Before the colonoscopy, the gastroenterologist who will perform the procedure should be informed about issues, such as:
The intestines must be empty and cleaned for colonoscopy to be successful. Different methods can be applied for this. If the intestines are not cleaned properly, lesions or polyps may be overlooked during the procedure, the duration of the procedure may get prolonged (prolonged colonoscopy may bring risks), and the procedure may have to be repeated.
Diet for preparation to colonoscopy: There may be some diet or fluid restrictions before the colonoscopy procedure. However, whether such a diet will be given or not depend on the patient. The doctor decides whether a diet is required before colonoscopy after evaluating the patient's condition.
The purpose of the colonoscopy diet is to avoid high-fiber plant foods that leave behind residue. Since consuming fibrous foods will leave too much residue, colon cleansing may be troublesome.
A few days before the colonoscopy: Foods such as whole grain foods, nuts, seeds, dried fruits, stone fruits, fruits with skin, pasta, peas, dried beans should be avoided. Low-fiber diet should be followed. Eggs, yoghurt, cheese, red or white meat and fish, excluding offal, can be consumed until one day before the colonoscopy.
The day before the colonoscopy: Solid foods should not be consumed. Instead, water, tea, fruit juice can be consumed. Yogurt can be consumed once or twice. It is important to avoid consuming red fluids that can be mixed with blood during a colonoscopy. You must not eat or drink anything after the midnight before the colonoscopy. After 6 pm, the drugs recommended by the doctor should be taken to cleanse the intestine.
Colonoscopy day: You should not consume solid or liquid foods at all.
Since a sedative anesthetic will be used during colonoscopy, smoking and tobacco products should be avoided.
Drugs for preparation to colonoscopy: There are different medications and methods to cleanse the intestines for colonoscopy.
The doctor who will perform the colonoscopy will adjust the medications and dosages according to the patient. In addition to the colonoscopy diet, many drugs such as sodium phosphate, laxatives, drugs containing macrogol, mannitol, polyethylene glycol are used for cleansing the intestines. These drugs must be finished 8 hours before the colonoscopy.
In addition to these drugs, the colon can be cleaned with methods such as enema and intestine irrigation.
How is Colonoscopy Performed?
After the colonoscopy procedure:
You should watch out for symptoms after the colonoscopy, and consult your doctor if you experience problems, such as:
Especially severe abdominal pain, fever, shivering, nausea, and vomiting can be symptoms of colon perforation.
At What Intervals Should Colonoscopy Repeated?
Colonoscopy is vital in the early diagnosis of intestinal cancer. People who do not have any risk factors should start routine colonoscopy screenings at the age of 45-50. People in the risk group whose family histories include people with colon cancer may need to start routine screenings at an earlier age. The frequency of screenings also depends on the results of the procedure performed. Patients whose colonoscopy results do not include any abnormalities, such as polyps, are recommended to repeat colonoscopy screenings every 5 years. The frequency of screenings changes if any abnormal structures or polyps are encountered during colonoscopy. The number, type, and size of the polyps are of great influence in determining the frequency of following colonoscopy screenings. Colonoscopy should be repeated within a year if there are so many polyps that prevent the colon from being examined or if the intestines cannot be cleaned completely.
What Should I Do If I Feel Nausea During the Preparation Period of Colonoscopy?
Liquid medications taken to cleanse the intestines before colonoscopy can sometimes cause severe nausea. If you feel nausea or queasy, you should stop taking these liquid medications for a short time. You should take the medications again after a break of 30-60 minutes. Taking the liquid medications slowly may be helpful for you to prevent the feeling of nausea or queasiness again. You can also take antiemetic drugs in consultation with your doctor.
Tips: You can cool the medication before taking it or you can drink cold water with the medication.
What Should I Do If I Experience Anal Fissure or Irritation During the Preparation Period of Colonoscopy?
During the process of cleansing of the intestines, problems like anal fissure and irritation may occur because of having frequent bowel movements. It is very useful to apply diaper rash cream or Vaseline in preventing such problems. Wet wipes can be preferred instead of toilet paper. You can also sit in a warm tub of water after the bowel movement and then dry the skin in your rectal area with a soft cloth.
What are the Length and Width of a Colonoscope?
There is a tiny camera and light at the tip of the colonoscope, which is a flexible tube. In addition, there is an inflator apparatus on the colonoscopy device that helps the doctor to obtain a view from the inside of the large intestine more easily, and another apparatus to remove polyp-like structures from the intestine, if necessary. Colonoscope is approximately 60 cm long and has 1 cm diameter.
Are There Alternatives to Colonoscopy?
Although colonoscopy is the most effective method for detecting colon cancer at an early stage, there are also alternative tests. The effectiveness of these methods, which are applied to patients who do not want to undergo colonoscopy or who are not suitable for colonoscopy, in detecting colon cancer is different.
Which Conditions Prevent the Performance of Colonoscopy?
