Papafragkakis
Charilaos Papafragkakis, MD
Gastroenterologist - Hepatologist

Colonoscopy

Colonoscopy is the basic test for the early diagnosis of colon cancer. It is a very important preventive test, like mammography and Pap test. That means that someone does not need to have symptoms in order to have colonoscopy. It is a very common and safe examination done by conscious sedation, i.e. the patient is asleep.

Colonoscopy is recommended for every adult male or female over 45 years of age, and in case of a completely normal examination it is recommended to repeat it every 10 years.

If a first-degree relative of yours has colon cancer at an early age, you may need colonoscopy earlier than 45 years of age.

When cancer is diagnosed at an early stage, the chances of successful treatment are greater. Each patient should be observant of any changes in the normal bowel habits, such as blood in the stool, new and unusual constipation or new anemia and consult his or her physician without delay. Colonoscopy is a procedure that is usually done to investigate gastrointestinal symptoms such as abdominal pain, blood in stool or changes in bowel habits or in cases where there is a family history of dangerous polyps or cancer of the colon.

There is an increased risk of colorectal cancer in the following cases:

  • Personal history of adenomatous polyps in the intestine
  • Family history of colon cancer or precancerous polyps (adenomas). In other words, when a member of your family has colon cancer or precancerous polyps
  • Family history of adenomatous polyposis or suspicion of familial adenomatous polyposis without having been documented genetic diagnosis
  • Personal or family history of inherited non-polyposis colon cancer (Lynch syndrome)
  • History of inflammatory bowel disease (Ulcerative colitis, Crohn's Disease).

What are polyps?

Usually with colonoscopy we are looking to find polyps and to remove them endoscopically. Polyps are usually small bulges in the bowel wall that may grow over several years and eventually become cancer. Some are relatively easy to detect, but some are more flat and therefore more difficult to detect. That is why it is very important to prepare properly before the colonoscopy.

Steps for a successful colonoscopy

The most important step is the proper preparation of the bowel. If the intestine is not sufficiently clean we will probably not be able to see everything. Your primary goal is to clean the bowel as well as the palm of your hand.

  • Follow the instructions for using the special laxative
  • Follow the diet guidelines
  • Do not drink anything or water for at least 2 hours before the colonoscopy. The stomach must be empty.

Sometimes you may feel irritation in the perianal area due to liquid stool during the preparation. To avoid or minimize irritation, you can put Vaseline to the skin round the anus before you start the bowel preparation. Clean the area well with wet wipes or just water instead of regular toilet paper.

It is essential to tell your doctor about any medications you may be taking. It is important to know if you are taking aspirin, medicines that affect blood clotting, anti-inflammatory, joint medications, iron or insulin. If you have diabetes, you may need to reduce the dose of insulin or other medicines.

What happens during colonoscopy

The endoscope is inserted from the rectum and advanced to the end of the colon, which is located in the lower right side of the abdomen. If necessary, biopsies may be obtained from the bowel wall or polyps may be removed.

  • When you come to the hospital for the examination you will be asked to wear a hospital robe
  • Nursing staff of the endoscopy department will place a small IV catheter in your hand
  • You will be asked to turn on your left side and you will be given an anesthetic medicine from the vein
  • The duration of the colonoscopy is approximately 30 minutes, but it may last longer depending on the difficulty, the quality of the bowel preparation and the findings.

What happens after the colonoscopy

  • You will stay in the recovery area for a while, until you are ready to get dressed and go home
  • You must have a responsible family member or a friend to take you home because you are not allowed to drive immediately after colonoscopy
  • Avoid drinking alcoholic drinks or operating machinery for 24 hours after the colonoscopy
  • You can usually return to your normal diet immediately after colonoscopy
  • If polyps are removed or biopsies taken, you may see a little blood from the rectum for 1 to 2 days after the colonoscopy. That may be normal. However, If you see a large amount of blood, have a high or persistent fever or severe abdominal pain within the next 2 weeks, contact your doctor or go to the hospital.

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