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Colonoscopy

Description
Possible Complications with a Colonoscopy
Sedation
Preparation
Post Colonoscopy Instructions
Instructions Following a Colonoscopy with Removal of Polyps
Cancellation Policy
FAQS

Description

A colonoscope is a long flexible tube, which is passed through the rectum into the colon. Colonoscopy is used to diagnose diseases like polyps, cancer, colitis and diverticular disease. If any diseases are found during the test, some interventions such as polyp removal and or biopsy may be taken for further evaluation.

Possible Complications with a Colonoscopy

  • Bleeding following removal of a polyp can occur rarely in 1 in 1000 patients.
  • Perforation (a hole) can occur unintentionally in less than 1 in 1000 cases on average. If perforation or significant bleeding occurs, admittance to the hospital for surgery and further observation will be required.
  • Sometimes lesions can be missed, especially if the bowel preparation is not very good. This can occur in less than 5% of cases.

Prior to completing the procedure, the doctor will discuss the possible risks of complications with the patient. We encourage patients to use this opportunity to have an open dialogue about any concerns they may have with respect to the proposed procedure. Patients should familiarize themselves with the consent form that will need to be signed prior to undergoing any procedure at the clinic.

Sedation

Sedation is given by a physician through an IV site that is started before the procedure begins. This is to make sure that the patient is comfortable and without pain throughout the procedure. Your heart, blood pressure, and breathing is monitored throughout the procedure. The medication begins to work immediately and will last for the duration of the procedure.

Sometimes the medication can cause stinging at the injection site. Possibilities of side effects/complications can arise such as an allergic reaction, blood pressure fluctuations, and rare heart or lung complications. More serious complications are extremely rare. The anesthetist will be available to discuss any further questions.

Prior to the procedure, a bite block will be placed between the upper and lower teeth to prevent unconscious biting and damage to teeth and/or caps. Although, there is a possibility that teeth can get chipped while unconscious.

Patients may feel disorientated, forgetful, and or sleepy for a short time following the examination. This is due to the sedation. As a result patients may not remember what they have been told about the test. For this reason each patient will be provided a copy of the written findings to take home for later reference. A full report will be sent to the referring doctor within 3 – 5 business days of the procedure.

Preparation

Consult your physician about the use of medication during this preparation period. Heart, blood pressure, asthma and epilepsy medication may be taken in the morning of the appointment, with a small sip of water.

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Required:

  • A MOVI-PREP kit and 2 DULCOLAX tablets can be purchased from your pharmacy without a prescription.
  • If you have a sensitive stomach you may take Gravol® 1/2 hour prior to starting MOVI-PREP.
  • Arrange for a family or friend to drive you home after the procedure. You are not permitted to drive after the procedure and for the remainder of the day, as you will receive IV sedation for the procedure. Following your procedure, you must remain with this person for the remainder of the day.

Instructions:

Three days prior to your appointment avoid nuts and seeds, berries, grapes, and multigrain bread.

The day before your appointment remain on a clear fluid diet all day. This means no milk. You may have jello or ice popsicles (but not red or purple), black coffee or black tea with sugar, clear soup, and juice without pulp.

IF YOUR APPOINTMENT IS PRIOR TO 11:00am:

1. Take 2 tablets of DULCOLAX at 8:00am the day before your procedure.

2. At 5:00pm start to drink the MOVI-PREP solution. Dissolve the contents of packet A + packet B into 1 litre of water. Drink 250mL (one regular drinking glass) of the solution every 10 minutes until you have completed the litre. If you feel nauseous, slow down. After you finish the solution, follow it with 0.5 litre of any clear fluid.

3. Approximately one hour after you begin to drink the solution you will start to experience a diarrhea type of bowel movement (this can vary by person).

4. At 9:00pm, or later, mix the remaining two packets of MOVI-PREP. Drink 250mL of the solution every 10 minutes, or as quickly as you can. After you finish the solution, follow it with 0.5 litre of any clear fluid.

5. You may continue drinking clear fluids until midnight.

6. The morning of your procedure, do not eat or drink prior to your appointment.

IF YOUR APPOINTMENT IS AT OR AFTER 11:00am:

1. Take 2 tablets of DULCOLAX at 8:00am the day before your procedure.

2. At 6:00pm start to drink the MOVI-PREP solution. Dissolve the contents of packet A + packet B into 1 litre of water. Drink 250mL (one regular drinking glass) of the solution every 10 minutes until you have completed the litre. If you feel nauseous, slow down. After you finish the solution, follow it with 0.5 litre of any clear fluid.

3. Approximately one hour after you begin to drink the solution you will start to experience a diarrhea type of bowel movement (this can vary by person).

4. You may continue drinking clear fluids until midnight.

5. The morning of your procedure, at 5:00am mix the remaining two packets of MOVI-PREP. Drink 250mL of the solution every 10 minutes, or as quickly as you can. After you finish the solution, follow it with 0.5 litre of any clear fluid.Do not ingest anything further until after your scheduled appointment.

