What Is Colonoscopy?
The endoscopic examination of the large intestine and the distal end of the small intestine with the help of CCD cameras is known as colonoscopy. The medical terminology used for large intestine is the word ‘colon’, hence the name of the procedure. It is majorly indicated in cases of colon cancer where a biopsy needs to be performed and a section of the cancer mass removed for the assessment of type and nature of the cancer. Sigmoidoscopy is a part of colonoscopy in which only the sigmoid part of the large intestine is examined thoroughly. However this is the choice of diagnostic method when the pathology is restricted to the sigmoid curve of the large intestine. Various other pathologies of the colon can also be detected and diagnosed with the help of colonoscopy which are explained in further lines.
Why Is Colonoscopy Needed?
Indications for colonoscopy are as follows:
- Intestinal/large intestinal polyps, less than 1-3 mm in diameter
- Gastrointestinal hemorrhages
- Suspicion of malignancy/colon or colorectal cancers, screening for the same
- Irregular movements of the bowel
- Inflammatory bowel disease
- Ulcerative colitis
Signs and Symptoms A Colonoscopy Is Needed:
- Blood in stools, bad fecal odors
- Irregular bowel movements
- Pain and discomfort while passing stools
- Abdominal distention and bloating
- Reduced appetite, loss of weight, decreased urge for hunger
Treatment Procedure for Colonoscopy: The Standard Method
- Preparation of the patient/colon: Three days prior to the planned colonoscopy, the patient is advised to keep the colon free of any solid mass. The patient is advised to maintain a low fiber diet along with liquids for these three days, simultaneously remaining adequately hydrated. A day before the scheduled procedure, either laxatives are given to the patient with large quantities of fluid or a whole bowel irrigation is done by using polyethylene glycol and electrolytes. However a combination of the two can also be given. The goal of the above mentioned methods is to clear the bowel completely of any solid mass so as to facilitate the procedure of colonoscopy.
- Colonoscope: This is an endoscope which is used for the examination of the large intestine and the terminal part of the small intestine. The proximal end is used to gain access to the large intestine via the anus, moving upto the rectum and then eventually to the large intestine. On its way, the above mentioned structures are also examined. To this part are attached many channels to which instruments, illumination gadgets and suction tubes are attached. It can be both flexible and rigid, and used as per the need of the case.
- Procedure: Once the bowel has been cleared and prepared for the colonoscope insertion, sedation is given to the patient intravenously. This is done to avoid any pain or discomfort while the colonoscope will be inserted through the anus into the colon.
- Step 1: As soon the colonoscope is inserted via the anus, the first step is to digitally carry out a rectal examination to examine the tonicity of the sphincter and the muscles.
- Step 2: The colonoscope is then pushed further up and made to gain access ot the large intestine/colon such as the sigmoid, descending, transverse, ascending parts, cecum and finally the terminal ileum (small intestine).
- Step 3: The part inside the colon has a movable tip and many channels for the attachment of various instrumentation, illumination or suction. Depending upon the need for which the colonoscopy is being done, the channels can be put to use. As for example, a micro scissor can be attached in case biopsy is to be done for the examination of colon cancer is suspicion. Air can also be insufflated inside the colonic cavity in order to enable maximum visibility of the polyps, mucus membranes or the engorged blood vessels.
Types of Colonoscopy:
- Virtual colonoscopy/CT colonoscopy/VC/CT pneumocolon:
This variation of the standard colonoscopy produced two and three dimensional images of the colon starting from the rectal canal down upto the lowest part of the small intestine, with the help of computers and radiographs. These radiographs are majorly computed tomography scans or the magnetic resonance images providing a 3D reconstructed view of the bowel. This is the choice of diagnostic method for average to large intestinal polyps, mucus membrane irregularities and colon or colorectal cancers such as adenomas and neoplasias.
This procedure does not make use of the conventional colonoscope and hence no insertion of the same is needed. Thus there is no need for administration of any sedation to the patient. However this procedure also requires an empty bowel for which laxatives are given to the patient prior to the onset of the procedure. Thus the side effects that can arise due to over dose of sedation are also avoided.
- Sigmoidoscopy: This is the diagnostic method for the examination of the large intestine where access is gained through the rectum and then through the sigmoid colon. Thus it only examines uptil the sigmoid colon and does not go beyond it.
It is of two types, depending upon the type of colonoscope used. A flexible sigmoidoscopy uses a flexible endoscope and a rigid sigmoidoscopy will use a rigid endoscope.
Complications And Risk Factors Associated With Colonoscopy:
- Perforation of the mucus membranes is a common and one of the most serious complications of colonoscopies
- Flatulence/farting is also a very common side effect of colonoscopy procedure
- Pain in the lower abdomen
- Peritoneal bleeding and infections go hand in hand, when one occurs the second is bound to happen
- Temporary drop in blood pressure, oxygen saturation as a result of overdose of anesthesia
- Pulmonary embolism and deep vein thrombosis can also occur due to the same
- Laxatives are given for preparing the bowel prior to colonoscopy, these may cause excessive dehydration
- Intra colonic explosion may also occur
- Diarrhea, constipation depending upon how the bowel contractions and relaxations take place
- Nausea, vomiting, allergic to sedative medications
Am I Good Candidate For Colonoscopy?
If you have any of the following signs and symptoms, you surely are an ideal candidate for undergoing the colonoscopy procedure:
- Heavy abdominal cramps and bleeding
- Blood in stools
- Bloated abdomen, smelly flatulence
- Ulcerative colitis
- You have been diagnosed with inflammatory bowel syndrome
- Your ultrasound shows a single small or multiple small polyps in your bowel
- You have been under suspicion for developing colon cancer/adenoma/neoplasia
- It will take you around 30 to 60 minutes to recover form the sedation that had been given to you
- About an hour or later, you will be advised to go home
- You are advised to slowly come back to your normal solid diet after a period of about say 3 to 5 days
- You can resume your daily chores as soon as you are home
- Excessive pain, bleeding or pain immediately calls to see your gastroenterologist as soon as possible
Success Rate of Colonoscopy:
An overall success rate of 85 percent is associated with colonoscopy procedure. There are chances of perforations and bleeding that occur after the completion of the procedure. The virtual colonoscopy however has an increased success rate of 93 percent since the insertion of colonoscope is eliminated.
Benefits of Colonoscopy:
A colonoscopy procedure has the following advantages:
- Helps in the early detection of the pathologies in your large intestine
- Also helps in the biopsy and histological examination of the cancer mass
- Is a minimally invasive process
- Does not require extensive hospital stay and monitoring
Cost Comparisons for Colonoscopy:
There is a a huge variation in the fees that you will be required to pay for the colonoscopy here in India. the price varies from anywhere between 10,000 INR to 22,000 INR. This price is fifty percent lesser as compared to what you will be required to pay in countries abroad.
Why choose India?
Team MedcureIndia righteously represents the Indian nation where medical expertise is found in abundance. Colonoscopy is a medical diagnostic aid that has seen an extensive use in hospitals all over the country and is a routine practice and recommendation by the gastroenterologists. We make sure the process goes very smooth for our clients without any side effects, assuring n affordable cost too.