Endoscopic bowel examination
We perform colonoscopy – i.e. an endoscopic bowel examination – on a routine basis as part of screening or differential diagnosis for benign/malignant tumours and polyps.
The bowel exam procedure involves looking at the rectum and colon from the inside, using a flexible device called a colonoscope, hence the term “colonoscopy”. Before the examination, the intestine must be clean, i.e. “flushed out”: this is a procedure that the patient will need to start the day before.
The device is thin (13 mm) and flexible. The tip can be angled in any direction by turning a thumb wheel on the handle, which is held by the doctor during the examination. A light source illuminates the probe, while a CCD chip (similar to that on a digital camera) transmits the image to a monitor. The device is inserted as far as the appendix, i.e. the beginning of the colon; in almost all cases, the end of the small intestine, the “terminal ileum” is also examined. During withdrawal, the intestine is inflated a little, to smooth its lateral folds as much as possible. Once back in the rectum, behind the sphincter, the examination is complete. We then attempt to remove as much air as possible (possibly by moving the device back up the intestine a little), since this can cause discomfort after the examination.
Every year, we perform well over 1,000 colonoscopies.
We use only the very latest high-resolution video endoscopes: both the processors and the rest of the equipment are state-of-the-art and are upgraded on a regular basis. We source our endoscopic equipment from the Japanese firm Fujinon; the pumps are supplied by the Swiss company Medela.
On your first consultation, you visit us in our clinic: here, we explain the preparation and the examination itself in detail. We give you the necessary drugs and an info sheet to take home with you.
This first consultation is required by law and cannot be skipped: the actual colonoscopy takes place during your second visit.
Please allow two days for the examination: the bowel must be cleansed on the day before the exam and you should not go straight back to work after the examination.
We recommend patients receive a mild general anaesthetic: this means you are much more relaxed during the examination. You then “doze” through the exam and we can usually wake you up normally. Propofol is typically used as the anaesthetic. This is a very fast-acting sedative that is also metabolised very quickly afterwards. In this way, we can sedate patients for the examination only to the extent required by the actual procedure. If endoscopic conditions are simple, hardly any sedative is required. If difficult “twists and turns” must be negotiated, it’s easy to administer a little more; this higher concentration then wears off by itself. The way Propofol dosage can be regulated like this is certainly a milestone in endoscopy. Administering additional opiates is almost never necessary; we only do so under exceptional circumstances.
After the examination, you are neither physically nor legally able to operate a vehicle (whether car, motorbike or bicycle). If you can, please arrange for someone to collect you.
By law, patients must be provided with information about their colonoscopy. We always provide both written and verbal information about major risks such as bleeding or perforation. Written information is provided at your preliminary consultation: you give your consent by completing and signing this, and bringing it with you to your examination.
Alternatively, you can download the information/consent form here and bring it with you yourself.