Colonoscopy Laboratory

WHAT IS COLONOSCOPY?

It is a safe and effective visual examination of the entire lining of the large intestine with a long and bendable tubular instrument. The thickness of the device is smaller than our finger.

Colonoscopy Laboratory

It is used in the diagnosis of large intestine diseases, taking biopsy and removing polyps. It can be done many times without the need for hospitalization and with very little discomfort to the patient.

WHO SHOULD HAVE A COLONOSCOPY?

Problems such as changes in defecation habits and bleeding indicate possible problems in the large intestine and the doctor may recommend a colonoscopy. At the same time;

  • Controlling unexplained abdominal pain and symptoms
  • Control of inflammatory bowel diseases (Colitis, Crohn’s Disease, Ulcerative Colitis)
  • When a polyp or tumor is suspected on barium radiographs of the large intestine
  • In those with blood detected in the stool
  • Unexplained diarrhea and changes in defecation habits
  • In patients with previous colon polyps or cancer
  • Colonoscopy should be performed in those with a family history of polyps or Colon Cancer.

INFORMATION THE PATIENT SHOULD GIVE TO THE DOCTOR BEFORE COLONOSCOPY:

Does he/she use blood thinning drugs / aspirin and its types (Voltaren, Apranax, Ibufen, Naprosin etc.)?

Do you have a health problem that requires the use of antibiotics?

Do you have a tendency to bleed? (Does nosebleeds, bleeding after accidents take a long time?

Do you have diabetes / Heart disease / Neurological disease? Is she pregnant ?

HOW TO PREPARE FOR A COLONOSCOPY?

Eating and drinking

Restricting fibrous foods and consuming fiber-free foods at least 3-4 days before the day of the procedure will be beneficial for bowel cleansing. No food should be eaten on the day of the examination. If using, heart, blood pressure and thyroid medications should be taken with water.

Special cases / Medication use

  • Those who are allergic to any drug, have heart and lung diseases and pregnant women should inform the doctor about their condition.
  • Patients using insulin can consult their metabolism doctors to adjust the drug dose on the day of the procedure. They can use their medications after the procedure by bringing them to the unit where colonoscopy will be performed.
  • Patients using blood-thinning drugs (coumadine, dipyridamole, ticlopidine, etc.) should consult their doctor before the procedure and ask for these drugs to be adjusted for colonoscopy.
  • Aspirin and other anti-inflammatory drugs (ibufen, naprosin, etc.) should be discontinued at least 1 week before colonoscopy.
  • At least 1 week before the procedure, fibrous food should be consumed and ready-made fiber products and iron preparations should not be used.
  • In addition to the above, if there are other medications that the patient uses regularly, especially if there is an obligation to use antibiotics, it is necessary to inform the doctor about them when making an appointment.
  • You should not stop all medications that you need to stop due to colonoscopy without talking to your doctor about that disease.

Bowel Preparation

Intestinal cleansing should be done before colonoscopy. A good bowel cleansing is essential in order to examine the layer that covers the inner surface of the large intestine. For this reason, the doctor may recommend fibrous food restriction a day or two before the procedure. In addition, special solutions are given orally for intestinal cleaning, which provide cleaning in a short time. Since there will be excessive water loss during this rotation, it is necessary to drink plenty of water.

Necessary Medicines for Intestinal Preparation;

  1. Fleet Oral 45 ml 2×1 (two bottles)
  2. Fleet enema 2×1 (two bottles)

*NOTE: When making an appointment for your medications, have your doctor write your prescription.

Use of Medicines – Both Medicines are Used Together at Different Times on the Same Day.

No solid food will be eaten 2 days before the appointment, only water and liquid foods (you can consume as much as you want from liquids such as water, compote juice, fruit juice, apple juice, grape juice, linden, broth, chicken broth, boiling water) will be taken.

Fleet Oral 45 ml Usage:

Drink the entire first bottle of fleet oral 45 ml at 18:00 1 day before the appointment. Drink 4-5 glasses of water after taking the medicine. Drink 2 pearl bottles of fleet oral 45 ml in full at 24:00 of the same night. Drink 4-5 glasses of water after taking the medicine.

Fleet enema 45 ml Usage:

1 day before the appointment, at 16:00, in the left side lying position, squeeze all of the fleet enema into the anus for 5-10 minutes, then perform your defecation. On the same day, at 07:00 in the morning, in the left side lying position, squeeze all of the fleet enema drug into the anus. After 5 – 10 minutes lying on your left side, perform your defecation. Drink at least 12 glasses (2.5lt) of water throughout the day one (1) before the Appointment Date.

