Wayne Schonfeld, MD
David Weiss, MD
Barry Migicovsky, MD
Leon Maratchi, MD

Jeffrey Kaner, MD
Charles Gluck, MD
Alix Lanoue, MD
Colonoscopy

Your physician has determined that an examination of your colon is necessary to further evaluate or treat your symptoms. This information has been prepared to answer questions our patients' most frequently ask.

What is a colonoscopy?
An exam using an instrument called a colonoscope. The colonoscope is a thin, lighted flexible tube. This instrument allows the physician to directly view the inside of your colon (large intestine). Photos can be taken to document findings and tissue samples (biopsies) may be taken. This is a way for your physician to evaluate the colon in great detail.

Polyps are small growths originating in the lining of the colon. Most polyps are non-cancerous (benign), but the physician cannot always tell a benign polyp from a malignant (cancerous) polyp by its visual appearance. For this reason, all polyps found will be removed and sent to pathology for analysis. You should feel no discomfort during the polyp removal. Removal of colon polyps is important in preventing colorectal cancer.

What preparation is necessary?
Your colon must be clean in order for your physician to get the best view possible. A special diet followed by a laxative preparation is necessary to clear out any waste or solid residue. The instructions must be followed exactly. Any solid material retained in the colon may prolong the procedure or make it necessary to repeat the examination at another time

Will the procedure hurt?
Your physician or a Certified Nurse Anesthetist (CRNA), under the supervision of an Anesthesiologist, will give you an intravenous medication to make you feel relaxed. Some people fall asleep and do not remember the procedure when they awaken. The physician will put air into your colon to help visualize the lining and this sometimes causes a cramping or bloated sensation. (Passing this air during and following the exam will relieve any discomfort.)








What can I expect when I arrive at the endoscopy center?
When you arrive at the endoscopy center, you will be asked to change into a gown. The nurse and/or an Anesthesiologist will ask you questions about your medical history and current medication use. Updating this information will make the procedure safe for you. Please be prepared to review your health history at this time. Bring a list of medications and drug allergies, if necessary. Your blood pressure, pulse rate, and oxygen saturation will be monitored before, during and after the exam. An intravenous (I.V.) needle will be placed in your hand or arm.

What can I expect during the colonoscopy?
The nurse will help you get comfortable on a stretcher. After blood pressure and heart rate monitors are applied you will lie on your left side. Your physician or Certified Nurse Anesthetist (CRNA) will give you an intravenous injection of medication. After you become relaxed, the physician will insert the tip of the scope into your rectum and advance it forward into the colon. The procedure takes 20-45 minutes. When your exam is finished you will be taken to the recovery room for observation.

The sedation used during your exam impairs judgment, memory, and equilibrium. We cannot perform this procedure unless we know that you will arrive home safely, so please bring a friend or family member with you:

  • Do not drive, operate machinery, make critical decisions, drink alcoholic beverages, or do activities that require coordination or balance for 24 hours.
  • Because air was put into your colon during the procedure, you may experience cramping, bloating and expelling large amounts of air from your rectum. This is normal for the first 24 hours.
  • You may not have a bowel movement for 1-3 days because of the colonoscopy prep. This is normal.

Except for these restrictions, you may resume your normal diet unless directed otherwise by your physician. Your physician may give you additional instructions at the time of discharge.

What are the possible complications of colonoscopy?
Please be informed that a colonoscopy is never 100% accurate. The accuracy varies with the quality of the prep and the size of the polyp. After the procedure, if you develop any new or recurrent gastrointestinal signs or symptoms, immediately bring it to the attention of your physician.

When performed by a knowledgeable and competent physician, a colonoscopy is a very low risk procedure. Very rarely, bleeding or perforation (tearing of the lining of the colon) may occur. Other risks include a reaction to medication, irritation at the site of the injection, or complications related to other medical problems that you may already have.

  • Perforation: Passage of the instrument may result in an injury to the gastrointestinal tract wall with possible leakage of gastrointestinal contents into the body cavity. If this occurs, surgery to close the leak and/or drain the region is usually required.
  • Bleeding: Bleeding, if it occurs, is usually a complication of biopsy, Polypectomy or dilation. Management of this complication may consist only of careful observation, or may require transfusions or possibly a surgical operation.
  • Medication Phlebitis: Medications used for sedation may irritate the vein in which they are injected. This causes a red, painful swelling of the vein and surrounding tissue. The area could become infected. Discomfort in the area may persist for several weeks to several months.
  • Conscious Sedation Medication and Pregnancy: There are risks involved with Anesthesia, especially as it relates to a pregnancy. If there is a question that a pregnancy is possible, a urine pregnancy test will be performed prior to the procedure. If you are breast feeding, do not breast feed for 48 hours.
  • Other Risks: Include drug reactions and complications from other diseases you may already have. Instrument failure and death are extremely rare but remain remote possibilities.
  • YOU MUST INFORM YOUR PHYSICIAN OF ALL YOUR ALLERGIC TENDENCIES AND MEDICAL PROBLEMS.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Go directly to the emergency room and contact your physician if you notice any of the following:

  • Chills and/or fever over 101
  • Persistent vomiting
  • Severe abdominal pain, other than gas cramps
  • Severe chest pain
  • Black, tarry stools
  • Any bleeding-exceeding one tablespoon.

What are the alternatives to Gastrointestinal Endoscopy? 
Although gastrointestinal endoscopy is an extremely safe and effective means of examining the gastrointestinal tract, it is not 100 percent accurate in diagnosis. In a small percentage of cases, a failure of diagnosis or misdiagnosis may result. Other diagnostic or therapeutic procedures, such as medical treatment, x-ray and surgery are available. Another option is to choose no diagnostic studies and/or treatment. Your physician will be happy to discuss these options with you.

Other Questions
If you have any questions please contact your physician and your doctor will be happy to answer any questions that you may have.