Colonoscopy Examination For Your Large Bowel

Who Needs A Colonoscopy?

You may need a colonoscopy if you have any of these conditions:

• passing blood in the stools
• positive faecal occult blood test
• recent change in bowel habit
• passing slime or mucus in the stools
• difficulty passing motions
• persistent diarrhoea
• unexplained abdominal pain
• unexplained anaemia (low blood count)
• raised blood tumour markers (CEA)
• abdominal mass
• past history of colon polyps or colon cancer
• strong family history of bowel cancer – surveillance

What Happens During A Colonoscopy Procedure

• Set aside a day in your schedule.
• I do this procedure as a day case – you are admitted in the morning and discharged in the evening after the procedure.
• Starting from 0700am in the morning on the day of your appointment, take only clear fluids. This means water and flavoured water like Ribena. Avoid milky drinks & fruit juices.
• If you are on regular medication, skip all of them EXCEPT your blood pressure pills.
• If you have any questions whether you should take a particular medication or not, check with me first.
• Come for admission at 8 am. Once you are settled in the day care unit, the nurse will serve you 2 doses of Oral Fleet to drink at 9 am and 11 am. This is a strong laxative so be sure you are near a washroom!
• After the first dose you should continue to drink clear fluids – the more the better as it helps the Oral Fleet to work.
• After the 2nd dose at 11 am, stop drinking all fluids completely.
• When your bowels are clear, you will be transferred to the Endoscopy Unit where you will be given mild sedation. This is not an anaesthetic so you will be awake during the procedure though you may not remember all of it.
• I then begin the colonoscopy examination. During the procedure, we will need you to turn from time to time and the nurse may need to press on your abdomen. This is to help steer the scope through your large bowel. The scope should take 20-30 minutes.
• If I find any abnormality I may take a tiny sample (biopsy) for testing. If I find a polyp I will usually try to remove it at the same time with a polyp snare.
• I will also take some photographs and a video of the inside of the bowel.
• On completion of the scope you will rest in the Endoscopy Unit for a while. You will then be transferred back to the Day Care Unit. I will discuss the findings of the scope examination with you and your accompanying family members and you will receive a folder with a written report, photos and a DVD. Keep that safely as we do not keep backup copies of your DVD in our records.
• When you have fully recovered from the sedation, you will be able to return home. Do NOT drive, operate machinery or cross the road unaided for 24 hours!

Tips For Colonoscopy

If you intend to undergo a colonoscopy, here are some of my best tips.

• If you intend to claim from your insurance provider, we will need to get a guarantee letter from your insurance company before we start. This means filling out a form a day or two before. The insurance company will then fax notification of the guarantee letter to us.
• If you are not claiming from your insurance, or your insurance has declined your application, you will need to prepare a deposit of RM2,000. This covers the basic procedure – it does not cover the cost of medicines you may be given upon discharge or additional procedures like polypectomy.
• Bring someone with you to hospital so you don’t have to drive home. We will not be responsible for accidents you have outside the hospital due to failure to adhere to our advice.
• Do wear sensible clothing on the day of the procedure. Leave your jewellery and valuables at home. Ladies, bring flat soled shoes so you don’t have to go home tottering on high heels!
• If you are on blood thinning medication (anticoagulants, antiplatelet agents) and need to have a polyp removed you will need to stop the medication for 5-7 days before the procedure. Examples of blood thinning medication include Aspirin, Cardiprin, Clopidrogel, Ticlodipine, Xarelto and Warfarin. If in doubt, check with me or your own doctor.
• Colonoscopy is a pretty safe procedure overall. The vast majority of patients do not have any problems. However in very rare situations when I may have cause for concern, I may request you to stay overnight for observation.