What is it?
Tests so far point to there being one or more polyps in your lower bowel. A polyp is an overgrowth of the lining of the bowel wall. It usually looks like a raspberry dangling from the lining on a short stalk. The best way of dealing with the polyp is by doing a colonoscopy. Some patients, such as those who have had a polyp in the bowel before, need to have repeated colonoscopies to check that the bowel is healthy.
You will have a sedative injection or a short general anaesthetic. A colonoscopy means passing a flexible telescope (colonoscope) up the back passage (rectum) into the lower bowel (colon) for a distance of about 5 feet (1.4 metres). Usually, the polyp is snared with a hot wire and removed whole through the colonoscope. Snippets of the polyp can be taken through the colonoscope if the polyp is too large to be snared. The polyp or the snippets (biopsies) are sent to be examined under the microscope. The bowel has to be cleaned out beforehand to give a clear view. You can plan to go home the evening of your colonoscopy, provided you have recovered from the examination.
Leaving things as they are is really too risky for you. Polyps can change into bowel cancer if left too long. Other forms of scanning are not as useful as a colonoscopy at this stage.
Before the operation
You will be given instructions about cleaning the bowel out in the 48 hours or so before the colonoscopy. Most colonoscopies are done on the day of coming into the hospital. You should be able to leave the same day. Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital take you home and look after you for the first week after the operation. Bring all your tablets and medicines with you to the hospital. On the ward, you may be checked for past illnesses and may have special tests to make sure that you are well prepared and that you can have the procedure as safely as possible. You will be asked to fill in a procedure consent form. Many hospitals now run special preadmission clinics, where you visit for an hour or two, a week or so before the procedure for these checks. You will be asked to go on a special diet three days before the colonoscopy.
After - In Hospital
You may have slight tummy cramps as you get rid of air used during the examination. You may notice slight bleeding from the back passage for a day or two. A sedative injection will make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with everything you need until you are able to do things for yourself. Do not make important decisions, drive a car, use machinery, or even boil a kettle during this time. The discomfort of the procedure can make it difficult to pass urine and empty the bladder. It is important that your bladder does not seize up completely. If you cannot get the urine flowing properly after six hours, contact the nurses at the hospital or your doctor. You will probably be given an appointment to visit the surgical outpatient department for a check-up about one week or so after you leave the hospital. The results from the laboratory will be ready then. Some hospitals leave check-ups to the general practitioner. The nurses will advise about sick notes, certificates etc.
After - At Home
You are likely to feel back to normal within 24 hours of the procedure. You can start driving again within 24 hours of the sedative. The test should not interfere with sexual relations.
if you have this procedure under a short general anaesthetic, there is a very small risk of complications related to your heart and lungs. The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.
Complications are relatively rare and seldom serious. Persistent bleeding from the area of the bowel where the polyp was removed or from the area of the biopsies occurs in 3% of cases. Making a hole in the colon wall is a rare event but a very serious complication that can cause massive infection in the abdomen and can be potentially lethal. If you have one of these serious complications you will most likely need an operation to fix the problem. If you think that all is not well, please let the nurses or doctors know.
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