COLONOSCOPY

Colonoscopy is a test that allows your doctor to

look at the inner lining of your large
intestine (rectum and colon). He or she uses a
thin, flexible tube called a colonoscope to look
at the colon.

A colonoscopy helps
find ulcers, colon polyps,
tumors, and areas of
inflammation or bleeding.
During a colonoscopy, tissue
samples can be collected
(biopsy) and abnormal
growths can be taken out.
Colonoscopy can also be
used as a screening test to
check for cancer or
precancerous growths in the
colon or rectum (polyps).

The colonoscope is a thin, flexible tube that ranges

from 48 in. (122 cm) to 72 in. (183 cm) long. A small
video camera is attached to the colonoscope so that
your doctor can take pictures or video of the large
intestine (colon). The colonoscope can be used to look
at the whole colon and the lower part of the small
intestine. A test called sigmoidoscopy shows only
the rectum and the lower part of the colon.

 Evaluate chronic constipation, diarrhea, persistent

bleeding, or lower abdominal pain in the absence of
definitive findings from proctosigmoidoscopy and
barium enema.
Locate source of Lower G.I bleeding
Periodic follow-up for recurrent disease or pathology
and monitoring effectiveness of treatment.
Biopsies, removal of foreign bodies and polyps, and
other interventional procedures.
Recommended as primary diagnostic tool for firstdegree relatives of colon cancer patients.

The procedure typically lasts from 30 minutes to 1

hour.
before a colonoscopy
1. Ask on going meds: ASA
1. Bowel must be empty(bowel preparation: drink a
bowel prep solution: laxative tablet or drink a
laxative solution (such as Nulytely or Golytely) the
evening before your colonoscopy)
2.Apply vaseline or Desitin ointment to the skin
around the anus before drinking the bowel
preparation medications

During procedure

you may get a pain medicine and a sedative put in a vein in your arm (IV).

You will need to take off most of your clothes. (gown)

You may lie on your left side with your knees pulled up to your belly. The
doctor will gently put a gloved finger into your anus to check for blockage.
Then he or she will put the thin, flexible colonoscope in your anus and move
it slowly through your colon. The doctor can look at the lining of the colon
through the scope or on a computer screen hooked to the scope.

You may feel the need to have a bowel movement while the scope is in your
colon.

You may also feel some cramping.

You will likely feel and hear some air escape around the scope. The passing
of air is expected. You may be asked to change your position during the
test.

Your doctor will look at the whole length of your colon as the scope is gently
moved in and then out of your colon.

After the test,

you will be watched for 1 to 2 hours. When you are fully
awake, you can go home.
You will not be able to drive or operate machinery for 12
hours after the test.
Your doctor will tell you when you can eat your normal diet
and do your normal activities. Drink a lot of fluid after the
test to replace the fluids you may have lost during the
colon prep but do not drink alcohol.

PRETEST:
Explain the purpose and test procedure, and indicate that
the examination can be fairly lengthy. The examination
time is 30 to 60 minutes.

Check the patients medical history for allergies,

medications, and information pertinent to the current
complaint.
Instruct the patient regarding a clear liquid diet up to 72
hours before examination (according to physicians
orders). The patient must fast (NPO) for 8 hours before the
procedure, except medications (check with the physician).
Inform the patient that hell receive an I.V. line and I.V.
sedation before the procedure.

 Tell the patient that the colonoscope is well lubricated

to ease insertion and initially feels cool.
Explain that he may feel an urge to defecate when its
inserted and advanced.
Inform him that air may be introduced through the
colonoscope to distend the intestinal wall and to
facilitate viewing the lining and advancing the
instrument.
Laxatives need to be taken to thoroughly clean the
bowel; bowel cleansing can also be done through
enema.

INTRATEST
Administer intravenous analgesics, anticholinergics,
or glucagon as ordered. Monitor for respiratory
depression, hypotension, diaphoresis, bradycardia,
or changes in mental status.
Coach the patient to breathe deeply and relax.
Take vital signs according to protocols. Use a pulse
oximeter. Properly preserve specimens, and
transport them to the laboratory immediately.

POSTTEST
Check vital signs frequently after the procedure
according to protocols. Inform the patient that
he or she may expel large amount of flatus.
After recovery from the sedation, he may
resume his usual diet unless the physician
orders otherwise.
After polyp removal, the stool may contain
some blood. Report excessive bleeding
immediately.

 If a polyp is removed, but not retrieved, give enema and strain

the stools to retrieve it.
Observe for complications of bowel perforation, hemorrhage,
abdominal pain, hypotension, and cardiac or respiratory arrest
(can be caused by oversedation or vagal stimulation from the
instrumentation).
Stools should be observed for visible blood.
The most frequent adverse reactions to oral purgatives
include nausea, vomiting, bloating, rectal irritation, chills, and
feelings of weakness.
Interpret test outcomes, and counsel the patient appropriately.

 Risk for bleeding

Risk for infection
Risk for ineffective therapeutic regimen
management r/t lack of knowledge of the
procedure
Impaired physical mobility r/t pain
Acute pain

 Colonic perforation
Hemorrhage
Postplypectomy electrocoagulation
syndrome
Mortality
Infection
Gas explotion
Abdominal pain/ discomfort