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Step by Step, What Happens During a Colonoscopy

Step by pace, what happens during a colonoscopy

In this article, you will larn step-past-step what happens during a colonoscopy. In a colonoscopy, your gastroenterologist will exist closely examining your rectum and colon looking for signs of aberrant tissue, sources of bleeding, and inflamed pouches or sections. In order for you to empathise what occurs during this procedure, it is important to know nearly the anatomy of the colon and the rectum. This information may seem overwhelming at first. But, assuredly, with a grasp of the anatomy of your colon before the colonoscopy, you are well-prepared in understanding the complication of the procedure and in asking your doctor any questions you may take. After the introduction to the beefcake, you will have the opportunity to walk through the procedure with a bird'south heart perspective from pre procedural preparation, the procedure itself,  to the mail service-procedural procedure.

Anatomy of the Colon and Rectum

The gastrointestinal (GI)  tract is a long and twisted tube that consists of a series of hollow organs joined from the rima oris to the anus. The hollow organs of the GI tract include:

• Mouth
• Esophagus
• Small intestine
• Large intestine or colon
• Rectum
• Anus

The colon, or large intestine, is a long (approximately vi feet) muscular tube that connects the small intestine to the rectum. It'due south main function is to procedure wastes to allow for an easy bowel motion or elimination of the bowels. Other functions of the colon are  to blot water and electrolytes and digest chemicals with the assist of gut microbes.

https://world wide web.shutterstock.com/image-vector/anatomy-large-intestine-medical-illustration-human being-228073756

The parts of the colon are:

• Cecum – Pouch-like passage connecting small intestine to colon
• Ascending colon – Absorbs water from waste material
• Transverse colon – Absorbs water and salts from waste product
• Descending colon – Stores stool to be emptied
• Sigmoid colon – Contracts to increase colon force per unit area to motility stool into rectum
• Rectum – Holds stool until evacuation happens

Stool is the waste matter left over from the process of digestion later on information technology passes through the modest intestine. Stool passes through the colon from a liquid to solid state due to peristalsis – wave-similar muscular contractions of the gastrointestinal tract. As the stool moves through the colon, water and salts are captivated into the abdominal wall. The ascending and transverse sections of the colon take benign bacteria that assist to break downward nutrient into smaller pieces.

 Once the stool reaches the sigmoid colon, information technology is in solid course and stored until emptied into the rectum for a bowel motility one to ii times daily The average time information technology takes feces or stool to get through the colon is 24-36 hours.

The lining of the colon is actually a series of layers that consist of inner linings (mucosa and submucosa), a thick layer of muscle (muscularis propria), and outer layer (serosa).  The mucosa is responsible for absorbing the h2o from the liquid waste product and some nutrients. The mucosa also makes mucus to help the stool move with ease through the colon and rectum.

Colonoscopy Equipment

The colonoscope is the main tool of the colonoscopy procedure. The tool is basically a long flexible tube with a camera attached on 1 end. The colonoscope has a channel where different surgical instruments can be inserted to exist used during the procedure. The instrument has five main components, including:

• Control section
• Instrument channel (where the surgical instruments are inserted)
• Tip (photographic camera on end)
• Connectedness section (connects to power and video)
• Line (flexible tube of colonoscope)

What Happens During a Colonoscopy: Detailed Pace By Stride Breakup

Timeline

Step i: Cheque-in                                               five minutes

Step 2: Preparation for procedure       15- 20 minutes

Step three: Encounter with doc                     v-10 minutes

Pace four: Colonoscopy                               20-45 minutes

Step v: Recovery                                           thirty minutes

Step 6: Discharge                                            five minutes

Pre-procedure: Preparation and Sedation

Before your colonoscopy, you volition be escorted to a individual prep room where you will be asked to change into a hospital gown. Your nurse volition inquire nigh your current medications, allergies, and your medical history. Then your nurse will place an intravenous (IV) line where y'all will receive your sedation medicine and fluids. Yous will also accept your vitals measured, including blood pressure, oxygenation content, and heart rate.

Sedation

Later on your physician checks in with you to encounter if you have questions and explain the procedure, you lot will be taken to the procedure room to be sedated. In the room, you volition be connected to a monitor that records your middle rate, claret pressure level, and level of oxygenation.  Y'all will exist asked to lie downwardly on your left side with your knees bent and pulled upward. Your nurse volition give yous sedation medications.

During procedure

The procedure is done with the patient in the left lateral decubitus position or laying down on their left side.

The colonoscope is inserted through the patient's rectum into the colon. The telescopic is so moved throughout the colon to visualize the lumen (the opening within the bowels)  and the walls of the colon.

The gastroenterologist first inspects the region around the anus to cheque for skin tags, hemorrhoids, prolapse, or anal fistulaw and fissures.A digital rectal exam is too performed and topical anesthetic is applie to lubricate the canal and relax the sphincters.

Anal canal: In medicine, an intubation is when a tube is placed in a body crenel. Thus an insertion of the colonoscope in the anus is referred to as an intubation. When the colonoscope is intubated, the gasteroenterologist will inflate the anal canal with air to allow for ease of entry and visualization of the anal region. The anal sphincter restricts the examination of the anus and must exist examined once information technology passes through the canal.

