What is Colonoscopy?

A colonoscopy is a vital medical procedure that allows doctors to examine the inside of your colon (large intestine) and rectum. It involves using a long, thin, flexible tube with a camera attached, called a colonoscope, which is gently inserted into the rectum. The camera transmits images onto a monitor, enabling the doctor to visualize the lining of your entire colon.

This procedure is crucial for both screening and diagnosing various conditions affecting the lower digestive tract. It's not just about finding problems; colonoscopies also allow doctors to take biopsies (tissue samples) for further analysis and even remove polyps (small growths) that could potentially become cancerous. Early detection and intervention through colonoscopy are key to preventing and treating colorectal cancer.

Key Facts:

• Colonoscopy is a safe and effective way to screen for colorectal cancer and diagnose other bowel problems.
• It involves inserting a flexible tube with a camera into the rectum.
• Preparation is essential for a successful colonoscopy.
• Polyps can be removed during the procedure.
• The cost of a colonoscopy varies depending on the hospital and city in India.

Why is Colonoscopy Performed?

A colonoscopy is recommended for several reasons, including both screening for potential problems and diagnosing existing conditions.

Main Conditions/Indications:

• Colorectal Cancer Screening: Especially for individuals aged 45 and older, or earlier if there's a family history of colorectal cancer.
• Investigating Abdominal Pain: To determine the cause of unexplained or persistent abdominal discomfort.
• Rectal Bleeding: To identify the source and cause of blood in the stool.
• Changes in Bowel Habits: Such as persistent diarrhea, constipation, or changes in stool consistency.
• Chronic Diarrhea: To investigate the underlying cause of long-term diarrhea.
• Follow-up After Abnormal Stool Tests: If other stool tests indicate potential problems.

When Doctors Recommend It:

Doctors in India are increasingly recommending colonoscopies for individuals over 45 due to the rising incidence of colorectal cancer in younger populations. They may also recommend it if you have:

• A family history of colorectal cancer or polyps.
• A personal history of inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis.
• Unexplained anemia (low red blood cell count).
• Symptoms that suggest a problem in the colon or rectum.

Preparation for Colonoscopy

Proper preparation is absolutely essential for a successful colonoscopy. It ensures that the colon is completely clear, allowing the doctor to have a clear view of the lining.

Essential Preparation Steps:

• Bowel Preparation: This is the most crucial step. Your doctor will provide specific instructions, but it typically involves:
  • Clear Liquid Diet: Starting the day before the procedure, you can only consume clear liquids like water, clear broth, clear juice (apple, white grape), clear sports drinks, and plain tea or coffee (without milk or cream).
  • Bowel-Cleansing Solution (Laxative): You will need to drink a prescribed solution to empty your bowels. Follow the instructions carefully, as the timing and amount are critical.
  • Increase Fluid Intake: Drink plenty of clear liquids throughout the day to stay hydrated.
  • Avoid Solid Foods: No solid foods are allowed the day before the procedure.
• Dietary Restrictions:
  • Low-Fiber Diet (a few days before): Your doctor may recommend avoiding high-fiber foods like nuts, seeds, raw fruits and vegetables, and whole grains for a few days leading up to the procedure.
• Medication Adjustment:
  • Inform Your Doctor: It's crucial to inform your doctor about all medications you're taking, especially blood thinners, diabetes medication, and iron supplements. They may need to be adjusted or temporarily stopped.
• 7 days before colonoscopy:
  • Continue with your aspirin medication (unless otherwise instructed by your doctor).
  • Contact your doctor and tell them about all the medications you are taking.
  • Refrain from taking any type of iron supplements.
• 3 days before colonoscopy:
  • Stop consuming nuts, any fruits containing small seeds (like strawberries, raspberries, and kiwi), tomatoes, corn, popcorn, and celery.
• The day before colonoscopy:
  • Wake up early and have the final liter of the solution 5 hours before your procedure.
  • Do not have any kinds of solid foods, broth, or jello.
  • Follow your doctor's instructions if you take some medicines for your diabetes.
  • Complete your morning mandatory medication (as instructed by your doctor) before 4 hours of your appointment time with a small amount of water.

India-Specific Tips:

• Fasting: Be prepared for a longer period of fasting than you might be used to in your daily routine. Follow your doctor’s instructions about when to stop eating and drinking.
• Documents: Carry all necessary medical records, insurance information, and identification documents with you to the hospital or clinic.
• Consult Your Doctor: Don't hesitate to contact your doctor or the hospital if you have any questions or concerns about the preparation process.

What to Expect:

• The bowel preparation process can be uncomfortable, and you may experience frequent trips to the bathroom.
• Stay close to a toilet during the preparation period.
• It's important to follow the instructions carefully, even if it's unpleasant.

The Colonoscopy Procedure

The colonoscopy procedure itself is typically straightforward and relatively quick.

Step-by-Step:

1. Arrival and Check-in: You'll arrive at the hospital or clinic and check in for your procedure.
2. Preparation: You'll change into a hospital gown and have your vital signs checked (blood pressure, heart rate, etc.).
3. Sedation: You'll receive sedation through an IV to help you relax and minimize discomfort. You'll likely be drowsy but not fully unconscious.
4. Positioning: You'll lie on your side on the examination table.
5. Insertion: The doctor will gently insert the colonoscope into your rectum and advance it through your colon.
6. Visualization: Air is gently inflated into the colon to provide a better view of the lining. The camera transmits images to a monitor, allowing the doctor to examine the colon.
7. Polyp Removal and Biopsy: If any polyps or abnormal tissue are found, the doctor can remove them using instruments passed through the colonoscope. Biopsies (tissue samples) can also be taken for further analysis.
8. Withdrawal: Once the examination is complete, the colonoscope is slowly withdrawn.
9. Recovery: You'll be monitored in a recovery area until the sedation wears off.