Patient's consent is required for colonoscopy to be performed. Even if the patient gives consent, it is not true to perform colonoscopy in patients,
How Long Does A Colonoscopy Procedure Take? How Long Does Its Effect Last?
Colonoscopy procedure takes between 20-60 minutes. However, it may take 1-2 hours for the sedation, which is given to the patient to undergo a comfortable colonoscopy, to wear off. In addition, the gas pain and the feeling of bloating caused by the air given to the intestines to obtain a better view disappear in1-2 days.
Is Colonoscopy A Painful Procedure?
During colonoscopy, patients do not feel pain because they are anesthetized or sedated. Patients mostly complain of gas pain experienced after colonoscopy. Therefore, patients should consume plenty of fluids and walk after the procedure.
What Should Diabetics Pay Attention to During the Period of Preparation to Colonoscopy?
Maintaining the blood sugar at healthy levels is very important for diabetics. Diabetics should pay more attention to the diet during the cleaning of the intestines before colonoscopy. Remember that liquid foods can be consumed, although solid foods are prohibited on the day before colonoscopy. Drinks such as apple juice and pulp-free orange juice can be consumed to maintain blood sugar levels.
Does Having Colonoscopy Prevent Breastfeeding?
The effect of anesthesia or sedative drugs given in the colonoscopy application is eliminated from the body approximately 1 day later. Although anesthetic drugs are unlikely to be passed on to the baby through breastfeeding, patients can take measures such as breastfeeding the baby before colonoscopy and storing some amount of milk beforehand to feed the baby with later. If the patient does not have the chance to store the milk and has to breastfeed, she can express some milk and put it aside. Then, she can feed her baby with the milk that she expresses for the second time.
What is Endoscopy?
Endoscopy is an oral procedure performed to examine the digestive system without surgical operation. Endoscopy, which is used to diagnose and sometimes treat disorders in the esophagus, stomach, large intestine and duodenum, is performed with a flexible tube which contains a camera and light at the tip. In some cases, special instruments may be attached to the endoscope to do a biopsy.
Why is Gastroscopy Performed?
For diagnostic purposes: Gastroscopy can be done to investigate the causes of different disorders in the digestive system and due to a number of symptoms, such as:
Biopsy: In suspicious cases, tissue samples can be taken from the stomach, esophagus or duodenum of the patients for biopsy.
What Are the Types of Endoscopy?
There are various types of endoscopy for different areas to be examined
What are the Most Recent Technological Techniques in Endoscopy?
New generation endoscopes use high resolution imaging to create detailed images. In addition, innovative techniques combine endoscopy with imaging technology or surgical procedures.
Capsule endoscopy: If other examinations are not sufficient to confirm a diagnosis, capsule endoscopy can be performed. In this method, the patient swallows a pill with a small camera inside. The patient does not feel the progress of the capsule in the digestive tract. The capsule progressing in the digestive tract obtains images for a detailed examination.
ERCP: In this method, X-rays are combined with endoscopy to diagnose or treat problems in the gallbladder and pancreatic ducts.
Narrow-band imaging (NBI): A special filter is used to help create more contrast between the vessels and the mucosa, which is the inner lining of the digestive system.
Things You Should Know About Endoscopy
Is Endoscopy a Risky Procedure?
Endoscopy is a very safe method compared to surgical procedures. However, like any other medical procedure, endoscopy has risks of complications, albeit low.
If you experience one of these symptoms after the endoscopy procedure, you should talk to your doctor.
How to Prepare for Gastroscopy?
Patients should stop eating and drinking eight hours before the endoscopy to ensure that the stomach is empty for the procedure.
Before all endoscopic procedures, Op. Dr. Izzettin KAHRAMAN should be informed about chronic diseases that patients have and all medicines that patients take.
The gastroenterology doctor will give necessary information and instructions to people with chronic diseases such as diabetes, heart diseases or high blood pressure.
Sedation is applied to patients before the endoscopy so that they do not feel pain or discomfort during the procedure. For this reason, patients should have someone with them who can help them after the procedure.
How is Gastroscopy Performed?
Before the procedure, the patient rotates his head 90 degrees to his left side. If deemed necessary, electrodes can be attached to the body to monitor the patient's breathing, blood pressure and heart rate.
Before the procedure, sedatives are given to the patient to minimize gagging and discomfort.
A plastic mouth guard is used to keep the mouth open. Anesthetic spray is applied through the mouth to numb the throat.
The endoscope is inserted through the mouth. Your doctor may ask you to swallow as the endoscope passes through your throat. You may feel pressure in your throat, but usually you do not feel pain.
After the endoscope passes through the throat, the patient cannot speak but can make sounds. Endoscopy does not prevent breathing.
During the procedure, images are transferred to the screen in the examination room. Images of your digestive system obtained in this screening process are saved for post-procedure review.
The endoscope can blow gentle air pressure through the esophagus to inflate the digestive tract. This allows the endoscope to move freely and makes it easier for the doctor to examine the folds of the digestive tract. The patient may feel pressure or fullness due to the air given.
