Colonoscopy

What is it?

A colonoscopy is an exam in which a flexible tube with a fiber optic light and camera (colonoscope) is passed through the rectum along the full length of the colon (large intestine).

It is done to screen for colon cancer and to diagnose diseases of the bowel such as colitis, irritable bowel syndrome and diverticulosis.

Colorectal cancer (colon cancer) develops in the colon or rectum. Before a cancer develops, there are often changes in the lining of the intestines. One of these changes is the abnormal of tissue, called a polyp. Although usually benign (non cancerous), a polyp may develop into colon cancer. They vary in size from tiny to several millimeters in size and usually are removed during a colonoscopy

Beginning at age 50, individuals at average risk for colon cancer should have one of these five screening option, according to the American Cancer Society:

  • A fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year**
  • Flexible sigmoidoscopy every 5 years**
  • An FOBT* or FIT* every year plus flexible sigmoidoscopy every 5 years (of these first 3 options, the combination of FOBT or FIT every year plus flexible sigmoidoscopy every 5 years is preferable).
  • Double-contrast barium enema every 5 years** For FOBT or FIT, the take-home multiple sample method should be used.
  • Colonoscopy every 10 years (colonoscopy should be done if the FOBT or FIT shows blood in the stool, if sigmoidoscopy results show a polyp, or if double-contrast barium enema studies show anything abnormal. If possible, polyps should be removed during the colonoscopy.)

Many individuals are at heightened risk for colon cancer. The key factors that can increase risk are:

  • Age: Simply being over the age of 50 is the most common risk factor for developing colon cancer.
  • A personal history of colon cancer: People who have had colon cancer are more likely to have a recurrence.
  • A personal history of polyps: While most polyps are benign, some may develop into colon cancer.
  • A personal history of inflammatory bowel disease: Conditions such as ulcerative colitis and Crohn's disease increase the risk of colon cancer.
  • A family history of colon cancer or polyps.
  • Familial adenomatous polyposis (FAP) - a hereditary condition which results in the development of hundreds of polyps in the colon and rectum. Cancer may occur between the ages of 30 and 50 in patients with this condition.
  • A diet high in animal fats from animal sources can increase the risk of colon cancer.
  • Physical Inactivity: Inactive individuals are more likely to develop colorectal cancer.
  • Obesity: Being very overweight increases the risk of dying from colorectal cancer.
  • Smoking: Smokers are 30 to 40 percent more likely than non-smokers to die from colorectal cancer.
  • Alcohol use: Colorectal cancer has been linked to the heavy use of alcohol.

Individuals with one or more risk factor should consult with their doctors about the appropriate tests and frequency of tests.


Your Colonoscopy Procedure

Before the Procedure

Bowel prep
Your physician will order a bowel prep regimen that is appropriate for your medical history. It consists of oral laxatives and clear liquids and usually is started the day before the scheduled procedure. You will also be instructed not to eat or drink anything after midnight before your exam. The colon must be completely empty for the exam to accurate and complete. Be sure to follow your doctor's instructions carefully. On occasion, a colonoscopy has had to be rescheduled because of poor bowel prep. If you are passing clear or green liquid with brown flecks prior to the exam, it is a good indication your colon has been adequately cleaned. If this is not the case, you should call your physician's office for further instructions.

Routine Medications
You should always check with your physician about taking any medication the day of your exam. This includes over the counter medications and herbal supplements. You may be advised to stop taking any blood thinners (such as aspirin, vitamin E, ibuprofen or Coumadin) two weeks prior to the exam, or modify the dose (insulin, oral hypoglycemic, blood pressure and cardiac medications) the day of the exam. Please bring a list of ALL medications you take with you.

Be sure to inform your physician if you require antibiotics before dental or similar procedures. This may also be required before a colonoscopy or endoscopy.