Duration, Comfort Level:

• The procedure itself usually takes about 30-60 minutes.
• Most patients experience little to no pain during the procedure due to the sedation. You may feel some pressure or bloating.

What Happens During the Test:

• The doctor carefully examines the entire colon lining for any abnormalities.
• Polyps are removed to prevent them from potentially developing into cancer.
• Biopsies are taken to diagnose various conditions, such as inflammation or infection.

Understanding Results

After the colonoscopy, the doctor will discuss the findings with you.

Normal vs. Abnormal Ranges (if applicable):

In a colonoscopy, the primary result is whether any abnormalities, such as polyps or inflammation, are found. There aren't specific "normal" or "abnormal" ranges in the same way as blood tests. The focus is on the presence or absence of these abnormalities.

What Results Mean:

• Negative: This means that no abnormalities were found in the colon. A repeat colonoscopy may be recommended in 1 to 10 years, depending on your individual risk factors and your doctor's recommendations.
• Positive: This means that polyps or other abnormalities were found.
  • Polyps Found:
    • The doctor will analyze the polyps under a microscope to determine if they are benign (non-cancerous), precancerous (adenomas), or cancerous.
    • The size, number, and type of polyps will influence the recommended follow-up schedule.
      • More than two polyps.
      • A large polyp.
      • Polyps with specific cellular traits that indicate an elevated risk of cancer.
    • If a polyp or other abnormal tissue could not be removed during colonoscopy, your doctor may recommend a repeat visit to a gastroenterologist.
  • Other Abnormalities Found:
    • The doctor may have found inflammation, ulcers, or other signs of disease. Biopsies will help determine the cause and guide treatment.

Next Steps:

• Polyp Removal Follow-Up: If polyps were removed, your doctor will recommend a follow-up colonoscopy in a specific timeframe, depending on the size, number, and type of polyps found.
• Further Testing: If other abnormalities were found, you may need additional tests to determine the cause and guide treatment.
• Treatment: Based on the results, your doctor will recommend the appropriate treatment plan. This may include medication, surgery, or other therapies.

Costs in India

The cost of a colonoscopy in India can vary significantly depending on several factors.

Price Range in ₹:

• Private Sector: ₹2,600 to ₹12,000.
• Government Sector: ₹350 to ₹850.

Government vs. Private:

Colonoscopies in government hospitals are generally much cheaper than in private hospitals. However, there may be longer waiting times.

Factors Affecting Cost:

• Admission fee.
• Health condition of the patient.
• Type of room you opt for.
• Age of the patient.
• Doctor's fee.
• Hospital type (multi-specialty hospitals tend to charge more).
• The city where the procedure is performed (costs may be higher in tier-1 cities).
• Equipment used.
• Whether the procedure is diagnostic or involves therapeutic interventions (polyp removal).
• Sedation type.
• Pathology costs (if biopsies are taken).
• Some hospitals may provide colon prep kits, or the doctor may ask the patient to buy specifics.

Insurance Tips:

• Check with your insurance provider to see if a colonoscopy is covered under your policy.
• Inquire about any pre-authorization requirements.
• Understand what portion of the costs your insurance will cover and what your out-of-pocket expenses will be.

How Ayu Helps

Ayu helps you manage your health records conveniently and securely.

• Store Results Digitally: Keep your colonoscopy reports and other medical records organized in one place.
• Track Over Time: Monitor your health trends over time to identify any changes.
• Share via QR: Easily share your records with doctors and family members using a secure QR code.

FAQ

Q: Is a colonoscopy painful?

A: Most patients experience little to no pain during a colonoscopy because they are given sedation to relax and minimize discomfort. You may feel some pressure or bloating.

Q: How long does a colonoscopy take?

A: The procedure itself usually takes about 30-60 minutes.

Q: How often should I have a colonoscopy?

A: The recommended frequency depends on your individual risk factors. If you have a family history of colorectal cancer or polyps, you may need to start screening earlier and have colonoscopies more frequently.

Q: What if polyps are found during my colonoscopy?

A: If polyps are found, they will be removed and analyzed. Your doctor will recommend a follow-up colonoscopy based on the size, number, and type of polyps found.

Q: What are the risks of a colonoscopy?

A: Colonoscopy is generally a safe procedure, but potential risks include bleeding, perforation (tear) of the colon wall, and allergic reaction to the sedative.

Q: How do I prepare for a colonoscopy?

A: Preparation involves following a clear liquid diet the day before the procedure and taking a prescribed bowel-cleansing solution to empty your bowels. Follow your doctor's instructions carefully.

Q: What should I wear to my colonoscopy appointment?

A: Wear comfortable, loose-fitting clothing. You will be asked to change into a hospital gown for the procedure.

Q: Can I drive myself home after a colonoscopy?

A: No, you should not drive yourself home after a colonoscopy because you will be under the effects of sedation. Arrange for someone to drive you home.