A colonoscopy is a visual examination of the entire large intestine, also known as the colon. This exam is used to explore possible causes of abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea and other intestinal problems. A colonoscopy is also used as a method of screening for colon cancer.

A gastroenterologist (GI) uses a lighted, flexible tube called a colonoscope that has a small video camera attached to the tip, allowing the GI doctor to view the inside of the entire colon. GI doctors can also sample tissue and/or remove polyps in the colon during a colonoscopy.

Men and women who are at average risk for colon cancer are advised to schedule regular colonoscopies starting at age 50 (age 45 for African Americans), and continue to get a colonoscopy at 10-year intervals thereafter to screen for colon cancer. Patients who have a family history of colon cancer, have inflammatory diseases such as inflammatory bowel disorder (IBD) or other risk factors for colon cancer may be advised to be screened earlier or at increased frequency.

Preparing for a Colonoscopy

Thorough cleansing of the entire bowel is essential for effective results so there will not be a need for retesting. Instructions for doing this will be given by your physician, but this can include a combination of the following: restriction from eating solid foods a day or two before the test and taking pill-form and/or liquid laxatives. The following recommendations are general guidelines, however, your physician may have varying instructions for your specific procedure. Please confirm with your physician the details of your prep instructions.

You will not be able to eat or drink the day of the procedure. You may be asked to stop strong blood-thinning medications for before the procedure as well. Check with your physician for exact instructions.

To avoid dehydration, patients should drink clear, fat-free bouillon or broth, gelatin, strained fruit juice (no grape juice or any liquid with red color) and water. Unless otherwise instructed, continue taking any regularly-prescribed medication. Your physician may ask you to stop taking iron preparations a few weeks before the test if you are on them. Finally, you need to arrange for someone to drive you home afterward because lingering, subtle effects of the sedation will make it unsafe for you to drive until the next day.
Your doctor will also want to know if you have heart disease, lung disease or any other medical condition that may need special attention.

What Happens During a Colonoscopy?

Typically intravenous (IV) sedation is used during a colonoscopy. When it’s time to start the examination, you will be asked to lie on your side. Once sedation takes effect, the colonoscope is inserted through the rectum and moved gently around the bends of the colon. As the colonoscope makes its way through the colon, the physician can see the lining of the colon on a television screen. Typically, the physician looks all the way to the end of the large intestine, and back, for anything unusual. The scoping process typically takes 30 minutes.

After your procedure, your nurse will take you into a recovery area, where the sedation quickly wears off. Your physician will talk to you about your test and any findings.

What Happens After a Colonoscopy?

Depending on the type of sedation (moderate or deep) used for your procedure, it can take anywhere from 30 minutes to an hour to recover from the sedation. You will need someone to drive you home because it can take up to a day for the full effects of the sedative to wear off. You should be able to resume normal activity the next day. Be sure to ask your doctor when you can resume taking any medications you had to stop taking before the colonoscopy.

Your doctor will talk to you when you are awake and go over the results with you. If a biopsy was taken, your doctor will do a follow-up to let you know the results. If a polyp was removed during your colonoscopy, your doctor may recommend having a follow-up colonoscopy in as little as three months depending on the size and number of polyps found. If no polyps were found, your next colonoscopy will need to be in 10 years, or sooner depending on your family history and other factors.

Test Findings

Possible findings include diverticulosis and polyps. If polyps (growths of tissue) are found, they will be removed during the colonoscopy and sent to a pathologist.

Polyps are small growths in the lining of the colon. They are common and there are different types such as benign and cancerous polyps. While the overwhelming majority of polyps are benign, your physician will have it tested, and as soon as your lab results are ready, your physician will contact you to schedule a time to confirm the results with you.

A sigmoidoscopy is an internal exam of the lower part of the large intestine (colon) using a short, thin, flexible lighted tube. The tube, called a flexible sigmoidoscope, has a tiny camera at the tip allowing the doctor to view the inside of the rectum and the sigmoid colon—about the last two feet of the large intestine. A small biopsy instrument to remove tissue samples to be checked under a microscope for signs of disease can be performed during the examination.

A flexible sigmoidoscopy can help your doctor determine the cause of abdominal pain, rectal bleeding, changes in bowel habits, chronic diarrhea and other intestinal problems. Your doctor may be able to diagnose the cause of diarrhea, bowel obstruction, diverticulosis, inflammatory bowel disease, anal fissures and hemorrhoids, as well as find colon polyps that might be in this lower part of the colon.

