Colonoscopy

OVERVIEW

Colonoscopy is a medical procedure used for the diagnosis of diseases in the colon, rectum and anus.

During colonoscopy a long, flexible tube (colonoscope) is introduced into the rectum. A tiny camera at the end of the scope enables the gastroenterologist to examine the lumen of the whole colon. If it is necessary, polyps can be removed through the scope during the procedure and biopsies (small tissue samples) be taken. A typical colonoscopy lasts for 20-45 minutes depending on the case.

 

HOW TO PREPARE

Before colonoscopy you should empty your bowels completely. Any fecal residue may prevent the complete examination of the colon.

In order to empty your bowels completely, you should have to:

• Follow a low-residue diet for the 3 days before the test. Avoid all legumes, fruits, salads, nut and seeds. You may eat light soups, white bread, rice, pasta, chicken. Drink plenty of fluids. This diet may not be necessary in certain situations.
• Follow a clear fluid diet the day before the test. Have a light breakfast of egg whites, white bread and. NO SOLID FOOD ALLOWED AFTER BREAKFAST! Until 6 pm have 10-12 glasses of CLEAR FLUIDS: plain water, tea/coffee without milk or cream, broth, apple juice. AVOID RED FLUIDS, CARBONATED DRINKS AND CHEWING GUM. Hard candies, honey, sugar and sports drinks are all allowed. For a morning appointment you are not allowed to drink anything after midnight.
• Use a laxative. Your doctor will recommend one of 3 laxatives and you may find detailed instructions in the respective links. You may be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure.
• Use an enema kit. In some cases you may be asked to use 2 enema bottles (enema Cooper) 2 hours before the test. You do not need prescription for the enemas.
• Adjust your medications. inform your doctor about your medications at least a week before the exam—especially if you have diabetes, high blood pressure or heart problems or if you take medications or supplements that contain iron.

 

Also tell your doctor if you take aspirin or other medications that thin the blood, such as warfarin (Coumadin); newer anticoagulants, such as dabigatran (Pradaxa) or rivaroxaban (Xarelto); or clopidogrel (Plavix). You may need to adjust your dosages or stop taking the medications temporarily.

AFTER THE TEST

After colonoscopy it will take approximately 20 minutes to recover from the sedative. You’ll need someone to take you home. Don’t drive or go back to work for the rest of the day.

If your doctor removed a polyp during your colonoscopy, you may be advised to eat a special diet temporarily.

You may feel bloated or pass gas for a few hours after the exam, as you clear the air from your colon. Walking may help relieve any discomfort.

RESULTS

After the procedure your doctor will review the results of the colonoscopy and then share them with you. Biopsy results are available after 5 days.

 

PREPARATION WITH PEG3350/4000 (EFFECOL PREP, FORTRANS, KLEAN PREP)

Morning appointment:

1. At 3 pm on the previous day, empty the content of one sachet into an empty bottle. Add 1lt of water or apple juice, close tightly and shake well. Repeat these steps for all 4 sachets (in total 4 liters of laxative solution).
2. Start drinking slowly one glass (250-300mL) every 15-20 minutes.
3. You should be able to drink the laxative (total volume of 4 liters) in 4-6 hours.
4. After drinking the laxative continue with clear liquids until bedtime.

 

Afternoon appointment:

1. At 7 pm on the previous day, empty the content of one sachet into an empty bottle. Add 1lt of water or apple juice, close tightly and shake well. Repeat these steps for all 4 sachets (in total 4 liters of laxative solution).
2. Start drinking slowly one glass (250-300mL) every 15-20 minutes until you have taken 2 liters (2 sachets).
3. After drinking the laxative continue with clear liquids until bedtime.
4. In the morning of colonoscopy and 10-12 hours after starting the preparation, repeat steps 1 & 2 until you have taken the remaining 2 liters (2 sachets). You should be able to complete the preparation at least 3 hours before colonoscopy.

 

PREPARATION WITH EZICLEN

Morning appointment:

1. At 6 pm on the previous day, empty the content of one EZICLEN bottle into the provided plastic cup.
2. Add water or apple juice until it reaches the indicator line (500mL).
3. Drink the solution very slowly in 30-60 minutes.
4. IMPORTANT! During the next hour drink slowly 2 more plastic cups of plain water (1 liter).
5. At 8 pm repeat steps 1 to 4 using the second bottle of Eziclen. You should be able to finish preparation by 10 pm.
6. After drinking the laxative continue with clear liquids until bedtime.

 

Afternoon appointment:

1. At 8 pm on the previous day, empty the content of one EZICLEN bottle into the provided plastic cup.
2. Add water or apple juice until it reaches the indicator line (500mL).
3. Drink the solution very slowly in 30-60 minutes. You should be able to finish by 9 pm.
4. IMPORTANT! During the next hour drink slowly 2 more plastic cups of plain water (1 liter). After drinking the laxative continue with clear liquids until bedtime.
5. In the morning of colonoscopy and 10-12 hours after starting the preparation, repeat steps 1 to 4. You should be able to complete the preparation at least 3 hours before colonoscopy.

 

PREPARATION WITH ENTEROUT, FLEET PHOSPHA SODA

Morning appointment:

1. At 12 pm on the previous day, empty the content of one laxative bottle into a glass.
2. Dilute with water or apple juice.
3. Drink the solution slowly in 5 minutes.
4. IMPORTANT! During the next hour drink slowly 4 more glasses of plain water (1 liter).
5. At 8 pm repeat steps 1 to 4 using the second bottle of laxative. You should be able to finish the preparation by 9 pm.
6. Between 12 pm and 8 pm and until bedtime, drink plenty of clear fluids, aiming for 10-12 glasses (2,5-3 lt in total.

 

Afternoon appointment:

1. At 8 pm on the previous day, empty the content of one laxative bottle into a glass.
2. Dilute with water or apple juice.
3. Drink the solution slowly in 5 minutes.
4. IMPORTANT! During the next hour drink slowly 4 more glasses of plain water (1 liter).
5. In the morning of colonoscopy and 10-12 hours after starting the preparation, repeat steps 1 to 4. You should be able to complete the preparation at least 3 hours before colonoscopy.

 

ADVICE FOR AN EASIER PREP

In case of nausea:

1. Drink the laxative at a slower pace e.g. in 1.5 hour instead of 1 hour, until you feel better.
2. Keep the solution in the refrigerator or mix it with ice.
3. Use a straw.
4. Add lemon juice.
5. Use candies or teeth-brushing to alter your taste.

 

In case of no results:

1. Drink more clear fluids.
2. Walk around the house.