COLONOSCOPY
COLONOSCOPY PATIENT INFORMATION
Colonoscopy is a procedure that allows the physician to look directly at the lining of your large bowel (colon) and remove growths (polyps) with a long flexible tube called a colonoscope. Reasons for doing Colonoscopy include screening for colon cancer in patients without symptoms, investigation of bowel symptoms (pain, bleeding, change in bowels, weight loss, positive fecal immuno test), anemia, follow-up of patients with Inflammatory Bowel Disease, previous polyps or bowel cancer.
Dr. Mandelbaum is extraordinarily experienced in performing colonoscopy and he has endoscopic skills that allow him to easily complete the most difficult procedures smoothly, safely and without discomfort.
Colonoscopy involves inserting a flexible tube (scope) into the rectum and examining the lining of the colon. On the end of the scope is a tiny camera which projects images on monitors, enabling physicians to see the inside of the colon. As physicians steer the flexible tube through the colon, they are able to spot polyps and remove them with devices passed through the scope. Sedation is given to keep you comfortable.
Most regular medications should be taken at your usual time (if in the morning) with a sip of water before you have the procedure. This is particularly the case for blood pressure medication, medication for epilepsy and heart medications.
DIABETES medications are different. If you take pills for diabetes they SHOULD NOT be taken before the procedure. Examples of diabetes pills include metformin, gliclazide, invokana, janumet, jardiance and ozempic. If you take insulin in the morning, you should take one half your regular insulin dose before the procedure.
Blood thinning medication such as, apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana), rivaroxaban (Xarelto), warfarin (Coumadin) or Plavix are usually stopped prior to a colonoscopy with Dr. Mandelbaum to allow him to remove any polyps that might be there without risk of bleeding. If Dr. Mandelbaum has not given you clear instructions at the time you agreed to the procedure please contact the office.
DIABETES medications are different. If you take pills for diabetes they SHOULD NOT be taken before the procedure. Examples of diabetes pills include metformin, gliclazide, invokana, janumet, jardiance and ozempic. If you take insulin in the morning, you should take one half your regular insulin dose before the procedure.
Blood thinning medication such as, apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana), rivaroxaban (Xarelto), warfarin (Coumadin) or Plavix are usually stopped prior to a colonoscopy with Dr. Mandelbaum to allow him to remove any polyps that might be there without risk of bleeding. If Dr. Mandelbaum has not given you clear instructions at the time you agreed to the procedure please contact the office.
These risks include: perforation, bleeding, missing something important. Perforation (puncture of the bowel) risk is 1 in 5000 if no polyps are removed and up to 1 in 1000 if polyps are removed. Bleeding can occur (1 in 5000) if polpys are removed or if biopsies are taken. If the bleeding cannot be controlled, a blood transfusion may be necessary, and very rarely, surgery may be needed. There is a 1 in 500 risk of missing an important finding.
You need to skip two doses of these medications prior to your colonoscopy. They will slow the bowels down and increase your risk of aspiration (vomiting into your lungs).
BOWEL PREPARATION
A good bowel preparation can save your life.
The colon must be cleaned out completely to ensure the best result for you. It is ESSENTIAL that the instructions for cleaning out the bowels are followed carefully. If your colon is not properly cleaned out, the test may need to be rescheduled. A full description of the preparation will be given to you on a separate sheet.
Remember that you should only be consuming fluids on the day of the preparation. No solid food that day.
DAY OF YOUR COLONOSCOPY
When you arrive at Scarborough General Hospital you need to check in at registration on the main floor by the entrance and then go to the endoscopy unit on the 3rd floor. In the endoscopy unit an intravenous will be started and then you will be placed on a stretcher and wheeled to the hallway outside the procedure room. The anesthetist will meet you and review your history. To begin the procedure monitors for your vital signs will be placed and you will be asked to turn onto your left side. Please curl your legs up into a fetal position.
The anesthetist will then begin giving you the sedative. This medication can burn in the arm for a short period as it goes in. We will then perform the colonoscopy. This portion takes about 20 minutes and most people do not remember having the tube inside at all. Many wake up wondering if the procedure was actually done.
During the procedure small samples (biopsies) may be taken and polyps may be removed. These will be sent to the laboratory for examination by the pathologist over the next week.
The anesthetist will then begin giving you the sedative. This medication can burn in the arm for a short period as it goes in. We will then perform the colonoscopy. This portion takes about 20 minutes and most people do not remember having the tube inside at all. Many wake up wondering if the procedure was actually done.
During the procedure small samples (biopsies) may be taken and polyps may be removed. These will be sent to the laboratory for examination by the pathologist over the next week.
RESULTS & FOLLOW UP PLAN
Dr. Mandelbaum will speak with you once you are awake in the recovery room to give you results.
At this time, we will make a plan for follow up.
GOING HOME
If you have sedation, you must have a responsible adult to accompany you to your home. We do not allow you to go home on your own. An Uber or taxi driver does not count.
You cannot drive or operate dangerous machinery for 24 hours after the procedure. You should avoid making important decisions during this period.
If you do not have a person to accompany you home no sedation will be given.
You cannot drive or operate dangerous machinery for 24 hours after the procedure. You should avoid making important decisions during this period.
If you do not have a person to accompany you home no sedation will be given.
DANGER SIGNS AFTER COLONOSCOPY
You should not have any pain after discharge from the endoscopy unit. If you have abdominal pain, fever or nausea/vomiting you should go to the nearest emergency department.
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