DE EN RU

Colonoscopy (anorectocolonoscopy)

Basics

Colonoscopy (anorectocolonoscopy) describes the endoscopic examination of the inner layer ( Mucosa) of the anus, rectum and colon (large bowel). We perform painless colonoscopy under sedation. Usually colonoscopy lasts 15-20 min. During the Endoscopy our anesthesiologist monitors your blood pressure, heart rate and breathing.

Indications

Indications for colonoscopy include a history of Barrett’s esophagus (25% coincidence), abdominal pain, gas bloating, (bloody) diarrhea, nausea and vomiting. Cancer prevention: screening colonoscopy is recommended at age 50 for men and women.

The technology

Colonoscopy uses a flexible endoscope for the examination of the anus, rectum and colon (large bowel). When indicated the endoscope can also examine the lower part of the small intestine (ileum). The endoscope is connected to the video tower (light source, video screen). The endoscopic images are followed on a high-resolution video screen. Data, images and videos are stored on a computer. The endoscope includes a working channel for the introduction of instruments ( Biopsy forceps, electro cautery devices for cutting and resection).

Preparation

For colonoscopy we recommend bowel preparation with Klean prep. The day before the Endoscopy you will drink 5 liters of Klean prep, thereafter keep fluid diet (clear soup, water, tea). Colonoscopy is conducted after 6 hours fast. Otherwise large bowel content (food, secretions) will impair the vision to the tissue. If the colonoscopy is scheduled for the afternoon the patient is allowed to take the morning medications (hormones, heart, blood pressure medications). If the colonoscopy is planned before 12 a.m. patients should not take hormones, heart, blood pressure medications. Our anesthesiologist will administer the drugs during the sedation.

Colonoscopy

We conduct colonoscopy under sedation and left lateral body position. Following the rectal digital examination (palpation of the rectum, hemorrhoids) the endoscope is introduced into the rectum and forwarded towards the beginning of the large bowel (coecum). During the Endoscopy we insufflate air to extend the gut to obtain adequate space for the examination. Now we slowly remove the endoscope from the coecum (right portion of the large bowel) towards the rectum. During the course we exactly inspect the Mucosa of the large bowel. Polyps are removed and suspicious areas are Biopsy sampled. Before retrieval of the endoscope we aspirate the insufflated air. Thereafter you relax in the recovery room.

Biopsy sampling

During the colonoscopy we obtain biopsies from any abnormality using the Biopsy forceps. The forceps is introduced via the working channel of the endoscope. Biopsy sampling is painless.

Complications

Complications are rare, occur in 0.02% of the cases and include perforation and bleeding. Minor side effects include gas bloat, abdominal discomfort, nausea and vomiting. Our anesthesiologist immediately antagonizes such complaints by the administration of effective drugs.

Endoscopy report

The Endoscopy report lists all findings (diverticula, inflammation, polyps, tumor). In addition the report catalogs the Biopsy sites and types of interventions (polypectomy). The report includes color images of the anus, rectum and colon. Finally the Endoscopy report includes therapy and management recommendations (medication, additional examinations etc.). The Endoscopy report is an important health document and should be provided to your physicians during health consultation.

Relevance of colonoscopy

The relevance of colonoscopy is the assessment of cancer risk (polyps) and the recommendation for surveillance for cancer prevention. Colon polyps and Barrett’s esophagus share the same 0.5% annual cancer risk.

Expert opinion

Martin Riegler (Surgeon, Vienna):

There is a positive (25%) correlation between polyps of the colon and Barrett’s esophagus. Both entities share the same cancer risk. Therefore we recommend: Gastroscopy and colonoscopy; removal of polyps and Barrett’s esophagus. Biopsy forceps or sling removes polyps. Radiofrequency ablation (HALO®) eliminates Barrett’s esophagus. This is our holistic approach for fair care and cancer prevention.

Literature

Gerson LB, Shetler K, Triadafilopoulos G. Prevalence of Barrett's esophagus in asymptomatic individuals. Gastroenterology 2002; 123(2): 461-7.

Rex DK, Cummings OW, Shaw M, Cumings MD, Wong RK, Vasudeva RS, Dunne D, Rahmani EY, Helper DJ. Screening for Barrett's esophagus in colonoscopy patients with and without Heartburn. Gastroenterology 2003; 125(6):1670-7.

Genericon