About colonoscopy

Gasztro3

Colonoscopy is an 10-30 minutes long, inconvenient test. Sometimes it might entail cramping pain, which can however be alleviated using intoxicating injections and the examination can be done under anesthesia, when the patient will for sure not feel anything from the examination. Colonoscopy may be more difficult and sometimes more painful for those who have already had several abdominal surgeries and has fused intestines. The great advantage of this method is that it allows the physician to take a tissue sample during the examination for biopsy, and he/she can also remove polyps. The patient is to take laxatives and also consume several liters of liquid on the day before the colonoscopy, in order to have his/her bowels cleaned. The physician leads the 160 cm long flexible instrument, the colonoscope, into the colon through the anus and can check the entire colon by proceeding slowly. The colonoscope used to have fiber optics to guide the light an the image. Today there is a chip at the end of the endoscope and it convers the image into an electric signal and the physician, or even the patient, can view the reconverted image on a screen and the view can also be recorded. The instrument requires free space to move and to create the right image, so the physician blows air into the colon through one of the channels of the colonoscope during the examination, which might make the patient feel abdominal distension and have flatulence later on. The other thin and small channel of the instrument can be used to take tissue samples with special grippers or to immediately remove polyps using a loop made hot with electricity. If the physician has taken a tissue sample or has removed a polyp during the examination, the patient may experience minor bleeding during his/her first defecation after the examination. This is however normal. It is advised to rest a couple of hours after the examination and to drink a lot of liquids so that the body can replenish the water lost due to the purgation. If the patient gets an intoxicating injection for the examination or if the examination is carried out under anesthesia, then he/she may be a bit intoxicated for a while after the colonoscopy and might need 1 hour of rest and may not drive a car on the rest of that day, thus it is advisable to have somebody accompany you to the examination.

Like all invasive procedures, colonoscopy may also entail complications: bleeding and perforation (puncture of the bowel wall), which are however quite rare if you are treated by an experienced person. These complications are not malpractices, because they might occur even with the most cautious care. The mistake is if complications remain unnoticed or are detected too late. This is why the patient should tell after the examination (either immediately after the examination or later) if he/she has any complaints. Medical supervision, tests and the proper interventions (blood transfusion, operation) might be necessary in such cases.

 

The diagnostic accuracy and value of the endoscopic test unequivocally surpasses any inconveniences associated with the examination or the risk of any rare complications. Failing to undergo the examination has a much higher risk than the complications. The frequency of complications requiring surgical intervention is 1:1000, according to statistics based on large samples.

 

In our office, we do the examination under anesthesia!

 

  1. X-ray examination with contrast agent. The bowels are cleared before this examination and the patient gets an enema with a contrast agent, which neatly shows the colon. The examination uses X-ray. The contrast agent makes the colon clearly visible on the X-ray screen or recording. This examination is far less sensible as colonoscopy and does not allow any interventions (biopsy, polyp removal).
  2. The special CT colon examination, or the so-called virtual colonoscopy, is the modern, accurate and less uncomfortable examination of the colon. The method allows the taking of pictures of the colon using a computer. Before the examination, the bowels of the patient get neatly cleared by the laxative solution and the stool will be water-clear. He/she is required to consume liquid X-ray contrast agent at certain intervals before the examination. On the CT table, a clyster pipe is lead into the anus, through which air is blown into the colon. While the patient is laying on the back, the colon is filled with air until the patient feels discomfort. The CT makes the measurement in 15 seconds, this is the time the patient needs to hold his/her breath for. In certain cases it is necessary to repeat the measurement after administering venous contrast agent or in a prone position. Interventions are also not possible in this case.

 

Physicians regard colonoscopy, together with all its inconveniences, to be the best solution, because it allows them to take tissue samples and remove polyps. Biopsy is necessary for the potential surgery as well, as this “evidence” is absolutely necessary for doing the surgery.

 

Surgical intervention

Colon cancer removed in time by removing a piece of the colon can be perfectly cured. The rectum, the anus and the sphincter can stay in this case. If the tumor is too close to the rectum, then, unfortunately, the patient can be relieved of the tumor by leading the colon out to the stomach wall, and the patient would then stool into a tightly sealed bag. If colon cancer is not detected in time and has already caused metastasis, then the ultimate healing of the patient is much more difficult. (Metastases can be anywhere, but they appear in the liver and the lung most frequently.) The physicians try to help the patient applying radiotherapy and chemotherapy in such cases. Whether these treatments can be administered is determined by a committee and based on the status of the patient and the extent of the tumor.

 

The disease through the eyes of those who have already gone through it

I had cramping abdominal pain, so I visited Dr. László, who run a laboratory test which already showed some anomalies. This was followed by ultrasonography and endoscopic test, and the result was positive, unfortunately. I had not been to a screening test before. The news were of course a shock to me, but I had great medical help, so I quickly decided to try everything and to try to get healed. I was having this strong desire to heal, and I believe it meant a lot. My family approached both this matter and me in a similar way and they gave a lot of support to me. I do not know what they felt inside, because they did not show.

 

I underwent the surgery immediately, than went to chemotherapy for 6 months, with all its possible side-effects, but knowing that this is just temporary. Then I had to go to checkups frequently, but now, after 5 years, I need to go only every 6 months, and I am symptomless. The disease did of course change my life: you need to live knowing that you have already had this and it might come again at any time. It is not simple Living a normal and active life, within reasonable limits, is something I regarded as important both while I had the disease and ever since. Neither this or adhering to some sort of a mild diet is an easy thing, because if I feel well, I like to forget the whole thing.

 

My advice to every patient: positive approach, desire to heal, no panic, haste, trust a doctor or a team, diligently adhere to any medical advice and also live a normal life. If I had my today mind back then, I would have went to screening earlier.

 

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