Colonoscopy

Colonoscopy (also known as a large bowel examination) is performed to effectively assess the risk of colorectal cancer in individuals over the age of 50 or in patients experiencing symptoms associated with colorectal cancer. This procedure can also be used as a treatment method to remove colon polyps, stop bleeding, and more. In our clinics, colonoscopy is performed using some of the latest and most advanced endoscopic equipment. The primary purpose of the examination is the diagnosis of colorectal diseases.

When is a colonoscopy necessary?

A colonoscopy is performed in the following cases:

• For preventive screening: if you are over 50 years old, as the risk of colorectal cancer increases with age;
• If symptoms are present: abdominal pain, bowel habit changes (constipation or diarrhea), blood in the stool, or other bowel function disorders;
• For diagnosed conditions: colon polyps, inflammation, cancer, or investigation of gastrointestinal bleeding.

How should you prepare for a colonoscopy?

What does proper preparation mean?

• If the entire colonic mucosa is clearly visible during the procedure, the patient is considered properly prepared. If stool remains in the colon, preparation is inadequate. This makes the examination less effective, as stool may conceal adenomas and polyps. In such cases, the endoscopist may reschedule the procedure.

How should you prepare for a colonoscopy?

• It is very important to follow a proper dietary regimen, divided into several strict stages: 2–3 days before the examination and 24 hours before the procedure. It is also essential to follow your physician’s instructions regarding prescribed bowel-cleansing medications (e.g., CitraFleet).
• Therefore, if your procedure is scheduled for Monday, begin preparation on Friday.

What should not be consumed 2–3 days before a colonoscopy?

• Avoid foods containing seeds, nuts, grains, cereals, fruits, or vegetables. Red and purple foods and beverages should also be avoided.

What can be consumed 2–3 days before a colonoscopy?

• Milk, plain yogurt without additives, cottage cheese, sour cream, cream, butter, and mayonnaise without herbs.
• Cheese without additives such as caraway seeds or herbs. Suitable options include cheddar, ricotta, feta, goat cheese, mozzarella, parmesan, and cottage cheese.
• White bread, white rice, refined pasta, refined wheat flour products, peeled potatoes, skinless white fish fillet, eggs, skinless chicken breast, vanilla ice cream, white chocolate without additives, and sugar.

What should not be consumed 24 hours before a colonoscopy?

• Alcoholic beverages, milk and dairy products, milkshakes, cream, soups, and red or purple foods and drinks.
• Smoothies and opaque juices (orange, tomato, multivitamin, grapefruit, etc.).

What can be consumed 24 hours before a colonoscopy?

• Remember that the final 24 hours before the procedure are the most important. During this period, you should drink 4 liters of clear non-carbonated fluids and take all prescribed bowel-cleansing medications (e.g., CitraFleet).
• You may consume water, tea, coffee without milk, cream, or syrup. Apple juice, clear non-carbonated soft drinks (excluding red or purple drinks), and clear broth without solids are also allowed. Plain hard candies and jelly desserts without additives are permitted (excluding red or purple colors).
• You may eat only a light breakfast before 9:00 a.m. (for example, a boiled egg with a slice of white bread).
• For the remainder of the day, consume only clear liquids. The timing of your last meal may vary depending on the scheduled time of your colonoscopy the following day.

Important information:

• Arrive with a driver or accompanying adult.
• If attending under a colorectal cancer screening program, bring an electronic referral from your family physician for a gastroenterologist consultation, including information about any coexisting diseases and a list of regularly used medications.
• Bring laboratory test results not older than 14 days:
  • Complete blood count (CBC);
  • Potassium test;
  • Blood coagulation test;
  • Blood glucose test (for patients with diabetes);
  • Electrocardiogram (ECG).

How is a colonoscopy performed?

• The patient changes into disposable clothing and lies on the left side. The physician performs the examination by gently inserting a colonoscope through the anus into the colon and cecum. During the examination, air is introduced through the scope to expand the bowel walls and improve visibility.
• The procedure is performed under general anesthesia. Medication is administered intravenously, allowing the patient to fall asleep and remain free of discomfort.
• On the day of the procedure, patients typically spend 2–3 hours at the clinic. The examination itself takes between 15 minutes and 1 hour, after which the patient rests until the effects of anesthesia wear off. Because general anesthesia is used, patients must be accompanied by an adult.

After the colonoscopy:

• Mild abdominal discomfort or bloating may occur but gradually resolves;
• Drink plenty of fluids and avoid alcohol and heavy meals after the procedure;
• Colonoscopy screening may be repeated every 5 years;
• Do not drive a vehicle after the examination.

Other procedures performed by gastroenterologists

In addition to standard colonoscopy, we also perform examinations of the anus and rectum, as well as polyp removal procedures.

Anoscopy is an examination of the anal canal and lower rectum performed using a special instrument called an anoscope. Unlike colonoscopy, anoscopy examines only the lower part of the rectum and anal canal, approximately 5–10 cm deep. The procedure is less invasive, takes only 10–20 minutes, and does not require general anesthesia. No special preparation is needed, although it is recommended to empty the bladder and bowels before the examination. Anoscopy is performed to diagnose hemorrhoids, anal fissures, fistulas, inflammation, and tumors.

Rectoscopy is an examination of the rectum performed using a rectoscope. The procedure typically lasts 15–30 minutes. Preparation with micro-enemas is required beforehand. Although less invasive than colonoscopy, it may still cause some discomfort. Rectoscopy is used to diagnose rectal inflammation, cancer, polyps, causes of bleeding, and mucosal abnormalities. It may be performed as a screening examination or when symptoms such as rectal bleeding, anal pain, changes in bowel habits, or mucus discharge are present.

Polypectomy is the removal of polyps (growths on the inner lining of the colon or rectum). It is performed during colonoscopy or rectoscopy. When a polyp is detected, a special loop is placed around it and the polyp is removed. The removed tissue is then sent for examination. Polypectomy is performed as a preventive measure against colorectal cancer. After the procedure, patients may experience bloating and abdominal discomfort. During the first few days after polypectomy, strenuous physical activity, heavy foods, and alcohol should be avoided.