Colonoscopy is a digestive endoscopy examination that allows the study of the internal wall of the colon. It is currently the only examination which allows the colon to be analyzed reliably and which allows the removal of polyps and the detection of cancer of the colon and rectum.
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Other examinations can be used in case of contraindication to a colonoscopy: The barium enema and the abdominal scanner . Virtual colonoscopy is currently being evaluated.
* The Barium Enema is an examination which consists in injecting into the rectum and the colon, a product opaque to X-rays, baryta, then taking X-ray images by varying the orientation of the rays. It was for a long time essential to search for cancers of the colon, but, today, it is advantageously replaced by colonoscopy, which makes it possible to explore the whole colon.
* Abdominal scannerremains an examination also which is carried out when colonoscopy is contraindicated. It is a powerful examination when it is carried out with injection. It makes it possible to objectify advanced colon cancer with stenosis with good sensitivity and specificity, but I remind you that the interest is to diagnose a cancer that is not very advanced and which may be resectable. This is why colonoscopy remains essential.
On the other hand, the abdominal scanner is used in first intention in the diagnosis of diverticulitis or diverticular inflammation. Indeed, it is contraindicated to perform a colonoscopy in this context because there is a risk of perforation.
Indications for colonoscopy
Your doctor may prescribe this examination if you have abdominal pain or transit disorders such as diarrhea or constipation. This is the most common indication. The interest, in this context, is to clear an inflammatory attack of the colon by visualizing the colonic wall and by performing biopsies.
A family history of colon cancer is the second indication for colonoscopy. It is indeed necessary to look in this context for polyps which can evolve into colon cancer. Colonoscopy is the best screening examination for this indication.
The presence of blood in the stoolrequires the performance of a colonoscopy in search of an inflammatory disease of the colon, diverticular hemorrhage, cancer of the colon or rectum.
The existence of anemia by iron deficiency even without visible bleeding requires the realization of a colonoscopy in search of an inflammatory disease of the colon, a cancer of the colon or the rectum.
Colonoscope on his video column
A control system located at the end of the endoscope allows the doctor to rotate the head of the colonoscope in all four dimensions to help progress by following the curvatures of the intestine. Thanks to two other commands, the doctor can aspirate liquid or air, inject air or rinse with water in order to clearly visualize the walls.
The colonoscope has a working channel that allows the use of biopsy forceps to take samples for laboratory analysis. This channel also makes it possible to introduce a “small lasso” which makes it possible to carry out a polypectomy.
Forceps for biopsy coming out of the working channel
Between each patient and according to the regulations in force, the endoscope is disinfected in a tray then machine washed and all the accessories used (biopsy forceps, etc.) are sterilized or discarded (single-use material). These procedures refer to preventing possible transmissions of infections.
Necessary preparation for colonoscopy
You must follow a residue-free diet for 2-3 days before the exam. This diet prevents food residue from remaining during the examination. You have an example of a residue-free diet to follow before performing the colonoscopy on the site.
Preparation the day before and the day of the exam:
The preparation for the exam is demanding but it is essential for a quality exam. The colon must be perfectly clean, to allow a precise examination and to carry out the useful therapeutic gestures.
The day before the examination, you must ingest a liquid whose purpose is to cleanse the colon.
In all, you must absorb 4 liters of this product (1 sachet diluted in 1 liter of water) either in a single dose the night before or divided (2 liters the night before and 2 liters in the morning). The volume of 2 liters must be taken in less than 1 hour to have the expected effectiveness.
If you have not been able to take the full amount of this product, you should inform the doctor or nurse. If the colon is not clean enough (the appearance and consistency of the stools are suggestive), the doctor or nurse can give you 1 liter of additional solution or 1 or 2 enemas of NORMACOL
After the preparation, you must be on a strict fast (without drinking, eating or smoking), unless otherwise advised by the doctor who will carry out your examination.
If you benefit from a colonoscopy under GA you will have a consultation with an anesthetist a few days before.
The diagram below shows you the progression of the colonoscope from the anal canal to the cecum. The doctor after having reached the cecum can cross the valve of Bauhin to go in the distal part of the small intestine. It is during the descent of the colonoscope that the doctor examines the wall of the colon.
After the examination, the nurse made sure that there was no bleeding and/or abdominal pain. She will tell you when you can get up, drink and eat as directed by the doctor. A 24-hour monitoring may be necessary in the event of a polypectomy. Otherwise you will leave the same day.
The doctor will give you an initial comment.
He will send his final report to your doctor as soon as possible.
This will explain the results to you and give you the action to take.
Complications of colonoscopy
These complications can be favored by your medical and surgical history or by taking certain treatments.
You should not take anti-inflammatory or Aspirin the week before the colonoscopy unless it is a treatment that you use regularly and the Doctor asks you not to stop.