What is a Polyp?
A polyp is a small clump of cells that forms on the colon lining. Although the great majority of colon polyps are harmless, some may become cancerous over time. Anyone can develop colon polyps, but you’re at higher risk if you are age 50 or older, are overweight or a smoker, eat a high-fat, or have a personal or family history of colon polyps or colon cancer. Sometimes colon polyps can cause signs and symptoms such as rectal bleeding. But most small colon polyps don’t cause problems, which is why experts generally recommend regular screening. Colon polyps that are found in the early stages usually can be removed safely and completely. If you have a polyp, it may be removed by electrocautery through the colonoscope. Electrocautery is a medical term that describes a procedure where heat is used to remove the tissue and stop the bleeding. This is a very safe and efficient way to remove a polyp. You will not feel any sensation or discomfort when the polyp is removed.

How do I Prepare for a Colonoscopy?
To complete a successful colonoscopy, your bowel must be clean so that the endoscopist can clearly view the colon. Please read all of your instructions when you receive them in the mail. It is very important to follow all of the instructions given to you for your bowel preparation well in advance of the procedure. Without proper preparation, the colonoscopy will not be successful and the test may have to be repeated.
Your endoscopist will provide written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Your bowel preparation will cause you to go to the bathroom a lot. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. You may drink any type of clear fluid. Make sure that you do drink enough to avoid getting dehydrated. It is important to avoid beverages containing red dyes. They can look red in the colon and be confused with blood.

Types of clear liquids are:
• water
• fat-free bouillon or broth
• strained fruit juice
• sports drinks, such as Gatorade
• gelatin

If you feel nauseated or vomit while taking the bowel preparation, wait 30 minutes before drinking more fluid and start with small sips of solution. Some activity (such as walking) may help decrease the nausea you are feeling. If the nausea persists or you have any questions, please contact your endoscopist office that scheduled the exam for you. You may experience skin irritation around the anus due to the passage of liquid stools.

In order to prevent and treat skin irritation, you should:
Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
Sit in a bathtub filled with warm water for 10 to 15 minutes after you finish passing a stool; after soaking, blot the skin dry with a soft cloth.

What do I Need to Know About My Current Medications?
On the day of your procedure remember to bring a written list of your current medications. Blood-thinning medications (such as Coumadin, Ticlid, Plavix, Persantine, Aggrenox and Lovenox) are commonly discontinued prior to your procedure. It is very important that you contact your prescribing physician for instructions well in advance; you may need to be off these drugs 5 to 10 days prior to your procedure. Your prescribing physician may also tell you to not take iron pills for 7 days prior to your procedure. Continue taking your other prescribed medications (e.g. blood pressure pills) as usual. If you have any questions about your medications, call your prescribing physician.

Diabetic patients: Your prescribing physician will determine if you should not take any oral diabetic medications the day of your procedure. If you are taking insulin, you should be sure to confirm with you doctor how much insulin you should take before your procedure. If you have an internal defibrillator device (AICD) or pacemaker, please bring your card to give to the nurse.

What Can I Expect on the Day of My Colonoscopy?
The morning of your procedure you need to arrive on time to the endoscopy suite. Remember to wear comfortable clothes because you will need to change into a hospital gown. An endoscopy nurse will meet you and check your blood pressure, heart rate, and temperature, obtain your past medical history, make sure there is an updated list of your current medications, bowel prep results, start your IV and answer any questions that you may have. Your family, significant other, friend and/or driver may wait for you in the endoscopy waiting room or they may go to the hospital’s food court. You will be in the endoscopy suite for a total of at least two hours. Your colonoscopy may take up to 1 hour. After your procedure, you will be in the recovery area of the endoscopy suite. Your family, significant other, family or friend may be with you at this time, if you permit it.

How Is a Colonoscopy Done?
After you are wheeled into the examination room you will receive medicine, also known as moderate sedation. This will be given through your IV. This medicine will make you feel sleepy and relaxed. As you lie on your left side, the endoscopist will insert the lubricated flexible colonoscope which may give you a mild sensation of wanting to move your bowels. As the colonoscope is carefully advanced throughout the colon, the endoscopist will examine the bowel lining thoroughly. You may feel some cramping or gas due to the air which the doctor is putting into the colon. You may be asked to change positions during the procedure to assist in passage of the colonoscope. After the procedure, you will probably feel drowsy and you may sleep for a short time. You may feel some bloating from the air inserted during the procedure. You will feel more comfortable if you pass this air.

When Do I Get My Results?
When you are recovering from you procedure your endoscopist will talk with you about the results of your exam. You are more than welcome to have your family and/or significant other present for this discussion.
Your endoscopist will send your primary care physician a copy of your exam results.

What Can I Expect to Do After My Exam?
You should expect a little gas and mild bloating. This should get better by evening. You may begin your usual diet unless you have been instructed not to. If you have received sedation for your exam you may feel relaxed, sleepy, dizzy or lightheaded. Do not drive for 24 hours. Do not drink alcohol for the next 24 hours. The sedation medication affects your judgment and your reflexes. Consuming alcohol within 24 hours of your exam may result in an unsafe decrease of your blood pressure and/or breathing. Do not operate machinery (power tools, lawn mower, etc) for 24 hours Do not plan to make important decisions (job related money matters, etc.)  for the next 24 hours. If you are going to be alone have family or friend check on you 2-3 times over the next 6-8 hours.

You need to notify your endoscopist if you have any of the following:
• Severe stomach , abdominal, shoulder, and/or back pain
• Temperature greater than 100 F
• Black or bloody bowel movements
• An unusually large or hard stomach and/or abdomen
• Dizziness, faintness, or weakness

Definitions of Some Words That May Be Used in Describing Your Exam:
Cecum: Where the large intestine and the small intestine meet
Endoscopy: an illuminated usually fiber-optic flexible or rigid tubular instrument for visualizing the interior of a hollow organ or part (as the bladder or esophagus) for diagnostic or therapeutic purposes that typically has one or more channels to enable passage of instruments (as forceps or scissors).
Endoscopist: a person trained in the use of the endoscope.
Colonoscopy: endoscopic examination of the colon, also called the large intestine.
Polyp: a growth on the surface of the colon, also called the large intestine. Colon polyps can be raised or flat. Sometimes, a person can have more than one colon polyp.
Biopsy: the removal and examination of tissue, cells, or fluids from the living body.
Electrocautery: the removal of tissue by means of an electrical current.
Inflammatory bowel disease: common inflammatory bowel diseases are colitis and crohns disease.
Moderate sedation: medications used during your exam that may make you relaxed and sleepy, such as Demerol, Fentanyl and Versed.
Colonscope: An elongated fiberoptic endoscope that allows the endoscopist to examine the inside of your colon on a video monitor in real time. A colonoscopy examines the entire colon from the cecum to the rectum and allows the endoscopist to remove polyps and tissue for analysis in a laboratory.

If you want more information about colon cancer and screening, please visit these links:
www.cancer.org  •  www.cdc.gov/cancer/colorectal
This information is provided by Rutland Regional Medical Center and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
Rutland Regional’s Endoscopy Unit is located on the 3rd floor. Take a left upon exiting the elevators and follow the signs to the Endoscopy Unit, almost at the end of the hall..