Colonoscopy / Polypectomy

Colonoscopy

A colonoscopy is an endoscopic examination of the colon. For this purpose, the bowels must be cleansed beforehand. Approximately 3 days prior to the examination the person to be examined should refrain from eating grains (no whole-grain bread which still contains grains, no poppy seed cake, cereal, kiwis, grapes, mixed-fruit jams, etc.). The person to be examined is informed about the upcoming examination and the course of the preparation in a preliminary discussion. As polyps are also removed during a colonoscopy, it is important to know the blood clotting values. That is why a small blood sample is also taken, to check the blood count and the clotting status. The actual preparation takes place the evening before the examination with the drinking of a solution. For this purpose, we hand out a granulate in our practice, which you dissolve in water or a light-coloured juice (apple juice) and drink the evening before the examination. After drinking this solution, you will have to go to the bathroom repeatedly, so it is recommended that you don’t make any special plans for the evening.

A colonoscopy usually takes approx. 15 minutes. If possible, polyps are removed painlessly in the same session. Medication, which influences blood clotting should be discontinued approx. 5 – 7 days before the exam (e.g. ASS, Plavix, Marcumr, Falithrom). This is discussed with the patient during the preliminary discussion. The endoscope is carefully passed through the anus with the patient lying on his/her left side. The physician can observe the intestinal mucosa on a screen via a video chip. The patient has the option of receiving a sedative for the examination. In this case, the patient is asleep during the examination and if necessary, can rest in a recovery room afterwards. Should a larger polyp need to be removed during the examination, the patient has to stay in a recovery room specifically intended for this purpose for approx. one more hour. After the examination the patient can eat and drink again as usual. A slight feeling of pressure, which could possibly still exist from the remaining air in the bowels, usually goes away after 1 – 2 hours.

It must be observed that after receiving a sedative, an active participation in road traffic (car, motorcycle, bicycle) is prohibited by law for 24 hours. On the other hand, for legal reasons the injection of a sedative can only be carried out if the person to be examined is in the company of a person, who can bring him/her home or if he/she is picked up by someone afterwards. If necessary, the person to be examined receives a sick note for the day of the examination.

Sigmoidoscopy

A sigmoidoscopy is a flexible endoscopic examination of merely the rectum. It is conducted for the diagnosis and treatment of anal and rectal disorders such as haemorrhoids, anal fissures, anal venous thrombosis or incontinence among other things.

Possible symptoms, for which a physician should be consulted, are among others itching, a burning sensation, pain, swelling, knotty alterations in the anal area and rectal bleeding.

In preparation of the examination, the rectum must be empty. This can be done by taking an enema shortly before the examination. The patient is examined while lying on his/her left side. The instrument is carefully inserted into the anus and the mucous membrane is thoroughly scanned for possible damages. Inflammations, stenosis, diverticulum and so-called polyps can be detected during the examination. Over a period of several years, polyps can turn into colorectal cancer and should be removed. This can be done painlessly during the examination. Bleeding can be immediately treated during the examination. A sigmoidoscopy is completely painless if conducted carefully.

Polypectomy

Polyps are benign fleshy growths on the intestinal mucosa, from which some can develop into colon cancer in the course of several years. The goal is to remove these polyps painlessly at the same time during a colonoscopy. Polyps, which are smaller than 4 mm are removed with small endoscopic forceps. Polyps with a diameter of 5 millimetres and larger are removed painlessly with a fine wire sling with electric current. After the removal of polyps, the patient has to lie in a recovery room for observation for one hour. Complications from the removal of polyps are a bleeding of the removal site, which is stilled by injecting a saline solution possibly combined with a coagulation-inhibiting drug or with a small metal clip. In the event of very large polyps, a colonic perforation can occur in very rare cases. Therefore, large, rare polyps are removed in a hospital – just to be on the safe side. We have been removing polyps regularly since 1993. Due to our cautious examination technique and large amount of experience (over 6000 documented colonoscopies), we have never once had any complications. After the removal of a polyp, a colonoscopy check-up should take place after 1 – 3 years depending on the results.