Instructions on Colonoscopy

Introduction This pamphlet has been written to ensure your comfort during the procedure. Please read it carefully before your colonoscopy to better understand the procedure. Who should have a colonoscopy? Your colorectal surgeon may recommend a colonoscopic examination if you have a change in bowel habit or experience rectal bleeding. This indicates a possible problem in the colon or rectum. What are the benefits of colonoscopy? It is possible for colonoscopy to detect or remove most polyps without abdominal surgery. Colonoscopy is more accurate than an X-ray examination of the colon in detecting major step toward the prevention of colon cancer. A colonoscopy is also necessary to:

Check unexplained abdominal symptoms. Check inflammatory bowel disease (colitis). Verify findings or to remove polyps or tumours located by a barium enema examination. Examine patients who were tested positive for blood in their stools. Monitor patients with a past history of colonic polyps or cancer. Examine high-risk patients with a family history of colorectal cancer or familial colorectal polyposis.

What is colonoscopy & how is it performed? Colonoscopy is a procedure where the doctor examines the interior of your large bowel by using an instrument called a colonoscope. Before the procedure, you may be given a mild sedative via an injection to make you feel more comfortable. Because of this, it would not be safe for you to drive, as you may feel drowsy. However, not all patients need the injection as most find the procedure bearable and prefer to participate in the colonoscopy actively. If you prefer to have the sedative, you should arrange for someone to take you home after the procedure. During the colonoscopy, you may experience a feeling of fullness as air is introduced into your colon. This is to expand your colon so your doctor can see the interior of your colon. As the bowel passage is not straight, you may also experience cramps when the instrument passes around the corners of your colon. Apart from this, the procedure is usually safe and is very well tolerated. The entire procedure usually takes between five to 15 minutes. Following the colonoscopy, you may experience slight abdominal distension. This quickly improves with the expulsion of gas. Most patients can resume their regular diet almost immediately. What are the risks of a colonoscopy? Colonoscopy is a very safe procedure, with less than 0.05% risk of perforation to the wall of the colon. Other occasional problems may include bleeding from polypectomy sites. Patients with heart valve disease are advised to receive antibiotic prophylaxis as transient bacteremia during colonoscopic insufflation may case bacterial infection of diseased heart valves. Bowel preparation A clean bowel is essential for this procedure. Before the procedure, the bowel must be thoroughly cleansed. This will increase both the accuracy and safety of the test as well as shorten the time needed for the examination. Poor preparation may result in the need for a repeat colonoscopy. Please follow the instructions given carefully. Different consultants may use different regimens for bowel preparation. Cleansing of the bowel is done one day before the procedure in the morning. For colonoscopy performed in the afternoon, bowel preparation may be performed in the same morning. Please follow all preparation instructions given. Your examination may have to be cancelled if you do not follow the instructions. If you have any queries, please contact our staff at 6436 8120 (Listing Room) or 6436 8116 (Endoscopy Suite). Post colonoscopy instructions You will be able to return home immediately after the colonoscopy if no sedation was given to you. If sedation was given, you will have to be accompanied home. You should not drive until you have fully recovered from the sedative. Any unusual abdominal pain or rectal bleeding within the next three days should be reported immediately to your doctor. Examination Schedule DIET A) From:______________________________(Day before the examination) Avoid all solid food, cereals, vegetables, fruits and meat. You may have low residue food such as fish porridge, soft drinks, plain tea or coffee and clear soup. Do not take milk-based beverages. B) On:________________________________(Evening before the examination) You will be given oral medications to clean the colon. 1st packet dissolved in 500 ml of water to start at

2nd packet dissolved in 500 ml of water to start at

The above medication should be taken and completed within 2 hours. You may feel "bloated" after taking the medication. However, this feeling usually subsides when bowel movements begin. This usually occurs 30 to 60 minutes after taking the medication. If you feel like vomiting, please wait 15 minutes before drinking again. If you continue to vomit or have severe abdominal pain, stop taking the medication and consult your doctor immediately. Do not add sugar or flavouring to the oral medication. You may place the solution in the refrigerator. Drink as much clear fluid as possible after taking the medication. An average of 2 litres of fluid is needed for colonic cleansing. C) On:____________________________(Day of the examination) 1) Drink as much clear fluid (water, plain coffee and tea) as you like. 2) Please proceed to NCC 'D' Clinic, Level 2, Reception Counter at the appointed time.