The doctor may pass special surgical instruments through the endoscope to collect a tissue sample or remove a polyp.
When the doctor finishes the examination, the endoscope is slowly retracted through the patient's mouth. An endoscopy typically takes 5 to 10 minutes, depending on the situation of the patient.
What Does the Patient Experience After Endoscopy (Gastroscopy)?
After the endoscopy, the patient rests for about 1 hour in the hospital, and and go home on the endoscopy day.
Since sedation is applied to patients for this procedure, they should have someone who can accompany them after the procedure.
When the patient is at home, he/she may experience some mildly uncomfortable symptoms after gastroscopy, such as:
These signs and symptoms will disappear with time.
When are the Endoscopy Results Available?
You can learn the results right after the procedure. However, if the doctor collected a tissue sample for biopsy, you may need to wait several days to get results from the testing laboratory.
What is ERCP?
ERCP is a procedure of reaching the bile duct and pancreatic duct by passing through the stomach and intestines with a special endoscope. This procedure is performed to diagnose and treat the diseases in these ducts. The bile ducts and pancreatic duct open to the second part of the duodenum through an area called papillae. During ERCP, a special dye is injected into the bile ducts and pancreas with special plastic catheters through the papillae, and X-rays are taken get pictures of these ducts. Then, treatments are applied according to the detected disease. Usually, the papilla is enlarged by being cut with a special cautery knife. This procedure is called papillotomy. Then, the bile ducts are intervened from here.
Who Can Perform ERCP?
ERCP must be done by a experienced doctor like Op. Dr. Izzettin KAHRAMAN. The risk increases and the chance of success decreases if the operation is performed by an inexperienced person.
How Do Diseases Occur in the Biliary Tract?
Bile produced in the liver is stored in the gallbladder and secreted into the intestines after meals to help with digestion. Bile passes into the intestines via the bile ducts. If there is a disease in the biliary tract that prevents the passage of bile into the intestines completely or partially, serious health problems occur. The harmful substances in bile that cannot pass into the intestines can pass into the blood and cause jaundice and damage other organs. Bile that cannot be secreted at all or can be secreted slowly can cause significant damages, especially to the liver. It may cause abscess in the liver and severe inflammation in the blood in the early stages. Liver failure and cirrhosis may develop in the late stages. These problems can become life-threatening. In addition, digestive problems and vitamin deficiencies can be seen due to the lack of enough bile in the intestines.
Which Diseases Does ERCP Diagnose and Treat?
Gallstones are the most common disease in the bile ducts and can cause the problems mentioned above. They usually come from the gallbladder or sometimes form in the ducts. Apart from the gallstones, some parasites can settle in the bile ducts and cause obstruction. The bile ducts of those who have had gallbladder surgery before may sometimes become narrow. Especially in elderly patients, gallbladder, bile ducts and pancreatic tumors can narrow or obstruct the bile ducts. In all such cases, it is vital to open the ducts and let the bile flow. ERCP shows whether there is a disease in the ducts by screening the bile ducts. In addition, with a special endoscopic surgery, the bile ducts are opened from where they join the intestines, and all kinds of duct diseases are intervened. If there are gallstones or parasites, they are removed. If there is stricture, the duct can be widened, or a stent can be placed to ensure the bile flow. This procedure has been lifesaving at many times.
What is the Alternative Treatment Method of ERCP?
The alternative of ERCP is to perform open surgery by cutting the patient's skin on the abdomen. However, this procedure is much more risky, difficult and costly than ERCP.
Does ERCP Have Risks? If Yes, What Are They?
ERCP is much safer and less risky compared to conventional surgeries. The greatest risk of the procedure is temporary inflammation of the pancreatic gland. This risk is typically 4-5%. However, it can be further reduced with some precautions. Rarely, bleeding due to the incision or, very rarely, a minor perforation may occur in the intestines. These problems are usually tackled during ERCP, an open surgery is rarely required. The risk of serious complications related to the procedure is low. On the other hand, serious and life-threatening risks may arise if the procedure is supposed to be done but has not been done.
Does the Patient Feel Pain or Discomfort During the Procedure?
The patient is mildly sedated for this procedure. General anesthesia is not required. The patient does not feel any discomfort during the procedure. However, there may be abdominal pain due to gas for up to 3 hours after the procedure.
Does the Patient Need to Make Any Special Preparation for the Procedure?
Patients should stop eating and drinking eight hours before the ERCP. For this reason, the procedure is usually performed in the morning. Also, if the patient is on blood thinners, he/she needs to discontinue taking them 1 week before the procedure.
Does This Procedure Require Hospitalization?
This may vary by the procedure and disease. The patient can either be kept under observation for 3-4 hours and can be discharged on the same day without being hospitalized or he/she may also need to be hospitalized and monitored for 1-2 days.
Which Diseases Can Be Treated with ERCP Besides Bile Duct Diseases?
With the same procedure, the pancreatic ducts can also be entered and more rarely seen pancreatic stones can be removed or the duct stricture can be treated.
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