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Diagnostic Colonoscopy

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What is a diagnostic colonoscopy?

A diagnostic colonoscopy is a test carried out by a gastroenterologist or colorectal surgeon to check the health of the inside of your bowels.

Why would I need a diagnostic colonoscopy?

Patients needing a colonoscopy usually do so because they have bowel symptoms including:

  • Abdominal pain
  • A significant change in bowel habit
  • Chronic constipation or diarrhoea
  • Bleeding from the back passage
  • Unexplained weight loss
  • Unexplained tiredness

Those with inflammatory bowel conditions such as Crohn’s disease or ulcerative colitis or with a family or personal history of bowel cancer or polyps may also have regular diagnostic colonoscopies to check on the health of their bowel.

What symptoms does a diagnostic colonoscopy address?

A diagnostic colonoscopy isn’t carried out to provide relief from symptoms. Instead, it’s carried out to help a doctor diagnose the cause of certain bowel symptoms including abdominal pain and bleeding from the back passage.

This procedure is used to help diagnose or rule out conditions such as Crohn’s disease, ulcerative colitis, microscopic colitis, bowel cancer, polyps or diverticular disease.

When should you speak to your specialist about a diagnostic colonoscopy?

If you have any of the above bowel symptoms or you’re worried about a change in bowel habit, a specialist may recommend a diagnostic colonoscopy.

How is a diagnostic colonoscopy performed?

A diagnostic colonoscopy is performed under sedation, which means that you’ll be awake throughout but you’ll be feeling drowsy and relaxed and may not remember the procedure afterwards.

During the procedure, you’ll be asked to lay on your left hand side with your knees up towards your chest whilst your doctor passes a long, thin medical instrument called an endoscope into your anus. The endoscope is flexible and has a camera and a light on the end to allow your doctor to see the inside of your bowel on a nearby screen.

Your doctor will slowly pass the endoscope up into your large intestine (colon) in order to view the full length. They may need to pump air into your bowel through the endoscope to get a better view.

If they find any small growths, called polyps, in your colon, they will either remove them, or take a small sample of tissue, called a biopsy, from them, using a small surgical tool through the endoscope.

The whole procedure usually takes around 30 to 45 minutes and you’ll be able to return home the same day.

What is the recovery like for a diagnostic colonoscopy?

Your recovery from a diagnostic colonoscopy will depend on multiple factors, including your age, fitness level and the nature of your procedure.

You may feel a little discomfort or cramping from the air that was pumped into your bowel after the procedure but this should only last a few hours. You may also notice a small amount of blood in your stools for a few days afterwards but this will also soon disappear.

After sedation, there are certain things you must not do for 24 hours, such as drive or make important decisions. Your medical team will give you further advice before sending you home.

Your medical team will discuss any immediate results with you before you go home, and will tell you when to expect the results of any biopsies taken.

Are there any risks/complications associated with a diagnostic colonoscopy?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

A diagnostic colonoscopy has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

  • Perforation of the bowel
  • Bleeding from the bowel

How can I prepare for a diagnostic colonoscopy?

Prior to a diagnostic colonoscopy, your consultant will discuss with you how best to prepare for the test, as each patient is different.

Common preparations for a diagnostic colonoscopy include:

  • Routine blood tests, x rays or scans as requested by your surgeon
  • Taking steps to stop smoking if you smoke
  • Losing weight if you’re overweight
  • Remaining active and doing regular exercise

There are also specific preparations involved with having a diagnostic colonoscopy. These include eating a low fibre, basic diet and taking a laxative bowel preparation to clear the bowel in the two days before your procedure. Your medical team will give you more explicit advice.

Are there alternatives for a diagnostic colonoscopy?

A flexible sigmoidoscopy is similar to a colonoscopy, but the endoscope doesn’t travel as far into the bowel. This may be enough, but you may also need a colonoscopy after a flexible sigmoidoscopy so that your doctor can look further into your bowel.

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