Colonoscopy / Endoscopy

Endoscopy is a term used to describe procedures where scopes are used to view the insides of the body. The term endoscopy means to “look inside”.  There are many types of endoscopic procedures but the two most common are colonoscopy and esophagogastroduodenoscopy.  The term esophagogastroduodenoscopy is often referred to as an EGD or just as an endoscopy because of the frequency of use.

A Colonoscopy is a procedure where a fiber- optic scope is inserted into the anus to examine the large bowel.  While performing the colonoscopy, the doctor can take pictures, biopsy portions of the colon for examination, or remove polyps and lesions with a snare device that is inserted into the scope.

Colonoscopies are used to diagnose changes in bowel habits such as diarrhea, constipation, a decrease in stool caliber, blood in stool as well as other gastrointestinal problems like massive bleeding or anemia.  Colonoscopies are also used as a preventive measure against colorectal cancer.   It is recommended that adults have a screening colonoscopy done every 10 years starting at age 50 and if they have a family history of colorectal cancer to have a colonoscopy every 5 years.

Prepping your colon for a colonoscopy procedure is vital to ensure the procedure goes well.  Without adequate removal of intestinal and bowel waste, the endoscopist cannot properly see the lining inside the colon.

colonoscopy

One week prior

Stop taking Aspirin, Ascripton, Naprosyn and any products containing Ibuprofen, Motrin, Aleve, and Advil. Tylenol or Acetaminophen is okay.  Stop taking iron tablets or vitamins with iron.  If you are on Coumadin, or any “blood thinners”, e.g. Plavix, or Aggrenox, you need to make a plan with your doctor, at least one week ahead of time, regarding these medications.  Do not eat popcorn, nuts, seeds or corn.  Stop all fiber supplements (Metamucil, Citrucel, Fibercon, etc.)

One day prior

Only clear liquids may be taken the day before.  Clear broth, black coffee or tea, flavored gelatin (NOT RED), fruit juices without pulp, soda, sports drinks, and water are all acceptable choices.  Stay away from alcohol, any juice with pulp, all dairy products, and anything not naturally red in color (NO RED DYE).   A light breakfast is allowed if the procedure is scheduled for the afternoon of the following day.   Examples of a light breakfast would include Toast & Fruit, Cereal & Fruit, or a small bowl of oatmeal & fruit.  This should be a small breakfast and should be finished before 9am.  Continue to take all your regular medications (including blood pressure medication) with the exception of the blood thinners and Aspirin.

That day, you will take a laxative type drink. The drink must be taken before the procedure to expel all waste from the colon.  There are a few options when it comes to this mixture and the patient is given one according to the Doctor’s recommendation.  This is typically taken in the afternoon or evening (some the day of) but all preparations are different and the individual instructions need to be followed.  The worst part of a colonoscopy is becoming dehydrated. Be sure to stay hydrated by drinking plenty of water before the procedure.

Day of the procedure

You may have clear liquids up until four hours before your procedure.  Then, four hours prior to the procedure, nothing by mouth, not even water.  You may rinse & swish at any time, but you must not swallow.  You may also brush your teeth if you are careful not to swallow.

The final step of colonoscopy preparation involves going to the appointment and relaxing. A sedative is given to you through an IV tube. This sedative is designed to relax the body but not put it in a complete deep sleep. The camera will be inserted and the procedure should only take 30 minutes to an hour. If there are abnormalities then they will be biopsied and/or photographed.

Important things to remember

Make sure that there is a responsible driver to take you to and from your procedure.  They will be responsible for getting you to and from your appointment but will also listen to post-operative instructions as you may still be experiencing some confusion from the sedative.

An Esophagogastroduodenoscopy or EGD is a procedure where a fiber optic scope is inserted through the mouth and down the throat.  A mouth guard is put in place to keep you from biting down on the scope and the scope is inserted over the tongue and down the throat into the esophagus.

EGDs are used to diagnose upper gastrointestinal bleeding, vomiting, heartburn, gastroesophageal reflux disease, Barrett’s esophagus, dysphagia and nausea to name a few.  GERD- Gastroesophageal reflux disease is a condition in which the stomach contents (food or liquid) leak back from the stomach up into the esophagus (the tube from the mouth to the stomach). This action occurs when the muscle between the stomach and the esophagus does not close properly or opens often, allowing acid to flow into the esophagus.  This action can irritate the esophagus, causing heartburn and other symptoms.  Many of you have heard of GERD or Acid Reflux Disease but may be unaware that you are experiencing symptoms at all.

Symptoms include

  • A Feeling of food stuck behind the breastbone
  • Heartburn-Especially at night and while bending over, lying down, or eating
  • Nausea after eating
  • Regurgitation(food coming back up into the throat)
  • A chronic cough or wheeze
  • Difficulty swallowing
  • Sore throat or sour brackish taste in the mount
  • Hiccups
  • Hoarseness or change in voice

GERD can lead to more serious problems of the esophagus including esophageal cancer or Barrett’s Esophagus.   It is important to contact your physician if you have any of these symptoms to rule out more serious conditions.

Twenty percent of Americans suffer from heartburn at least two times a week and 10 to 20 million Americans suffer from GERD.

  • Ten to 15 percent of people with GERD will develop Barrett’s esophagus.
  • Thirty percent of esophageal cancers are related to GERD.
  • GERD can occur in adults, children, and even babies.

GERD can still be present in people who do not have heartburn. Other symptoms include coughing, asthma-like symptoms, and problems swallowing food.