REMEMBER! If you do not make the preparation completely, your procedure will not be done because your intestines will not be clean and you will have to make an appointment again. You can drink Fleet orals by adding them to juice. Even if you drink little by little, you have to finish all two bottles. If you vomit the medicine you have taken, do not drink the same amount of medicine again

HOW IS COLONOSCOPY PERFORMED?

Blood pressure and pulse rate are recorded by the nurse in the unit where the procedure will be performed. The nurse opens an intravenous line and inserts an IV to give sedatives and painkillers during the procedure.
To perform the colonoscopy procedure, you lie on the stretcher in the left side position and the feet are pulled towards the abdomen. The doctor first examines the anal area. Using gloves, he evaluates the last part of the large intestine and the anus with his finger. Following this, the colonoscopy device is advanced through the anus and begins to examine the large intestine. In order to perform this examination, the intestine must be inflated by injecting air into it. During this procedure, some patients may experience tension and cramp-like pain. All of these complaints will go away when the procedure is completed. The examination continues until the large intestine meets the small intestine. Thus, the entire large intestine (colon and rectum) is examined. During the procedure, biopsies (tissue pieces) can be taken from necessary places and polyps (raised benign formations in the large intestine), if any, can be removed.
The procedure can be performed under light sedation, with little pain, usually in less than an hour, and the patient can eat normal food the same day. After colonoscopy, the feeling of tension and bloating is reduced by passing gas.

WHAT SHOULD BE CONSIDERED AFTER THE PROCEDURE?

  • Some sedating medications are given during colonoscopy. Accordingly, you should not drive that day or be alone after the procedure. After the procedure, fatigue is felt, reflexes are prolonged, and the instinct to make healthy decisions is suppressed. Therefore, it is best to be accompanied by someone. After the procedure, it is necessary to stay in the unit under observation for a while until you wake up well.
  • For the rest of the day, it is necessary not to go to work, not to make important decisions, not to take responsibility for small children, not to drink alcohol, and to rest.
  • If only a colonoscopy is performed: (no biopsy (swab) is taken)
  • You can return to normal diet on the same day
  • After the procedure, work that requires attention, driving and exercise should not be done for 12 hours.
  • If it is necessary to use blood thinning medication or aspirin, the medications can be started on the same day.
  • If colonoscopy and biopsy or polypectomy was performed: (if a piece was removed)
  • Unless the doctor says otherwise, you can return to your normal diet on the same day. Foods such as nuts, corn, etc. should not be eaten before 72 (seventy-two) hours.
  • After the procedure, work that requires attention, driving and exercise should not be done for 12 (twelve) hours.
  • Aspirin and similar medications should not be used for 7 (seven) days. If necessary, acetaminophen derivatives can be used.
  • It is necessary to consult a doctor for blood thinning medications.

WHEN TO TAKE A BIOPSY (PIECE / SAMPLE)?

If the doctor sees suspicious areas in the intestine during the procedure, he or she may want to take a sample for further examination. For this purpose, a piece is taken from the biopsy channel of the colonoscope with the help of a special tool. These taken tissue pieces (biopsy) are analyzed in the pathology laboratory. Depending on this result, other tests may be necessary.

WHAT IS POLYPECTOMY?

Polyps are formations that develop as a result of abnormal growth of the layer (mucosa) covering the surface of the large intestine (colon and rectum) and grow into the intestinal tract (lumen). In other words, the swellings on the covering that lines the inner surface of the intestine are called polyps. Removing the polyp with the help of endoscopy (colonoscopy-sigmoidoscopy) is called polypectomy. The polyp can be removed with the help of special tools during endoscopy. The diameters of polyps can vary from a few millimeters to a few centimeters. If the doctor sees a polyp during the examination, it must be removed with a colonoscope and sent for analysis. The patient does not feel pain during this procedure.

For larger polyps, more than one treatment method may be required to completely remove them. However, some polyps cannot be removed by endoscopic methods due to their size, position and number. In this case, the part of the large intestine containing the polyp must be removed by surgery.
Although small polyps often do not cause any symptoms, they grow over time and can cause complaints such as bleeding and abdominal pain. The majority of polyps are benign formations. Polyps need to be removed early as they are precursor lesions in the development of cancer.

WHAT ARE THE BENEFITS OF COLONOSCOPY?