Post-Colonoscopy Instructions

  • Arrange for a family or friend to drive you home after the procedure. You are not permitted to drive after the procedure and for the remainder of the day, as you will receive IV sedation for the procedure. Following your procedure, you must remain with this person for the remainder of the day.
  • You may return to a regular diet after the procedure. However, it is recommended to avoid heavy/fatty meals. Refrain from Alcohol.
  • Some abdominal discomfort is normal after a colonoscopy. Bloating and abdominal discomfort is caused by the air pumped into your bowel during the procedure. This is usually relieved by passing gas. The following methods may help relieve gas:
    • Drinking warm liquids such as tea or coffee
    • Walking
    • A warm bath
  • If the abdominal pain worsens over time and is accompanied by a fever and/or nausea; you must go to the nearest Emergency Room right away. Bring your colonoscopy report with you. Please inform the clinic if this happens.
  • You may notice a small amount of bleeding when you go to the washroom, either in the toilet or on the tissue. This is normal after having a colonoscopy (especially if a polyp was removed). If the bleeding continues or increases after 24hrs please contact your doctor. The doctor may advise you to go to the nearest Emergency Room.
  • It is also normal to NOT to have a solid bowel movement within 12-24 hours as your colon was emptied by the preparation.
  • Certain foods may cause bloating and gas after the procedure. For example: onions, garlic, chocolate, dairy products, broccoli, cauliflower, cabbage and certain spicy foods. If you find these foods bother you, try to eat them in moderation. You may wish to eliminate them from your diet if you find them truly bothersome.
  • Refrain from any legal or financial decisions for 24-48 hrs after receiving I.V. sedation.

Instructions Following a Colonoscopy with Removal of Polyps

  • If you routinely take Aspirin/Coumadin on a daily basis, start again as directed by your physician.
  • You may experience abdominal cramps or pain if air had to be inserted during the procedure. This will diminish once physical activity resumes. You may drink warm fluids to help release flatus (gas).
  • Avoid vigorous exercise for 2 -3 days. Walking and light housework is fine.
  • A small amount of bleeding is normal. If you have severe bleeding, significant abdominal or shoulder tip pain, chills, and/or fever, please go to York Central Hospital or nearest emergency department with this paper.
  • It is important that you keep your follow-up appointment if one was suggested by your physician.

Cancellation Policy

To cancel or reschedule an appointment you must provide at least 3 business days notice or you will be charged a $150.00 cancellation fee.

FAQS

1. How long will the procedure take?

The procedure itself takes approximately 30 minutes. However, expect to be at the clinic for up to 3 hours due to the time required to complete registration, pre-operative preparation and recovery. We highly recommend that you do not book any appointments after the procedure.

2. Can I drive home after my procedure? Can I go back to work after my procedure?

You will be sedated for the procedure. As a result you will not be able to drive until the following morning. Do not go to work after the procedure.

3. Should I continue to take my medications/vitamins prior to my procedure?

Unless you have specific instructions from your doctor, you may take your blood pressure and heart medications in the morning but with a small sip of water. Diabetic patients will need special instructions.

4. As a diabetic, how can I fast for so long?

We recommend that you book one of the first appointments in morning to reduce the time required to fast. We also suggest you bring a snack with you to have after your procedure is completed. Please consult your doctor on how to take your diabetic medications and insulin the day before and the day of the procedure.

5. Can I stay awake during the procedure?

It is highly recommended by the physicians to receive the sedation. It makes it easier for you and the physician alike. However, if you absolutely want, you have the option to not be sedated. Should you choose this option we will make a note on your referral that you have requested “No Sedation.”

6. Can I take a taxi home?

You are permitted to take a taxi home ONLY if you have an escort or have somebody that can accompany you when you get home.

7. Last time I took my bowel prep I had a bad reaction. Do I have to take it?

The doctor prefers that you complete the prep as directed. If the colon is not clean on the day of your appointment, the procedure will be cancelled and we will have to rebook the procedure. If you have a sensitive stomach or are prone to nausea, we recommend that you take Gravol 50mg tablet 30 minutes prior to starting the preparation.

8. Can my spouse/family member stay with me during the procedure?

No they may not, as only patients are allowed in the endoscopy suite. Your escort will have to remain in the waiting area. If you need assistance with regards to dressing/undressing or for translation, please inform the nurse.

9. Will I see the doctor before and after my procedure?

Yes, the doctor will describe the procedure to you prior to beginning. If you have many questions or concerns we recommend you book a consultation appointment first. In addition, the doctor will give you a report on how the procedure went before you leave. You will also be given a written report.

10. Does the doctor see children?

A consultation appointment for children as young as 8 years of age can be booked with us. However, procedures for patients from 8 to 18 years of age will be performed at Mackenzie Health Hospital.

11. What is the difference between doing a procedure at the hospital versus the clinic?

The wait time for a procedure at the hospital is typically much longer. In addition, the hospital does not provide an anaesthetist to administer sedation, so the endoscopists will be administering a lighter sedative.

12. Why do I need a consultation before my procedure?

Given your specific circumstances (age, medical conditions, time of last scope), a consultation is required before your appointment. If you would like to book a procedure directly (without a consultation), prior authorization from the specialist would be needed.