, and other features. This is the latest technology!
The endoscope controls allow you to “steer” its distal end, and the light transmitted through the fiber fibers allows you to see the state of the mucosa of the organ under study on the monitor.

How do I prepare for a colonoscopy?

In order for the procedure to pass without difficulties and complications, preliminary preparation is necessary. Preparation for bowel colonoscopy includes two important points:
1. 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 create obstacles when advancing the diagnostic probe. Preparatory measures 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.

Should be excluded from the diet (forbidden foods):
• All fruits and vegetables
• Greens
• Berries, legumes, nuts
• Fatty meat, fish, sausages
• Cereals (barley, millet, oatmeal), pasta 901 91 • Artificially colored carbonated drinks
• Brown bread
• Whole milk, coffee, colored juices
• Alcohol

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

Recommended (permitted foods):
• Whole wheat bread (in small quantities)
• Lean boiled meat (beef, poultry) or fish
• Diet broths
• Dry biscuits (biscuits)
• Low fat fermented milk drinks (kefir, curdled milk, 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. Then 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, it is forbidden to eat food, you can drink only weak tea or drinking water.

Further preparation for a colonoscopy consists of bowel cleansing.
To do this, you can use one of the following methods:

Cleansing with an enema
In order for the preparation to be of high quality, a cleansing enema must be given twice on the eve of 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, in the evening, 3 liters of liquid are injected into the intestines and washed until “clean” 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 procedures.
Cleansing with enemas very often does not provide the necessary “cleanliness” of the intestine, which greatly complicates, and sometimes makes it impossible to examine the mucous membrane of the large intestine in detail.

Cleansing with the help of modern preparations
In many cases, it is rather difficult and sometimes very painful to make a high-quality bowel cleansing with enemas, especially in the presence of anal fissures or inflamed hemorrhoids. Special preparations come to the rescue, facilitating and stimulating bowel movements. They must be taken the day before the procedure.

Bowel cleansing before colonoscopy can be done with Fortrans , which is specially designed to prepare for diagnostic tests.
The dosage of Fortans will be calculated individually by the doctor, based on the patient’s body weight. The calculation is made from 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 sachets of Fortrans. For one package, you need to take one liter of warm boiled water. Dissolve all 4 packets in this way. Take the solution should begin 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 the solution at a time. It is recommended to pour the liquid with the dissolved drug into a glass and drink it in small sips, with breaks of 10-20 minutes. Thus, taking breaks between glasses with a 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 a not very pleasant taste, then you can divide it and drink 2 liters in the evening and two more liters in the morning. To facilitate the intake, doctors advise drinking the solution in small sips, without holding it in the 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 piece 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 correctly calculated, and if you drink 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 Fortans is not absorbed into the bloodstream and is excreted unchanged, so you should not be afraid of an overdose.
In some cases, when using Fortrans, adverse reactions occur in the form of flatulence, abdominal discomfort or allergic manifestations.

Another product specifically designed to prepare for diagnostic procedures is MOVIPREP . The drug provides a brilliant preparation of the intestine for colonoscopy.

Colonoscopy time	Dosing regimen
8:00 am – 10:00 am Diet on the eve of colonoscopy day: until 9:00 am Breakfast: according to the list of allowed foods. Lunch and dinner: permitted liquids only.	One-stage evening scheme: The day before the colonoscopy: 19:00 – 20:00 take the first liter of the drug solution 21:00 – 22:00 take the second liter of the drug solution After each liter of the drug taken, do not forget to drink 500 ml of the permitted liquid
10:00 – 14:00 Diet on the eve of colonoscopy day: Breakfast: according to the list of allowed foods. Before 13-00 light lunch: according to the list of allowed products. Dinner: Only permitted liquids.	Two-stage scheme: The day before the colonoscopy: 20:00 – 21:00 take the first liter of the drug solution Colonoscopy day: 06:00 – 07:00 take the second liter of the drug solution After each liter of the drug, do not forget to drink 500 ml of the permitted liquid
14:00 – 19:00 Diet on the eve of colonoscopy day: Breakfast and lunch: according to the list of allowed foods. Before 18-00 light dinner: according to the list of allowed products. On the day of the colonoscopy in the morning: only permitted fluids.	One-step morning regimen: Colonoscopy day: 0800–0900 take the first liter of the drug solution 1000–1100 take the second liter of the drug solution Remember to drink 500 ml of the approved liquid after each liter of the drug taken

How to prepare a solution of 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 non-carbonated drinking water at room temperature until completely dissolved, bring to 1 liter with water and mix.
2. To prepare the second liter of the drug:
Repeat the algorithm from paragraph 1 (see above), using the remaining sachets A and sachets B.

Take the drug solution in fractions of 250 ml every 15 minutes.

Additional advice:
Each liter of drug solution takes an average of 2 hours to work. While taking the drug, it is recommended to perform light physical exercises: circular rotation of the pelvis, tilting to the sides, back and forth, squats. You should not eat solid food from the start 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 readiness of the patient for colonoscopy is the appearance of a liquid transparent or almost transparent slightly colored stool. Patients need to consider the appropriate time slot for traveling to the clinic for the procedure.

Recommendations for concomitant diseases.

Regularly 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 agents, it is recommended that you stop taking them in preparation for your colonoscopy and return to taking them after starting a normal diet. It is not necessary to fast (especially if you have diabetes) on the day of your colonoscopy. Just 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 barium in the intestinal lumen, you should start the diet 5 days before your colonoscopy. During this period, you need to continue taking your usual laxatives. With constipation up to 6-10 days, it is required to double the dose of laxative.
If you have concomitant diseases, be sure to consult your doctor!

How is a colonoscopy 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 the couch on the left side, with the knees pressed to the stomach.
2. The specialist treats the anal area with an antiseptic and gently inserts the colonoscope probe into the rectum. In patients with hypersensitivity, anesthetic gels or ointments can be used before manipulation, which 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. To straighten the folds of the intestine, during the examination, air is pumped into it.
Thus, the large intestine is visually examined throughout. If no serious pathologies are detected, then the procedure takes about 15-30 minutes, while diagnostic or therapeutic actions may take more time.
If a biopsy is required, a small piece of tissue is cut and removed through a special channel of the endoscopic instrument with special forceps.
During a colonoscopy, polyps or small benign formations can be removed, for which a special loop is used, which captures the outgrowths at the base, cuts them off and removes them from the intestine.

How painful is the procedure?

Many patients are concerned about the pain of the upcoming manipulations. Before starting the procedure, the doctor should explain how an intestinal colonoscopy is done and resolve the issue of pain relief. In many specialized clinics, the procedure is done without anesthesia, since usually the manipulation does not cause severe pain.
The patient may feel some discomfort when air is injected to straighten the folds of the large intestine or when the diagnostic probe passes through some anatomical bends 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 to 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 pain during the procedure is possible. In such a situation, colonoscopy of the intestine is done under anesthesia. Usually, anesthesia is short-term, since the procedure itself does not take more than 30 minutes.

Alternative examination methods

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

After the procedure: possible complications

During the 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 bursting 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 the manipulation is carried out 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 wall. It is noted extremely rarely and most often occurs as a result of ulceration of the mucosa or purulent processes in the intestinal walls. In such cases, urgent surgical intervention is performed to restore the integrity of the damaged area.
• Bleeding in the intestines.