A colonoscopy is a procedure that examines the insides of the colon (large intestine) and rectum. It is used to detect early signs of issues in the digestive tract, such as inflammatory bowel disease and colorectal cancer.
A common misconception about colonoscopy is that it is a painful procedure. However, with proper sedation, patients typically experience little to no discomfort during the examination. Understanding what to expect can help ease worries and encourage early detection of colorectal conditions.
During a colonoscopy, the doctor gently inserts a thin, flexible tube (colonoscope) into the patient’s rectum. This tube has a lighted camera on the end, enabling the transmission of high-quality images to a monitor where the doctor can view them in real-time. As the scope moves through the colon, the doctor can carefully examine the colon lining for any abnormalities, such as polyps and other abnormal growths that could lead to cancer. The entire procedure may take around 30-60 minutes to complete.
A colonoscopy serves both diagnostic and therapeutic purposes.
Colonoscopy is the gold standard for colorectal cancer screening. The Singapore Ministry of Health recommends regular screenings for average-risk individuals, typically starting at age 50. High-risk individuals, including those with a family or personal history of polyps, colorectal cancer, or inflammatory bowel diseases, should begin screening earlier and undergo screenings more frequently.
A colonoscopy may be recommended to evaluate symptoms and identify their underlying causes. Unlike other imaging tests, colonoscopy provides a detailed view of the colon, enabling doctors to accurately diagnose conditions and determine the most appropriate treatment.
Common symptoms that might require a colonoscopy include:
- Rectal bleeding
- Abdominal pain
- Changes in bowel habits
- Unexplained weight loss
In some cases, minor procedures may be performed to address certain problems discovered during a colonoscopy. This may include:
- Removal of polyps (polypectomy)
- Removing blockages or any objects in the colon
- Sealing wounds
There is a common misconception that bowel preparation for colonoscopy is intolerable. This often stems from concerns about frequent bathroom trips and potential abdominal cramping. However, there are ways to make the process more tolerable for most individuals.
Here are some tips to enhance your colonoscopy prep experience:
- Follow Doctor's Instructions: Following the prescribed regimen for bowel prep medications is crucial for a successful and more comfortable procedure.
- Stay hydrated: Drink plenty of clear liquids like water, clear broth, and diluted fruit juices (apple, white grape) throughout the day before your prep. This helps prevent dehydration, which can worsen side effects.
- Low-fibre Diet: Begin a low-fibre diet 2-3 days before your colonoscopy. This helps reduce the amount of residue in your colon, making the cleansing process more effective.
Colonoscopy may cause mild discomfort during the procedure. This is typically due to the insertion of air into the colon to improve visibility, which can cause cramping, pressure, and bloating. However, sedation is administered to ensure patient comfort throughout the examination. Sedation options include:
- Light Sedation (Conscious Sedation): This is the most common type of sedation used during a colonoscopy. It involves medications that relax and calm the patient. Patients may feel drowsy or even fall asleep, but they typically do not remember the procedure afterwards.
- Deep Sedation or General Anaesthesia: In cases where conscious sedation is not sufficient, deep sedation may be used. This level of sedation induces a deeper state of unconsciousness during the procedure.
Following the procedure, patients are typically monitored in the recovery area for a few hours. During this time, medical professionals observe for any complications, such as bleeding or excessive discomfort. Once the effects of sedation have fully subsided, patients are generally discharged to go home.
Healthcare providers will provide comprehensive post-procedure care, which may include:
- Dietary Recommendations: Patients are generally advised to consume easily digestible foods such as soup and scrambled eggs. It is also advisable to limit high-fibre foods and dairy products, which can cause discomfort in some individuals.
- Managing Discomfort: It is common to experience flatulence (passing gas) and some abdominal cramping after the procedure. Walking and gentle movement can help alleviate mild discomfort.
- Hydration: Increase fluid intake to replenish fluids lost during the bowel preparation.
While it is common to experience some abdominal pain and bleeding, patients are advised to seek immediate medical attention if they experience symptoms such as:
- Fever or chills
- Frequent, bloody stools
- Severe abdominal pain or swelling
- Rigid or distended abdomen
- Inability to pass gas
While the idea of a colonoscopy might seem daunting, modern techniques and sedation options minimise discomfort during the procedure. If you are scheduled for a colonoscopy, your doctor will provide personalised guidance on the screening process, addressing any concerns you may have about pain or discomfort. Contact us today to learn more.