Flexible sigmoidoscopy does not allow the doctor to see the entire colon. Therefore, any cancers or polyps farther into the colon cannot be detected with flexible sigmoidoscopy. A colonoscopy allows the doctor to examine the entire colon.

Preparing for Flexible Sigmoidoscopy

The lower colon and rectum must be completely empty for a flexible sigmoidoscopy to be thorough and safe. Some doctors recommend a combination of a laxative and a small enema before the test. Some doctors may advise the patient to drink only clear liquids for 12 to 24 hours before the procedure is scheduled. A liquid diet means clear; fat-free bouillon or broth; gelatin; strained fruit juice (no grape juice or any liquid with red color); water; plain, unsweetened coffee or tea; or diet soda. The night before, or even immediately before the flexible sigmoidoscopy, the patient may be given an enema, which is a liquid solution that washes out the lower intestine.

What Happens During a Flexible Sigmoidoscopy?

During the test the patient is positioned on the left side with knees drawn up toward the chest. First, the doctor will do a digital rectal exam by gently inserting a gloved and lubricated finger into the rectum to check for any abnormalities.

Next, the sigmoidoscope is inserted into the rectum, and the patient will feel some pressure. Air is introduced through the scope to expand the colon and help the doctor see adequately. As the scope is slowly removed, the lining of the bowel is carefully examined. A hollow channel in the center of the scope allows for the passage of an instrument called a forceps for obtaining a biopsy if needed.

What Happens After a Flexible Sigmoidoscopy?

This procedure takes about 15 minutes. After the exam, you may have mild abdominal discomfort. You may feel bloated or pass gas for a few hours as you clear the air from your colon. You will be able to return to your normal diet and routine after the procedure.

You may have a small amount of blood in your stool with your first bowel movement after the procedure. This is normal. Call your doctor if this continues or you have persistent abdominal pain or a fever of 100 degrees Fahrenheit or higher.

What Are the Possible Outcomes of a Flexible Sigmoidoscopy?

You and your doctor will discuss the results of your flexible sigmoidoscopy. The exam is considered negative if the doctor does not find any abnormalities. A positive exam might identify polyps or abnormal issue in the colon. Depending on the findings, you may need additional testing, such as a colonoscopy, so that the entire colon can be examined.

An upper endoscopy, also known as esophagogastroduodenoscopy (EGD), is a procedure used to determine the cause of gastrointestinal disorders and symptoms including heartburn, Barrett’s esophagus, the presence of hiatal hernias, the cause of abdominal pain, unexplained anemia, and the cause of swallowing difficulties, upper GI bleeding, and the presence of tumors or ulcers. An upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine).

This procedure is the best option for a physician to determine the cause of bleeding in the upper gastrointestinal tract, and it is also more accurate than an x-ray for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum. Your doctor might use upper endoscopy to obtain a biopsy (small tissue samples) to distinguish between benign and malignant (cancerous) tissues.

Preparing for an Upper Endoscopy

Your doctor will give you specific instruction to follow to prepare for your upper endoscopy. Generally, because an empty stomach allows for the best and safest examination, you will be instructed to not eat or drink, with the exception of water, for approximately six hours before your procedure.

What Happens During an Upper Endoscopy?

You will lie on your left side, and an intravenous (IV) sedation is used during an upper endoscopy. Once the sedation takes effect your doctor will pass a lighted, flexible endoscope into your mouth. A plastic mouth guard is usually used to protect the endoscope from your teeth. A tiny camera at the tip of the endoscope will transmit images to a monitor for your physician to view. If your physician is using tools to obtain a biopsy, he/she will use the monitor to guide the tools used.

At the end of the exam, the endoscope is slowly withdrawn. The procedure takes about five to 20 minutes, depending on why the test is being performed and what your physician finds.

What Happens After an Upper Endoscopy?

Immediately following an upper endoscopy, you will spend some time resting in recovery while the sedation medication, if used, wears off. Upper endoscopy is performed as an outpatient procedure, so you can have your procedure in an ambulatory surgery center, which can provide better accessibility and ease compared to a hospital.

Once home, some patients report symptoms of bloating, cramping or a sore throat, but these symptoms should be mild and improve with time. Contact your doctor if your symptoms do not improve.

What are the Outcomes with Upper Endoscopy?

The timeframe it will take for you to receive results from your upper endoscopy will be determined by your situation. If a tissue sample was collected, it may take a few days for the testing laboratory to return your results to your physician. Ask your doctor when you can expect to hear your results.