COLONOSCOPY INSTRUCTIONS USING DR. CASSADAY’S PREP
COLONOSCOPY
Colonoscopy is the
examination of the colon (or large intestine) by the insertion of a flexible
light tipped tube (colonoscope) into the rectum and hence into the colon which
allows direct visualization of the lining of the colon.
Colonoscopy is used to
diagnose cancer, polyps, inflammation (for example, colitis), and causes of
bleeding, and abnormal or questionable x-rays. If the doctor sees a suspicious
area or needs to evaluate an area of inflammation in greater detail, he can
pass an instrument through the colonoscope and take a sample of tissue (a
biopsy), for examination in the laboratory. Biopsies are taken for many reasons
and do not necessarily mean that cancer is suspected.
During the course of the
examination a polyp may be found. Polyps are abnormal growths of tissue, which
vary from size to a tiny dot to several inches. Polyps require biopsy and
removal with a very small instrument through the colonoscope and are sent to a
lab for analysis. Biopsy results take 5-7 days. You will be notified of the
results. You should feel no pain during removal of the polyp. Polyps are
usually removed because they can cause rectal bleeding or may contain cancer.
Although the majority of polyps a benign (noncancerous), a small percentage may
contain an area of cancer in them or may develop into cancer. Removal of colon
polyps, therefore, is an important means of prevention and cure of colon
cancer, which is a leading form of cancer in the United States.
WHAT TO EXPECT
Colonoscopy may take
anywhere from 15 to 45 minutes. You should allow yourself 2-3 hours total time
at the Regional Surgery Center. Preparation for the procedure by the nursing
staff will take approximately a half hour. This takes place in the pre/post
procedure area. You will be given a gown to wear and an IV will be started. We
recommend that you wear loose fitting clothes the day of your procedure. You
are discouraged from bringing valuables with you.
You will be transported
by cart to the procedure room. You will be positioned on your left side with
your knees drawn up. Intravenous sedation will be given. Sedation medications
are provided for your comfort and relaxation during the procedure. When the
procedure is completed, you will rest until the sedation wears off. Your pulse
and blood pressure will be monitored during and after the colonoscopy. You may
feel some pressure and fullness in the abdomen after the procedure because of
the air that was introduced to examine your colon, but it passes easily in a
short time.
Your doctor will tell you
the results of your colonoscopy and findings are usually available when
sedation wears off. Biopsy results take several days.
You will be given a list
of instructions before you leave.
RISKS OF THE PROCEDURE
Colonoscopy and
polypectomy are safe and associated with very low risks when performed by a
trained and is experienced in these endoscopic procedures. But there is some
risk in everything we do from stepping out of the bathtub to driving a car to
the doctor’s office. Specifically, there is a very slight chance of having an
allergic reaction or other reaction to the medication used during the
procedure. Another complication, which occurs in about 2% of the population, is
perforation of the lining of the colon or a tear through the wall of the bowel,
which may allow leakage of intestinal fluid. This complication may require
surgery but is usually managed with antibiotics and IV fluids in most cases.
Bleeding may also occur from the site of the biopsy or polyp removal. It is
usually minor and stops on its own or can be controlled by cauterization
through the colonoscope. Rarely, transfusions or surgery may be required. We
would not be suggesting this procedure for you of we felt its risks were
greater than the risks of not getting the desired information about your colon
or carrying out the necessary treatment through the colonoscope. Every possible
precaution will be taken to minimize the possibility if any complication of the
examination.
PREPARATION FOR THE EXAMINATION
1.
It is extremely
important that you follow our instructions. Failure to follow these
instructions could lead to an unsatisfactory exam, which might have to be
repeated.
2.
If you are on medication for high blood pressure
or a heart condition, please take your medication the day of your procedure. Throughout the preparation period you may continue
all of your usual medications except medications containing iron.
These should be stopped one week before the examination. If you are currently
taking any of the following medications, please let us know immediately so that we may adjust or stop this medication
before examination: Coumadin, Aggrenox, Agrylin, Halfprin, Persantine, Plavix,
Pletal, Ticlid. We will give you special
instructions if you are a diabetic.
3.
A companion
must accompany you home from the facility because you will be given a
medication to help you relax. You will not be allowed to drive after the
procedure. Even though you may not feel tired, your judgment and reflexes may
not be normal. You should be able to resume driving and other normal activities
the next day.
4.
Two evenings
before your procedure at 8 p.m. drink 5 oz. of Magnesium Citrate.
5.
The morning
before your procedure begin a diet composed entirely of clear liquids and
remain on this until after the procedure. The diet may include:
§
Water
§
Tea or coffee
with sugar, but without milk or cream
§
Plain chicken
broth, beef broth, or bouillon
§
Clear fruit
juices (may include red); apple, cranberry, grape, powdered
lemonade, kool-aid, and soda pop, including cola drinks
§
Popsicles (any
color)
6.
At 8 a.m. the
morning before your procedure, drink 5 oz Magnesium Citrate.
7.
Stay on clear
liquids throughout the day.
8.
You will be
given a prescription for Golytely or Nulytely prep. It will come in a powdered
form, with instructions as to how to mix it. Mix and refrigerate before
drinking.
9.
At 4p.m. Begin
drinking the solution. Drink a glassful at a time (slower if needed) throughout
the evening. You will probably experience diarrhea approximately 20 minutes
after the first glassful. Some people have reported that it took one hour
before they experienced diarrhea but that is unusual. You may expect to have a
bowel movement after every glassful you drink. REMEMBER: You may not eat or drink anything while you are
taking the prep. DO NOT mix the
solution with anything, not even ice, as this will change the composition of
the solution and make it absorbable. You may use a straw to reduce the taste.
10. NOTHING
TO DRINK FOR 4 HOURS P