During the Procedure

After registering, you will be brought to a private exam room where a specially trained nurse and your physician will review your medical history, explain the procedure and answer your questions prior to the procedure. As most patients prefer to be sedated for the exam, and IV site will be established and your vital signs will be monitored closely. You will be placed on your left side, and after sedation is achieved, the physician will pass the scope slowly along your colon while watching a TV monitor. The scope is passed approximately 80 cm end of the large intestines and where the small intestines begin. Air and water are used to slightly inflate the bowel and wash away any residual flecks so that the lining of the intestines can be seen clearly. A sample of tissue (biopsy) may be taken or a polyp may be removed (polypectomy) during this procedure and is painless. The tissue sample will be sent to the pathology lab for evaluation. Results are usually available within a week. The actual procedure usually takes 15 - 20 minutes. The colonoscopy is usually well tolerated and rarely causes discomfort.


After the Procedure

You will be brought to a recovery room where your vital signs will be monitored for a brief period and you will be discharged with a family member or a friend. You should allow 2-3 hours for the total visit.

Discharge instructions will be reviewed with you prior to the start of the exam and will be given to you on discharge from the unit. The results of your exam and any other instructions will be written upon completion of your procedure.

You must be discharged with a person who will drive you home and assure your well being after arriving home. Please arrange to have someone stay with you or be accessible if a problem arises after discharge. This is especially important for elderly patients and those with significant medical histories, such as diabetes and cardiac conditions.

If you have been sedated, you will be instructed not to drive or drink alcohol for the rest of the day. Patients are also advised not to do any activities that require mental acuity or physical activity, such as sports, legal decisions, or using power tools. You should rest at home with light activity for the remainder of the day.

  • In most cases, patients may resume their usual diet immediately. If your doctor advises differently, this will be noted on the discharge instructions.
  • If you experience any "gas" discomfort after the exam, this is normal. Air is used to dilate the bowel during the exam. You may use a heating pad or ho water bottle, lie on your left side or walk around to relieve it.
  • You may resume your usual medications unless indicated on the discharge instructions. If biopsies were done or a polyp removed, your doctor may advise holding blood thinners, such as aspirin, Ibuprofen and coumadin for several days to prevent bleeding.

Specialists in Colonoscopy

Name Specialties Location
Cappa, Joseph Anthony, MD
860.657.1920
  • Gastroenterology
  • Glastonbury
  • Bloomfield
  • Hartford
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Cipolla, Donna Marie, MD
860.657.1920
  • Gastroenterology
  • Internal Medicine
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  • Glastonbury
  • Avon
  • Hartford
  • Manchester
  • West Hartford
  • Wethersfield
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Cohen, Jeffrey Lewis, MD, FACS, FASCRS
860.548.7336
  • Colon & Rectal Surgery
  • General Surgery
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  • Hartford
  • Farmington
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Feldman, Thomas Alan, MD
860.409.4567
  • Gastroenterology
  • Internal Medicine
Show Less
  • Farmington
  • Bloomfield
  • Glastonbury
  • Hartford
  • West Hartford
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Gelwan, Jeffrey Stuart, MD
860.657.1920
  • Gastroenterology
  • Internal Medicine
Show Less
  • Glastonbury
  • Farmington
  • Hartford
  • Rocky Hill
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Johnson, Kristina Hope, MD, FACS, FASCRS
860.548.7336
  • Colon & Rectal Surgery
  • General Surgery
Show Less
  • Hartford
  • Farmington
  • Glastonbury
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Johnson, Maria Elena, MD
860.246.2571
  • Gastroenterology
  • Internal Medicine
Show Less
  • Meriden
  • Farmington
  • Hartford
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Kroll, Sherry Lee, MD, MBA, FACP
860.230.0020
  • Internal Medicine
  • Plainfield
  • Putnam
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Sachdev, Kiran, MD
860.657.1920
  • Gastroenterology
  • Glastonbury
  • Bloomfield
  • Farmington
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Sardella, William Vincent, MD
860.548.7336
  • Colon & Rectal Surgery
  • General Surgery
Show Less
  • Hartford
  • Glastonbury
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Thurston, Kristy Tyler, MD
860.548.7336
  • Colon & Rectal Surgery
  • General Surgery
Show Less
  • Hartford
  • Manchester
  • Manchester
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Vignati, Paul Vincent, MD
860.548.7336
  • Colon & Rectal Surgery
  • General Surgery
Show Less
  • Hartford

Gastroenterology Division

  • Gastroenterology Division
    Hartford Hospital
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    Fax: 860.545.2785

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