Dorothy FarrarColonoscopy
Optical colonoscopy is a standardized routine examination of the intestinal mucosa. It is primarily used for the early detection of colorectal cancer and chronic inflammatory bowel diseases. Inpatient and outpatient, it is a quick painless method to provide preventive care.
What is a colonoscopy?
Classical colonoscopy, also known as colonoscopy, is an optical examination of the large intestine and parts of the small intestine. The examination can be carried out as an inpatient or on an outpatient basis in a gastroenterological practice. In preparation, a colon cleansing must have taken place. This is carried out by the patient himself through a prescribed laxative. This examination is painless and takes about half an hour.
The patient is given a sedative medication before the examination so that he sleeps during the examination or a short anesthesia. An endoscope (= a thin, movable tube with camera) makes it possible to assess the intestinal mucosa. The entire mucous membrane is examined for color, injuries, adhesions or scarring. If an abnormality is found, a tissue sample is taken and examined more closely in the laboratory.
Applications
Typical applications of colonoscopy :
- Chronic bowel diseases
Colonoscopy is generally used to clarify an acute or chronic intestinal disease. Through the examination, chronic inflammation of the intestinal mucosa, such as those caused by Crohn’s disease or ulcerative colitis, can be detected. These patients often suffer from digestive problems, abdominal pain and chronic diarrhea. Many patients describe colicky pain, which is often caused by intestinal protrusions in old age. These protuberances are called diverticula. Here, bacteria can collect and promote inflammation, so that diverticulitis exists. Another reason for a colonoscopy is colorectal cancer screening from the age of 55. Since 2002, they have been covered by all health insurance companies.
The intestine is scanned for cancer and precancerous lesions, the polyps. However, not all polyps have to degenerate into cancer. If a malignant cancer is suspected, a sample is taken. In the case of familial accumulation of colorectal cancer, a regular examination of the intestine is recommended, so that precancerous lesions can be removed and treated in good time. An increased risk of developing colorectal cancer is found in familial adenomatous polyposis coli (FAP). FAP is a genetic disease in which precancerous lesions develop in the intestine. Even in the case of acute bleeding, it may be useful to perform an endoscopy to locate and stop the bleeding.
What methods and procedures are there?
In addition to classic optical colonoscopy, in which a flexible endoscope is inserted rectally into the intestine, there are also other non-invasive procedures for detecting intestinal disease. Virtual colonoscopy (using CT colonography or MR colonography) is also available. These virtual colonoscopies usually take place after optical colonoscopy, unless they were completely feasible. The advantage of such an examination is the high diagnostic benefit, since not only the intestine, but also the surrounding tissue can be better assessed. The data is evaluated quickly and the patient does not need anesthesia or recovery time after the examination.
What does the patient have to consider?
Optical colonoscopy is an invasive examination of the intestine. This should also be well prepared by the patient. A clean bowel provides a solid foundation for an optimal examination. Low-grain diet is recommended . Cereals and whole wheat bread should be avoided for three days prior to the procedure. The grains can hinder the examination and damage the endoscope. As a rule, you should not eat after 6 p.m. on the day before the examination.
It is necessary to consume a salty cleansing solution. This is perceived by most patients as almost inedible and can also trigger nausea . If possible, the entire content, about two liters, should be drunk in the evening. It is important not to start cleaning the intestines too late, so that you can avoid going to the toilet at night. Only drinking is allowed directly before the colonoscopy. If the patient is taking blood-thinning medication , this must be discussed with the doctor in good time beforehand. The return home after the treatment should be clarified in advance, as you are not allowed to drive a car after the anesthesia. It is often suitable to be picked up by a family member or friend.
==Execution – How does the examination work?== Before the actual examination, the patient data is checked and queried. A sedative is then administered to the patient or anesthesia with propofol is initiated. For the examination, the patient lies sideways on a couch. The examiner stands behind the patient and slowly inserts the endoscope into The Anus . The doctor follows what is happening in the intestine on a monitor. Now the endoscope is advanced step by step. Particular attention is paid to colour, shape, protuberances, inflammation or other pathological properties.
During the examination, photos are also taken of the conspicuous areas. If the doctor needs a more precise clarification of the Mucous membrane , he takes a tissue sample with a loop on the endoscope. The approximately 150 cm long tube is inserted to the beginning of the large intestine, so that small parts of the small intestine can often be examined. After about half an hour, the doctor removes the endoscope and the examination is over. The patient wakes up from the anesthetic and remains in bed after the examination until the circulation has stabilized. This is usually followed by an interview with the doctor. The findings and the further procedure are discussed.
Self-service or health insurance – who bears the costs?
Colon cancer screening has been covered by health insurance twice in 20 years since 2002. Further examinations are paid for by health insurance if the patient belongs to a risk group, such as a family history of colorectal cancer. In the case of an existing chronic intestinal disease or acute bleeding from the anus, the examination is also taken over. If the health insurance companies do not cover the costs, or if the patient pays for himself, an examination costs between €300 and €450 including the laboratory costs. The costs for the Anesthesia are additional.
Risks, complications and side effects
Bleeding may occur during a colonoscopy. These can be caused by bursting polyps. In inflammatory bowel diseases, the Intestinal mucosa is often very irritated and can also bleed. It can also bleed easily after a biopsy. This bleeding can also occur the day after the examination. If the bleeding persists, a conversation or further examination should take place.
In the case of acute inflammation of the intestinal mucosa or Intestinal perforation , the colonoscopy must be performed at a later date. Inflammation weakens the stability of the mucous membrane, so that an intestinal breakthrough (= perforation) can occur. This can be fatal in peritonitis. Slight abdominal pain or cramps may occur a few days after the examination. However, if these persist, you should see your doctor again.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.