Rectum:The rectum is approximately 6 inches or xv cm long and is easily passed by the colonoscope considering information technology is immobile.

Rectosigmoid junction: Gastroenterologists consider this section of the colon challenging because it is such a tight bend. The lumen, or opening, bends significantly and care must exist taken to clear the bend and avert looping the tube of the colonoscope. One time the section is cleared, the descending colon is in clear view and able to be examined and visualized.

Sigmoid descending junction (SDC) and sigmoid colon: The S-shaped bend of the sigmoid colon make it the almost challenging part of the colonoscopy. There are many folds in the lining of the sigmoid colon which makes it very difficult to visualize the lumen. Thus, the gastroenterologist will add air into the colon and maybe movement the patient or colonoscope to allow passage of the tube further up into the colon. In this area, transmission abdominal compression may be used and the patient may be moved to ease move of the colonoscope.

Descending colon: After passing through the sigmoid descending junction and the sigmoid region, the gastroenterologist volition and then move through the descending colon which is a long tube with low mobility. This portion of the colonoscopy usually just takes a few seconds depending on findings (for example, if a polyp or patch of abnormal tissue is found).

Splenic flexure: This bend betwixt the descending and ascending colon is the highest portion of the big intestine. It is located just under the diaphragm. If the progression of the colonoscope is difficult, the examiner may motion the patient's position or have an assistant apply intestinal compression.

Transverse colon: The opening or lumen of the transverse colon is triangular in shape and is quite mobile. Again, if progression is difficult, an assistant will apply abdominal compression on the umbilical (navel) area to prevent looping of the colonoscope.

Hepatic flexure: This bend of the colon is like shooting fish in a barrel to identify for the examiner and the ascending colon is nigh oftentimes located on the right side. The gastroenterologist will turn the colonoscope to the right while applying air suction. Sometimes, the patient will be placed in the supine (on the dorsum) position to help with progression.

Ascending colon: This department of the colon is triangular in shape and has thick folds. It has low mobility, and so the examiner tin can advance the colonoscope easily with a straight push.

Cecum: Once the examiner reaches the cecum, the get-go of the colon, the colonoscopy is considered complete. The gastroenterologist will move the colonoscope through the ileocecal valve (the valve betwixt the ileum of the minor intestine and the cecum of the large intestine) to confirm that the entire colon was visualized.

Post-procedure

After the procedure, you volition be taken into the recovery room to be observed by medical staff every bit you regain consciousness. During this time your vitals volition be monitored to make sure y'all are oxygenating properly and that your blood pressure level and middle charge per unit are inside normal range. The recovery typically takes from xxx minutes to an hour, depending on how sedated you lot were. One time the medications accept worn off you will be allowed a drink of water and pain medication if needed.

Who reviews the results?

Your physician will review the preliminary results of your colonoscopy once you lot accept recovered from the sedation. Considering of the nature of the medication, your doctor volition most likely not spend too much time explaining the results to y'all and allow you lot to recover. Your doctor may send dwelling house a impress out of the results if yous request before the procedure. At that place are generally two findings from a colonoscopy:

Negative result. This result is the all-time outcome of a colonoscopy. Your colon is considered good for you with no abnormal findings. At this point, your doc may want to schedule your future screening. Your doctor may also ask you to schedule one sooner than recommended if there were any issues with visualization or if remainder waste material obscured the view.

Positive result. In this case, your doctor constitute a polyp or an abnormal site during the colonoscopy. This is really quite mutual and at that place is no reason to become overly concerned. Most polyps are benign and promptly removed during the procedure. If you had polyps removed during the colonoscopy, your physician will tell yous when to expect the results from pathology. The fourth dimension it takes to receive these results can vary from a few days to a week.

Post-procedural care and future screenings

Your recovery from the colonoscopy should have a brusque fourth dimension, normally only 24 hours. Your physician will review with you the plan of care in the hereafter depending on the results of the colonoscopy. If yous had a negative result, your physician will schedule your next screening based on your age, your health status, and family history of colon cancer.

If your physician institute a polyp, adenoma (abnormal growth), your physician volition talk over with you if yous need additional procedures. Sometimes, the examiner is unable to remove all the tissue or in that location are multiple polyps that require a more extensive colonoscopy. In this example, your dr. will develop a plan of activity with you lot for hereafter removal. If the tissue is precancerous or malignant then yous will need additional treatments as well.

References

Eberth, J. M., et, al. (2018, March). Who performs colonoscopy? Workforce trends over space and fourth dimension. Periodical of Rural Wellness, 34(two), 138-147. Retrieved from PMC:

https://world wide web.ncbi.nlm.nih.gov/pmc/articles/PMC5889340/

Health Partners Gastroenterology Writing Staff. (2021). What to expect at your colonoscopy. Retrieved from Health Partners:

https://world wide web.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/cntrb_027213.pdf

Lee, Due south-H, Park, Y-1000., Lee, D-J., & Kim, K-G. (2014, Dec). Colonoscopy procedural skills and training for new beginners. World Periodical of Gastroenterology, twenty(45), 16984-16995. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258567/

Los Angeles Colon and Rectal Surgical Associates. (2021). Agreement your colonoscopy results. Retrieved from LA Colorectal Associates, Inc.: https://colon90210.com/blog/understanding-colonoscopy-results

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