720 S.W. Lane
Topeka, KS 66606
Additional ReadingColonoscopy Q & A Flexible Sigmoidoscopy Q & A
Information for Patients Having a Colonoscopy
This information has been designed to answer your questions about colonoscopy. Your physician has determined that this procedure is necessary to further evaluate and treat your condition. It is important to read this carefully. If you have any questions or concerns, please call the Cotton-O’Neil Endoscopy Center or the office of the physician who has recommended the exam.
Q: Where am I receiving my colonoscopy?
A: The Endoscopy Center is located on the first floor of the Cotton-O’Neil Digestive Health Center, 720 S.W. Lane, Topeka. It is a Medicare/Joint Commission certified ambulatory Endoscopy Center, staffed by gastroenterologists. The Endoscopy Center phone number is (785) 270-4800. Office hours are 7 a.m. to 5 p.m. Monday through Friday.
Q: What is colonoscopy?
A: Colonoscopy is a diagnostic procedure where a physician (gastroenterologist) examines the inside of your colon (large bowel) for abnormalities. This is done by inserting a thin flexible tube into the rectum and advancing it slowly into the colon. The colonoscope is advanced to the first part of the colon (cecum) and then slowly withdrawn. As this is done, the colon is evaluated.
Q: Why is colonoscopy performed?
A: Colonoscopy is a common diagnostic procedure performed to evaluate signs and symptoms that may indicate a problem with the colon. These signs or symptoms include rectal bleeding, abdominal pain, anemia, occult (microscopic) blood in the stool, diarrhea, as well as a change in bowel habits. Colonoscopy is also performed for screening and for surveillance purposes in patients with a history of ulcerative colitis, colon cancer, colon polyps, and in those who have family history of colon cancer.
Q: What preparation is required?
A: The colon must be clean for the procedure to be accurate. In general, preparation of the colon prior to colonoscopy entails drinking laxative solutions. You will be given detailed instructions regarding the prep. It is important to follow these instructions. If your bowel preparation is inadequate, the procedure may have to be rescheduled. It is also important that you not eat any foods containing the ingredient Olestra for seven days prior to the procedure. This substance is a fat substitute used in snacks such as potato chips. Olestra adversely affects the equipment used during colonoscopy and can result in less than optimal visualization of the inner lining of the colon.
Q: What about my current medications?
A: Most medications may be continued as usual, but adjustments in other medications are frequently necessary. Inform your physician and the Endoscopy Center nurse of your current medications and any allergies to medications. Aspirin, aspirin products, arthritis medications, anticoagulants (Coumadin, Plavix), insulin, and iron are examples of medications that will need to be adjusted prior to your examination. Patients with prosthetic heart valves and certain other conditions may require antibiotics prior to colonoscopy. If you are a diabetic who takes insulin, please bring it with you on the day of your examination. If you use breathing inhalers, bring them along. Certain weight loss medications will need to be stopped for up to two weeks prior to your procedure.
Q: What can be expected during colonoscopy?
A: During the procedure, colonoscopy may cause a feeling of pressure, bloating, or cramping. Medications will be administered intravenously before the procedure to make you sleepy. This type of anesthesia is called “procedural sedation.” The vast majority of patients experience no discomfort with colonoscopy. You will be lying on your side or on your back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the inside of the colon is carefully examined. The procedure usually takes 15 to 30 minutes. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The gastroenterologist will decide if the limited examination is sufficient or if other examinations are necessary.
Q: What about family and friends?
A: From the time you arrive, plan to spend approximately two hours with us. This includes the time needed to check you in, get you ready for the procedure, do the examination, and allow for your recovery. A family member or friend may wait in the waiting room while we care for you. A telephone is available in the waiting room for local calls. Family and friends are allowed in the recovery room for a short visit. Your doctor will visit with them before your discharge.
Q: What if my colonoscopy shows something abnormal?
A: If your gastroenterologist thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining). These specimens are submitted to the pathology laboratory for analysis. If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulating the bleeding blood vessels. None of these additional procedures produce pain since the colon lining can only sense stretching. Biopsies are taken for many reasons and do not necessarily mean cancer is suspected.
Q: What are polyps and why are they removed?
A: Polyps are abnormal growths on the inner lining of the colon. They may vary in size from the size of a pea to several inches. The majority of polyps are benign (noncancerous). The removal of polyps is an important means of preventing colorectal cancer. Polyps known as “adenomas” start out small and slowly enlarge. Adenomatous polyps can eventually evolve into colon cancer. For this reason, polyps are removed and sent for tissue analysis.
Q: How are polyps removed?
A: Tiny polyps may be totally destroyed by fulguration (burning), but larger polyps are removed by a technique called snare polypectomy. The gastroenterologist passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall with an electrical current. You should not feel any pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the colon wall which could require emergency surgery. Colonoscopy and polypectomy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures.
Q: What are the possible complications of colonoscopy?
A: One possible complication is a perforation or tear through the intestinal wall, which usually requires surgery. Another complication is bleeding from the site of biopsy or polypectomy. Bleeding is usually minor and stops on its own or can be controlled through the colonoscope. Rarely blood transfusion or surgery is required. Other potential risks include a reaction to sedatives used and complications related to heart or lung disease. Localized irritation to the vein where the medications were injected may cause a tender lump that can last for several days. Applying hot packs to the area may help relieve discomfort. Although complications after colonoscopy are uncommon, contact the Endoscopy Center or the gastroenterologist who performed your examination, if you notice any of these symptoms: severe abdominal pain, fever or excessive rectal bleeding. Bleeding can occur several days after polypectomy.
Q: What happens after my colonoscopy?
A: After your colonoscopy, your gastroenterologist will explain the results to you and your family. You will receive written instructions and information regarding the results of your examination. Because of the lasting effects of the sedative medications you will receive, you may not drive yourself home. Some patients might benefit from having an adult stay with them until they are fully recovered.
Wear comfortable clothing. Be sure to leave all your jewelry and valuables at home. Unless we tell you otherwise, you should be able to resume your usual diet. You may also resume your medications unless otherwise instructed. Certain medications, particularly blood thinners such as aspirin, Plavix, and Coumadin, may need to be held if biopsies and/or polyps were removed.
Most people are ready to leave the Endoscopy Center after spending 30 minutes in recovery. If you live out of town, you might want to bring along a pillow and blanket so that you can rest on your trip home. Your primary care physician will be notified of the results. It will take several days to receive biopsy results. If a biopsy was taken or a polyp removed, you will be instructed as to when and how you will receive those results. In most cases, you will be notified by mail.
Q: What about my health insurance?
A: Our insurance clerk will call your insurance provider before the procedure date to verify your coverage. Please remember to have your primary care physician generate a referral for this procedure if necessary. Referrals must be done in advance of the examination date. Bring your insurance cards with you on the day of your procedure. For insurance questions before the procedure, please call (785) 270-4803 to speak with our insurance clerk.
Most insurance plans require the patient to pay a deductible and/or co-pay. These fees are the responsibility of the patient and are due at the time the medical service is rendered. If requested, we will assist you in determining the amount of fees you may be responsible for and will work with you to set up payment plans as needed. Our insurance clerk can quote you the basic fees for your procedure, but keep in mind that fees vary depending on the types of procedures being performed. For patients using Medicare as their primary insurance provider, we suggest you speak with your Medicare source to determine your coverage. If you are having a colonoscopy done as a screening examination, you may be asked to sign a waiver at your appointment.
You will receive two billing statements: one from the Endoscopy Center for the facility fee and one from the physician who does your procedure. If you should have biopsies taken or polyps removed, you will also receive a billing statement from the pathology group that processes the specimens.