Colonoscopy and Its Importance

What Is Colonoscopy?

Colonoscopy allows your physician to examine the mucosa of rectum and large intestine (colon). A colonoscope, a thin flexible tube, as thick as your finger, is inserted into your anus and slowly advanced into the rectum and colon.

How Should I Prepare for The Colonoscopy?

Your physician will tell you how you should prepare and provide necessary recommendations that generally consists of limiting your diet, consuming oral laxatives or, if needed, applying enema.  It is extremely important for you to follow your physician’s instructions carefully, as colon cleansing may affect the colonoscopy results.

You can find more detailed information regarding the preparation in our article titled PREPARATION BEFORE COLONOSCOPY.

Should I continue to take my current medications?

Most medications can be continued as usual. Please let your physician know about medications you are taking, particularly aspirin products, anticoagulants/antiaggregants (blood thinners) products. Also, remember to mention allergies you have to medications. Inform your physician if you have a vital health problem or antibiotic prophylaxis prior to a dental treatment. If you have diabetes or high blood pressure, dose of the medications you use can be changed by your physician.

What should I expect from colonoscopy?

As the colonoscopy is performed after you are given a sedative at our clinic, you will feel or remember nothing about the procedure. You will basically lie on your left side during the procedure, but position changes can be made if considered necessary by your physician. After waking up, you might feel mild bloating, which is normal and temporary.

What happens if something abnormal is detected during the colonoscopy?

If your physician sees a finding in mucosa of the large intestines that requires further evaluation, obtaining a sample of biopsy may be necessary. Biopsy is performed not only for cancer or tumor, but also benign formations.

When a benign formation such as polyp is detected, your physician naturally decides to take a biopsy sample for further analysis. For polyps, biopsy usually means removing the entire polyp. Polyps are the formations originating from mucosa and tending to grow in terms of size and type. Some types have the tendency to become cancerous at certain rates. For this reason, removal and analysis of polyps are important in terms of both analyzing and eliminating possible risks and determining the treatment and follow-up strategies in the future. Possibility of biopsy or more comprehensive interventions will be discussed with you prior to the procedure.

What happens after the colonoscopy?

Your physician will tell you the findings detected during the colonoscopy. It is natural for you to feel mild bloating and cramp-like abdominal pain after the procedure due to gas inflated into intestines during the colonoscopy. It is estimated that you will experience such complaints less, since carbon dioxide gas, which can be absorbed more easily in the intestine, is preferred at our endoscopy unit instead of inflating room air into the intestine during endoscopic procedures. When it is observed that you do not have a complication after 30-45 minutes on average at recovery unit following the procedure, necessary procedures will be carried out and you will be discharged from the hospital. Your colonoscopy result report will be handed over to you or your relatives, and if a biopsy sample is taken during the procedure, you will be informed how to track its results. Unless your physician provides additional recommendations with you, you are free to eat and return to your daily routines.

What are the possible complications of the colonoscopy?

This procedure is quite safe when performed by well-trained physicians who are specially experienced in endoscopy. Intestinal perforation or bleeding at the procedure site are the most serious complications, especially in the case of interventional procedures such as polyp removal. Although complications after colonoscopy are uncommon, it’s important to recognize early signs of possible complications. Contact your physician immediately if you notice severe abdominal pain, fever and chills, or rectal bleeding (in amount of over a half teacup). Note that bleeding can occur even several days after the procedure.

Process at the hospital:

If a colonoscopy procedure is planned by your physician, an appointment will be made from the endoscopy unit for date and time of the procedure. You will be informed by Admission Department in regard of the hospitalization process, preparation for anesthesia, performing the necessary tests and pricing.

Anticoagulant (blood thinner) tablets, if taken, will be discontinued at least 5 days before the procedure. And if it must be uninterruptedly taken by the patient, you will be started on some preparation injections to be administered by us. In some cases, aspirin-derived medications may not be discontinued. The day before the procedure, the endoscopy team will tell you how to do bowel cleansing, and you will be given a preparation form and prescription. Oral fluid intake, including food and water, will be discontinued as of 24.00 p.m. at night prior to the procedure Your physician and anesthesiologist will inform you about the medications you take routinely. It is important for you to come to the hospital at least 1 hour before the scheduled appointment time in the morning of the procedure. New bloodwork may be performed in some cases following your admission for the procedure. Once you are admitted to inpatient ward, you will be asked to read and sign the informed consent forms (for lower GI endoscopy [colonoscopy] and anesthesia) containing detailed information about the procedure your physician have already explained to you, if you have not read and sign before the procedure. After the nursing assessment and preparation are completed at your room, you will be transferred to the endoscopy unit at the time of the procedure. After sedation is applied by the anesthesia team at the beginning of the procedure, lower GI endoscopy (colonoscopy) will be performed. Then, you will be transferred to recovery unit/your room after the effects of the medication go down with the approval of the anesthesia team. You will be allowed to consume food approximately 45 minutes after the procedure. If no complication develops before and after the procedure, your follow-up examination will be scheduled, and you will be discharged from the hospital.

Colorectal Surgery

The field of general surgery that is specialized in intestinal diseases is known as colorectal surgery or coloproctology. Colorectal surgery is the surgical care of conditions affecting the colon and rectum.

COLONIC DISEASES

The colon has a tubular shape like the other parts of the digestive system. The small intestine drains into the first blind-ending part of the colon (cecum) in the right lower abdominal region. There is a finger-like tube, known as an appendix, connected to the cecum at this point. After the cecum, the colon goes up from the right lower region toward the area under the liver (“ascending” colon) and turns left, and continues through the left upper abdominal region, where the spleen is located, (“transverse” colon) and then, turns downwards and continues as “descending” colon. It forms an “S-like” structure in the left lower abdominal region, known as the “sigmoid” colon, and connects to the end of the colon, known as the “rectum” (in Latin: straight).

The main function of the colon is to absorb excess fluid from partially digested food while forming the stool. Aside from this, the colon has also some small but essential functions. The most crowded microorganisms are located in the colon -further digestion and absorption of nutrients are performed by microorganisms. Moreover, the rectum stores the stool and helps the release of stool periodically from the anus.

Moreover, various diseases may develop in the colon in comparison to the small intestine. Modern science considers this due to slower passage and more concentrated exposure to toxic agents in the colon.

Colonic diseases treated by general surgery:

• Acute appendicitis
• Malignant diseases of the appendix - carcinoid tumor, cancer
• Complicated inflammatory colon diseases (inflammatory intestinal diseases) - ulcerative colitis, Crohn’s disease
• Diverticular disease and complications - acute and chronic diverticula.
• Benign tumoral diseases - colonic polyps, rare colon tumors - lipoma, hamartomas
• Malignant tumors - colon and rectal cancer and rare stromal tumors.

In our hospital, endoscopic (colonoscopy) and laparoscopic (if not possible, open surgery is considered) methods are utilized for the treatment of colon diseases.

Colon resection (partial removal of the colon) is the most frequent method used in certain cases. If some factors are increasing the risk of complication before or during resection, opening a stoma, or an opening on the abdomen that can be connected to the colon may be considered. Stomas may be permanent or temporary. Stoma opening can be a single operation in some cases, such as intestinal obstruction due to various reasons, chronic fistula of bowels, etc.

Colorectal surgery performed at our department:

• Colonoscopic polyp removal
• Colonoscopic treatment in early-stage colon cancer
• Laparoscopic appendectomy
• Colon resection (laparoscopic or open) - the scope of the operation may vary depending on the type and extensiveness of the disease.
• Opening or closing a stoma (laparoscopic and open)