With colonoscopy, polyps can be removed without the need for abdominal surgery, and it is more sensitive than radiological methods in examining polyps and early stage cancers. Removing polyps prevents complications such as bleeding and cancer development that they may cause in later stages.

If the person who will undergo colonoscopy regularly takes aspirin or other drugs that disrupt clotting, has a high tendency to bleed, or is diabetic, it is necessary to warn the doctor before the procedure. After the procedure, normal food can be eaten on the same day, and excessive exercise should be avoided for 12 hours. Patients who underwent polyp removal during the procedure should not take aspirin for 7 days. Those who use other blood-thinning medications should consult their doctor about restarting the medication, and should not take any medication that facilitates defecation for three days.

ARE THERE ANY SIDE EFFECTS OF COLONOSCOPY?

It is a reliable examination performed by a specialist and experienced doctor. It has some complications, although very rare. During the procedure, a tear may occur in the large intestine wall and intestinal contents may pass into the abdominal membrane. This may cause inflammation of the inner abdominal lining.

Another side effect is bleeding from the site where a piece was removed or a polypectomy was performed. These usually stop on their own. In rare cases, emergency surgery may be required to correct these side effects. Another problem is pain and redness where the serum is applied. If you experience severe pain, chills, shivering, vomiting, fever, or lots of fresh red blood coming from the anus after the procedure, you should definitely call the doctor.

WHAT IS FLEXIBLE SIGMOIDOSCOPY?

It is a safe and effective visual examination of the entire layer (mucosa) covering the inside of the sigmoid colon and rectum, the last part of the large intestine, with a flexible tubular instrument. It is shorter in length than the colonoscopy device. The thickness of the device is smaller than our finger. As in colonoscopy, it is used in the diagnosis of diseases located in the last part of the large intestine, in taking biopsies and in removing polyps. There is no need to stay in hospital for this procedure. It can be done by daily appointment. It is a procedure that causes very little discomfort to the patient.

WHEN IS FLEXIBLE SIGMOIDOSCOPY APPLIED?

It can be performed to clarify the causes of complaints such as rectal bleeding, change in bowel habits, and abdominal pain. Another important reason is that most (50-60%) of the polyps located in the large intestine are located on the left side of the large intestine (sigmoid-rectum). These polyps are precursor lesions for cancer and these precursor lesions need to be recognized and removed early. This process prevents the development of colon cancer. Therefore, flexible sigmoidoscopy should be performed. Cancer screening programs in Western society recommend that individuals over the age of 50 be screened for colorectal cancer with flexible sigmoidoscopy. This age may be lowered for those with a family history of colorectal cancer.

WHAT HAPPENS DURING FLEXIBLE SIGMOIDOSCOPY?

During this procedure, you must lie on your left side or face down on a special examination table, depending on the doctor’s preference. The frequently preferred position is the left lateral position. The feet are generally pulled towards the abdomen. The doctor first examines the anal area and the last part of the large intestine (rectum) with his finger using gloves.

HOW SHOULD I PREPARE FOR FLEXIBLE SIGMOIDOSCOPY?

Eating and drinking

You can eat and drink normally on the day of the procedure.

Bowel Preparation

There is no need to use any oral bowel cleansing medication. For this examination, it is sufficient to use only two ready-made enemas [medicine used to cleanse the intestines given anally]. It is necessary to apply one of the enemas two hours before the procedure and the other one one hour before the procedure, as described by the doctor. After the enema, it is necessary to keep the solution (medicine) given into the intestine for at least 10-15 minutes and go to the toilet when the need to defecate thoroughly is required, otherwise bowel cleaning will not be sufficient and examination cannot be performed.

Special situations/Medication use

Those who are allergic to any medication, those with heart and lung disease, and pregnant women should inform the doctor about their condition.

In addition to the above, if the patient uses other medications regularly, especially blood thinners and antibiotics, it is necessary to inform the doctor about these when making an appointment.

WHEN WILL I KNOW THE RESULT?

The doctor tells you the results of his examination immediately after the procedure is completed. If a piece of tissue (biopsy) was taken, the results can be learned later.

ARE THERE ANY SIDE EFFECTS OF FLEXIBLE SIGMOIDOSCOPY?

It is a reliable examination performed by a specialist and experienced doctor. It has some complications, although very rare. These are procedure-related bleeding and intestinal perforation. If you experience severe pain, vomiting, chills, chills, fever, or lots of fresh red blood coming from the anus after the procedure, a doctor should be called.

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