Endoscopy and Colonoscopy: What They Are and How They Are Done

Endoscopy and colonoscopy are procedures in which parts of the digestive system are examined using a tube called an endoscope, which has a light source and a camera. These procedures are not surgical operations.

The term endoscopy most often refers to upper gastrointestinal endoscopy (gastroscopy). In this procedure, the endoscope is advanced through the mouth and throat to examine first the esophagus, then the stomach and the upper part of the duodenum.

No additional preparation is needed for endoscopy, but patients must have an empty stomach.

Examination of the rectum and the other parts of the large intestine by advancing the endoscope through the anus is called colonoscopy. In some cases, examining only the sigmoid colon is sufficient; this procedure is called sigmoidoscopy.

Endoscopy or colonoscopy usually takes about 10–30 minutes. If an additional procedure is performed (such as a biopsy or polyp removal), it may take somewhat longer.

For colonoscopy, the large intestine needs to be cleaned. For this cleansing, oral medications are given along with a few days of a liquid diet, and an enema is given close to the time of the procedure.

How Do I Prepare for Endoscopy?

For the procedure to be performed safely and completely, the stomach must be empty. Patients are asked not to eat or drink anything for 6–8 hours.

Before the procedure, patients are asked about other illnesses, and any history of allergy or other conditions that may be relevant to the procedure are assessed. Based on this assessment, doctors decide whether any antibiotic needs to be used before the procedure and take precautions against a possible allergy. They also make the necessary adjustments to change the patient's current medications or to pause them until the procedure.

If the patient has a pre-existing serious heart or lung disease, the doctor needs to take extra precautions.

How Do I Prepare for Colonoscopy?

For colonoscopy to be performed completely and accurately, the large intestine must be clean. There are many cleansing methods. These usually include medications taken by mouth and given rectally in addition to a liquid diet for a few days. These cleansing plans must be followed exactly, because if the bowel is not fully clean, the examination cannot be completed and the procedure may need to be repeated.

Patients generally continue taking medications for their other conditions. It is important that patients who take aspirin, blood thinners (such as Coumadin), insulin or iron supplements report this, because their medications will need to be adjusted. In addition, allergies and other serious health conditions need to be carefully assessed.

What Happens During Endoscopy?

Before the endoscopy, your doctor will explain why the procedure is being performed, whether there are any alternative tests and the complications that may occur.

After a numbing spray is applied to the throat, patients are given anesthesia and put to sleep. Throughout the procedure, the patient is monitored by the anesthesia team.

Once the patient is asleep lying on the left side, the endoscope, which is about as thick as a little finger, is inserted through the mouth to examine the esophagus, stomach and duodenum. Breathing is not affected during the procedure. Most patients do not remember the procedure and feel very little discomfort.

After the procedure, patients are taken to a recovery room until the effect of the medication wears off. On the day of the procedure, patients are asked not to do anything that requires concentration and, in particular, not to drive.

What Happens During Colonoscopy?

During colonoscopy, patients are given intravenous fluids and connected to a monitor to track their vital signs. The air introduced during colonoscopy causes cramping and a feeling of bloating, but thanks to the medications given, patients do not feel significant pain.

Once the patient is sedated, the examination begins at the anus and all parts of the large intestine are examined. Colonoscopy takes between 15 and 60 minutes. If the large intestine cannot be examined adequately, your doctor may decide to repeat the procedure or use other imaging methods.

Biopsies may be taken from areas that look abnormal, and the removed tissue is sent to the pathology department for examination. If an infection is suspected, a sample may be taken for testing. If colonoscopy is performed because of bleeding, procedures to stop the bleeding are carried out. If abnormal growths called polyps are found, they are removed during colonoscopy and sent for examination. Although polyps are usually benign, they have the potential to become cancerous and need to be removed when found. None of these procedures is painful. A biopsy may be taken for many reasons, and having a biopsy does not mean that cancer is suspected.

What Are the Risks of Endoscopy?

Endoscopy is generally a very safe procedure with a very low rate of complications. Possible complications include irritation around the IV site, an allergic reaction to the medications given, complications related to pre-existing heart, lung or liver disease, and bleeding from the site of a removed polyp, which is usually minor. Major complications such as perforation in the examined or treated areas are very rare.

What Are the Risks of Colonoscopy?

Complications after colonoscopy are quite rare and usually minor.

Bleeding may occur at sites where a biopsy was taken or a polyp was removed, and it usually stops on its own. Less often, perforation of the large intestine may occur after colonoscopy. These perforations can heal without surgery.

Other possible complications include irritation at the IV site and complications related to the patient's other illnesses. These complications occur in less than 1% of cases.

Although complications are rare, no time should be lost once they are noticed. Patients who develop severe abdominal pain, pass more than half a glass of blood from the rectum, or have fever and chills should contact their doctor again without delay.

Colonoscopy is still one of the best methods for diagnosing and treating diseases of the large intestine. The alternatives to colonoscopy are limited.

After colonoscopy, patients are kept under observation for about 1–2 hours. Once the effect of the medication wears off, patients are discharged, but on the day of the procedure they are asked not to do anything that requires concentration and, in particular, not to drive. Patients may have some cramping abdominal pain and bloating. These complaints ease quickly once gas is passed. Patients can start eating normally when they get home.

How Soon Will I Get My Endoscopy Results?

In most cases, doctors give patients their results at discharge after the procedure. If a biopsy is taken, the time it takes for pathology results to come back varies.

How Soon Will I Get My Colonoscopy Results?

Doctors give patients their colonoscopy results after the procedure, before discharge. If a biopsy is taken, the time it takes for the pathology result to come back may vary.

At İzmir Özel Can Hastanesi and Salihli Özel Can Hastanesi, endoscopy and colonoscopy procedures are evaluated by specialists in general surgery, internal medicine, anesthesiology and gastroenterology who have extensive scientific knowledge, skill and experience in their fields, and the most appropriate treatment approaches are applied. Please contact us for information and appointments.