Colonoscopy
Faecal Occult Blood Test (FOBT)
Colonoscopy and Sigmoidoscopy are the most important
investigative procedures of the bowel.
At The Wales Day Centre (Sydney), the most modern equipment is used to assist in
the examination, diagnosis and treatment of diseases
that may be present in the digestive system.
 Left:
A modern colonoscope assists in examination, diagnosis and treatment.
The modern colonoscope
is an exceptional examination device. It consists of a tiny
video camera attached to a flexible tube which is no thicker
than your index finger. It is inserted into the rectum of a patient
under mild sedation and a perfect picture is shown on a television
screen.
A colour photograph can be taken at any time during the procedure.
Colonic conditions can then be diagnosed and minor surgery
can be performed through the colonoscope.
To allow a clear view of your bowel, you will be asked to drink
a special mixture on the day before your procedure. You will
also be advised about what you can eat and drink prior to your
admission.
An endoscopic colour photograph showing the presence of a polyp
inside the bowel. This polyp gave no symptoms whatsoever. It
was removed during the examination.
When you arrive at the centre, our trained nursing sister will
admit you, and before sedation, our anaesthetist will examine
you.
You will
then be ready for the investigation.
The procedure takes approximately
ten minutes. Conditions are often discovered which can be dealt
with during the procedure,
without the need for further appointments or hospital admissions.
Possible discoveries
- Colon polyps. Rectal polyps
- Colitis. Proctitis. Ulcerative Colitis. Crohn’s disease. Inflammatory Bowel Diseases
- Malignancy of the bowel. Cancer Carcinoma of the colon or rectum.
- Diverticulitis Diverticulosis.
- The cause of bleeding per rectum.
- The Cause of anal irritation. (itching)
- A normal colon and rectum. This may eliminate worries caused by bleeding per rectum, abdominal pain, anaemia, irritable bowel syndrome and other problems.
Investigation of symptoms and signs, Surveillance and Screening.
These three concepts are often confused. As a result of taking your history and examining you the doctor may recommend a colonoscopic investigation. Surveillance differs from the above. As a result of your previous colonic problem it may be necessary to reexamine you colon from time to time. It may also be necessary to do this as a result of your family history if a close member of your family has or has had colonic polyps or cancer.
Surveillance is also recommended for people who are older than 50 years who do not have the above indications for colonoscopy. This recommendation however is controversial.
Screening is a method of discovering a disease although there is no specific reason for doing so. Clearly screening must be absolutely free from complications and generally should be cheap.
Complications
Colonoscopy is a safe procedure. Complications are rare. Going home after the procedure could be hazardous.. After the sedation usually necessary for a colonoscopy a patient must not drive or perform complex tasks such as crossing a busy road. The patient should be driven home and should stay there until the next day.
Bleeding. This complicates approximately one in every thousand procedures. It usually resolves rapidly but may require hospitalisation for a few days. Perforation of the bowel is also very rare. Although very unlikely to be life threatening it may require an operation to suture the defect in the bowel. This would necessitate a stay in a hospital. Other complications are even rarer and may relate to the patients fitness for the procedure. Obviously a preoperative assessment with regard to breathing problems, heart disease, diabetes and other conditions must be made.
Virtual Colonoscopy. (Colonography)
This is a method of visualising the colon by means of an Xray C.T. scanning technique.
Unfortunately there are many problems with regard to its widespread use.
- It requires the same bowel preparation as a regular colonoscopy.
- It does not show small polyps in the colon.
- If a problem is found by the scan a biopsy and regular colonoscopy is additionally needed. This would require another bowel preparation.
- The radiation dose administered is considered to cause a slight risk of cancer especially with patients under the age of 50.
- Patients complain of more pain and discomfort during virtual colonoscopy than with regular colonoscopy which is performed under sedation.
- It cannot adequately diagnose colitis.
- The cost is considerable.
Faecal Occult Blood Test (FOBT)
This is a screening test for symptom free persons. If a disease of the colon or rectum is suspected it should not be used.
Barium enema Xray
This investigation has been largely superseded by colonoscopy. It should be used when colonoscopy is not available. On the rare occasions when colonoscopy proves inadequate a barium enema can be additionally performed.
Click for a diagram of 'The Diseases of the Digestive System'
Return to Colonoscopy Information for Patients
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