Colonoscopy Health Article

Aftercare

After the procedure, the patient is kept under observation until the effects of the medications wear off. The patient will have to be driven home by somebody and can generally resume a normal diet and usual activities unless otherwise instructed. The patient will be advised to drink lots of fluids to replace those lost by laxatives and fasting.

For a few hours after the procedure, the patient may feel groggy. There may be some abdominal cramping and considerable amount of gas may be passed. If a biopsy was performed or a polyp was removed, there may be small amounts of blood in the stool for a few days. If the patient experiences severe abdominal pain or has persistent and heavy bleeding, it should be brought to the doctor's attention immediately.

Risks

The procedure is virtually free of any complications and risks. Very rarely (two in 1000 cases) there may be a perforation (a hole) in the intestinal wall. Heavy bleeding due to the removal of the polyp or from the biopsy site occurs very infrequently (one in 1000 cases). Infections due to a colonoscopy are also extremely rare. Patients with artificial or abnormal heart valves are usually given antibiotics before and after the procedure to prevent an infection.

Normal results

The results are said to be normal if the lining of the colon is a pale reddish pink and there are no abnormal looking masses that are found in the lining of the colon.

Abnormal results

Abnormal results would imply that polyps or other suspicious-looking masses were detected in the lining of the intestine. Polyps can be removed during the procedure and tissue samples can be biopsied. If cancerous cells are detected in the tissue samples, then a diagnosis of colon cancer is made. The pathologist analyzes the tumor cells further to estimate the aggressiveness of the tumor and the extent of spread of the disease. This is crucial before deciding on the mode of treatment for the disease. Abnormal findings could also be due to inflammatory-bowel diseases such as ulcerative colitis or Crohn's disease. A condition called diverticulosis, where many small fingerlike pouches protrude from the colon wall, may also contribute to an abnormal result in the colonoscopy.

BOOKS

Berkow, Robert, et al., eds. Merck Manual of Diagnosis and Therapy. 16th ed. Merck Research Laboratories, 1992.

The Patient's Guide to Medical Tests. Ed. Barry L. Zaret, et al. Boston: Houghton Mifflin, 1997.

Sobel, David S., and T. Ferguson. The People's Book of Medical Tests. Summit Books, 1985.

ORGANIZATIONS

American Cancer Society. 1599 Clifton Rd., NE, Atlanta, GA 30329-4251. (800) 227-2345. <http://www.cancer.org>.

Cancer Research Institute. 681 Fifth Ave., New York, N.Y. 10022. (800) 992-2623. <http://www.cancerresearch.org>.

National Cancer Institute. Building 31, Room 10A31, 31 Center Drive, MSC 2580, Bethesda, MD 20892-2580. (800) 422-6237. <http://www.nci.nih.gov>.

United Ostomy Association, Inc. (UOA). 19772 MacArthur Blvd., Suite 200, Irvine, CA 92612-2405. (800) 826-0826. <http://www.uoa.org>.

Lata Cherath, PhD

KEY TERMS

Barium enema—An x-ray test of the bowel after giving the patient an enema of a white chalky substance that outlines the colon and the rectum.

Biopsy—Removal of a tissue sample for examination under the microscope to check for cancer cells.

Colonoscope—A thin, flexible, hollow, lighted tube that in inserted through the rectum into the colon to enable the doctor to view the entire lining of the colon.

Crohn's disease—A chronic inflammatory disease where the immune system starts attacking one's own body. The disease generally starts in the gastrointestinal tract.

Diverticulosis—A pouchlike section that bulges through the large intestine's muscular walls but is not inflamed. It may cause bleeding, stomach distress and excess gas.

Pathologist—A doctor who specializes in the diagnosis of disease by studying cells and tissues under a microscope.

Polyps—An abnormal growth that develops on the inside of a hollow organ such as the colon.

Ulcerative colitis—A chronic condition where recurrent ulcers are found in the colon. It is manifested clinically by abdominal cramping, and rectal bleeding.