Colonoscopy & Alternatives
Colonoscopy
I am specialist endoscopist and performs diagnostic and therapeutic endoscopies.
I Am also Colorectal Lead and also Chair of the Colorectal Multi Disciplinary Meeting (MDT) at the Mid Cheshire NHS Foundation Trust. He is also the Lead for the Enhance Recovery Programme in Colorectal Surgery. He has special interest in diagnosis and management of inflammatory bowel disease and management of colorectal cancer. He also supervises the Family History clinics for bowel cancer and performs screening and surveillance colonoscopies.
A Colonoscopy involves the examination using a fibre-optic flexible tube of the entire colon (large bowel). The large bowel is about 1.5m in length and is responsible for the absorption of water and the formation of stool.
If you have symptoms of rectal bleeding, haemorrhoids, diarrhoea, alternating bowel habit (constipation and diarrhoea), weight loss, anaemia, suspected bowel cancer, bloating and abdominal pain you may require this procedure.
What does the procedure involve?
Specific instructions prior to the procedure will be provided to you by our endoscopy booking team. The day before the procedure you will be provided with bowel preparation to drink, which will clear your large bowel of stool. You will also be given dietary advice before the procedure as well. The bowel preparation is designed to clear your large bowel of faeces and requires you to be at home if possible as you may experience diarrhoea. You are encouraged to drink plenty of fluids to prevent dehydration.
For the procedure you will lie on your left hand side with your hip and knees bent. Sedation as well as pain killers (pethidine or morphine) is given to all patients at the start and the colonoscope is passed through your back passage with a small amount of air introduced to inflate the bowel to accurately visualise your colon. A tissue sample, biopsy may be taken, as well as removal of any polyps that may be found. During the procedure you may experience cramp like abdominal pain and bloating as the air is introduced, but this is temporary and resolves after the procedure is completed.
The procedure normally takes 20 to 30 minutes and you must ensure that someone accompanies you, as you will have sedation. After the procedure you may experience some bleeding and abdominal pain, but this should settle after a few days.
What are alternatives to Colonoscopy?Other options include Barium enema, CT Colonography and MRI Scan of bowel
Virtual Colonoscopy
Virtual colonoscopy involves the examination of the entire colon using computer tomography (CAT) scanning. A special computer enables the images to be put together to give an image of the inside of the bowel.
Its use is the same as for colonoscopy but only takes about 10 minutes and does not require sedation.
What does the procedure involve?
As for colonoscopy bowel preparation is required to clear the bowel out to enable good visualisation of the colon. Patients will lie face up on an XRay table with a thin tube inserted through the anus and into the rectum. In order to visulaise the colon carbon dioxide is used to inflate the colon. The table is rotated and you pass through the CAT scanner so that various images are taken with the final images taken with you lying flat face down. An advanced computer programme on the CAT scanner will then create a three-dimensional image of the colon, which is interpreted by a Consultant radiologist.
This procedure is safer than a colonoscopy as it does not require the direct endoscopy, which involves sedation and a small risk of perforation. However, it does not allow the removal of any polyps or taking of any tissue samples, biopsy. In addition smaller polyps (less than 5mm in diameter) may be missed. This makes virtual colonoscopy purely diagnostic.