Paracentesis

TIPS

What is the colon?
The colon, or large bowel, is the last portion of your digestive or GI tract. It starts at the caecum, which attaches to the end of the small intestine, and it ends at the rectum and anus. The colon is a hollow tube, about five feet long, and its main function is to store unabsorbed food products prior to their elimination.

What is meant by a Colonoscopy?
The term "colonoscopy" means looking inside the colon (Large bowel) using a fiber-optic or a video endoscope. It is a procedure performed by a gastroenterologist, a well-trained specialist.

What is the instrument used?
The main instrument that is used to look inside the colon is the colonoscope, which is a long, thin, flexible tube with a tiny video camera and a light on the end. By adjusting the various controls on the colonoscope, the gastroenterologist can carefully guide the instrument in any direction to look at the inside of the colon. The high quality picture from the colonoscope is shown on a TV monitor, and gives a clear, detailed view.

Colonoscopy is more precise than an X-ray. This procedure also allows other instruments to be passed through the colonoscope. These may be used, for example, to painlessly remove a suspicious-looking growth or to take a biopsy-a small piece for further analysis. In this way, colonoscopy may help to avoid surgery or to better define what type of surgery may need to be done.

The colonoscope, is long enough to inspect all of the large bowel and even part of the small intestine. Colonoscopy is a safe and effective way to evaluate problems such as rectal bleeding, anemia, pain, and changes in bowel habits such as chronic diarrhea or abnormalities that may have first been detected by other tests. Colonoscopy can also identify and treat active bleeding from the bowel
.
Colonoscopy is also an important way to check for colon cancer and to treat colon polyps - abnormal growths on the inside lining of the intestine. Polyps vary in size and shape and, while most are not cancerous, some may turn into cancer. However, it is not possible to tell just by looking at a polyp if it is malignant or potentially malignant. This is why colonoscopy is often used to remove polyps, a technique called a polypectomy.

What is a sigmoidoscope?
A shorter version of the colonoscope is called a sigmoidoscope, an instrument used to screen the lower part of the large bowel only.

How Do I Prepare for the Test?
It is best if you avoid taking aspirin or non-steroidal anti-inflammatory drugs for several days before this test to reduce the risk of bleeding if any biopsy sample needs to be taken. Let your doctor know if you have an artificial heart valve or have had a heart­valve infection "endocarditis", because your doctor may want to prescribe antibiotics for you. Tell your doctor about any prior surgeries that you have had in the abdomen or allergy to drugs.

In order for the doctor to get a clear look at the lining of your large intestine, you will be asked to drink only clear liquids (such as juice or broth) the night before the procedure. During the afternoon and evening of the day before the procedure, you will need to completely clear your bowels of stool by drinking a special fluid that will help flush out your intestines. Your doctor will choose the type of fluid depending on your other medical conditions. You will want to stay at home the evening prior to the test, since this fluid will make you need to go to the bathroom frequently. Some doctors will have you use a laxative medicine instead or in combination with this liquid. If your doctor wants you to be especially thorough, he or she may ask you to use an enema 30 to 60 minutes before the procedure to help rinse and empty your bowels. Using the enema you will fill your rectum with a quantity of salt water or tap water. The enema will make you have one last bowel movement.

If you are taking coumadin or insulin, discuss this with your doctor before the test, but please take your other medications in the usual way and time, and bring all medications with you.

Because of the medicine you will be given for this test, you will need to arrange for someone to drive you home.

What Can You Expect During a Colonoscopy?
During the procedure, everything will be done to ensure your comfort. Blood pressure, pulse and oxygen saturation will be monitored. An intravenous, or IV, line will be inserted to give you medication to make you relaxed and drowsy. The drug will enable you to remain awake and cooperative, but it may prevent you from remembering much of the experience.

Once you are fully relaxed on your left side, bending your hips and knees, your doctor will do a rectal exam with a gloved, lubricated finger; then the lubricated colonoscope will be gently inserted.

As the scope is slowly and carefully passed, you may feel as if you need to move your bowels, and because air is introduced to help advance the scope, you may feel some cramping or fullness. You may pass wind but, although this is embarrassing, remember the staff does understand what is causing it. Generally, however, there is little or no discomfort or you may be asked during the test to lie on your back.

What are the Possible Complications from a Colonoscopy?
Although colonoscopy is a safe procedure, complications can sometimes occur. These include perforation - a puncture of the colon walls, which could require surgical repair. This is a rare complication (less than 1: 1000).

When polyp removal or biopsy is performed, hemorrhage (heavy bleeding) may result and sometimes require blood transfusion or reinsertion of the colonoscope to control the bleeding. Be sure to discuss any specific concerns you may have about the procedure with your doctor.

The time needed for colonoscopy will vary, but on the average, the procedure takes about 30 minutes. Afterwards, you'll be carried for in a recovery area until the effects of the medication have worn off. At this time, your doctor will inform you about the results of your colonoscopy and provide any additional information that you need to know. You'll also be given instructions about how soon you can eat and drink, plus other guidelines for resuming your normal routine.

What Can You Expect After Your Colonoscopy?
Occasionally, minor problems, such as bloating, gas, or mild cramping may persist. However, they usually disappear within 24 hours or less. By the time you're ready to go home, you'll feel much stronger and more alert. Nevertheless, it is advised to have a family member or friend take you home, and to rest for the remainder of the day.

You must not drive for 24 hours as sedation impairs your judgment. You should not operate any machinery, sign any legal papers or travel by yourself for 24 hours.

If you experience any repeated vomiting, bleeding or severe pain, contact your doctor or the Emergency Department.

How long it is before the result of the test is known?
Your doctor can tell you what was seen in your colon right after the test. If biopsy samples or polyps were removed, these will require a few extra days to be inspected in the lab before your doctor has a report.