Colonoscopy

What is a Colonoscopy?

A screening colonoscopy is an easy, outpatient procedure to prevent the formation of colon cancer. Looking at the inside lining of the colon is one of the most important exams you can have to prevent colon cancer. This is done with a small, fiber-optic, camera called a colonoscope. When a colonoscope is used to look inside the colon, we call the exam a colonoscopy. To understand the term “screening colonoscopy,” we should discuss some basics of how colon cancer develops.


Having a colonoscopy is an easy, painless exam. While you are comfortably asleep, the colonoscope is carefully inserted and gently advanced through the colon. Air is used to inflate the inside of the colon. This allows visualization of polyps and other abnormalities.


As the colonoscope is carefully removed, the colon is gently washed with water to ensure polyps are not overlooked. This is a picture of a normal colon. (Figure 1) Off to the right is a stream of water, washing the inside of the colon to ensure colon polyps and colon cancer are not missed.


If any polyps are found, the physician has special tools which can be placed through the colonoscope to remove them. (Figure 2) This is a picture of a small colon polyp being removed with a special tool called a “snare.” (Figure 3) The snare is a small wire lasso which encircles the polyp and pinches it off at the base.


Fortunately, the colon cannot feel pain. You will wake up without knowing polyps were removed. Once the colonoscopy is complete, it typically takes half an hour or so for you to wake up. Dr. Hurdle will talk with you after the exam, but you may not remember what was said. They will discuss all findings with you again one week after your colonoscopy. Once you wake up, it’s time to get a nice breakfast and relax.

Colon Polyps

All colon cancer begins as a small growth called a polyp. As we age, polyps grow more frequently throughout the inside of the colon. Over time some of these polyps may change from harmless to harmful and will require a colonoscopy for removal to prevent the growth of colon cancer. A “screening colonoscopy” refers to performing a colonoscopy to look for these polyps and remove them before they become colon cancer.


A screening colonoscopy is also performed to detect colon cancer early. The earlier colon cancer is found and removed, the better the outcome.


Colon polyps are small growths on the inside of the colon. They develop from normal cells that have started to divide and grow at an increased rate. Notice the raised appearance of this polyp. It’s growing more quickly than the surrounding colon. Polyps can be classified by what type of cells they develop from, or by their appearance.


This is a picture of a “pedunculated” polyp. This polyp has a stalk beneath it. It is a large polyp which was causing the person to have bright red blood with bowel movements.


This is a picture of a flat or “sessile” polyp. These polyps can be difficult to spot if the colon is not properly cleaned.

Depending on what cells a polyp has developed from, some polyps will grow rather quickly and carry a greater risk of developing colon cancer. Any polyps removed from the colon need to be examined under a microscope to determine if they carry this increased risk. Your physician should meet with you after your colonoscopy to discuss these results.


These are some examples of polyps classified according to their cellular type:


  1. Hyperplastic polyps – Low risk of developing into a colon cancer.
  2. Tubular adenomas – Slightly increased risk of colon cancer.
  3. Tubular-villous adenomas – More of an increased risk of colon cancer.
  4. Villous adenomas – High risk of developing into colon cancer.
  5. Serrated adenomas – Highest risk of developing into colon cancer.


Colon Cancer

Colon cancer is one of the few types of cancer that usually does not produce symptoms until the later stages. We perform screening colonoscopies to find colon cancer early since it may not produce problems until it is rather advanced. One of the earliest symptoms of colon cancer is bright red bleeding with bowel movments. A common misconception is that colon cancer produces dark blood. Colon cancer is more likely to produce bright red bleeding.



This is a picture of colon cancer with active bleeding. Notice that the blood is bright red and not dark. Darker blood is more representative of blood from the stomach or small intestine. This is due to the fact that it becomes partially digested before it reaches the colon and produces the dark color.

Other common symptoms of colon cancer include abdominal cramping, a feeling that your bowels do not empty completely, and a change in the consistency or size of your bowel movements. This is a picture of colon cancer which has grown completely around the inside of the colon. Notice that the opening of the colon is now very small.


This colon cancer produced symptoms of abdominal cramping and a change in the size of the person’s bowel movements. Abdominal cramping was caused as stool passed through this area with difficulty. The person also experienced occasional bright red bleeding with more difficult bowel movements.


Colon cancer can also produce diarrhea by inhibiting the colon’s ability to absorb water out of the stool. This can result in frequent, loose, and sometimes watery bowel movements. This is a picture of colon cancer which was causing excessive diarrhea. The person experienced frequent diarrhea with an urge to use the bathroom unexpectedly. Colon cancer may also produce weakness, fatigue and unexplained weight loss. These symptoms may not occur until the latest stages.


This is a picture of colon cancer which was bleeding constantly every day. The person was experiencing weakness and fatigue from the excessive loss of blood. The person also had lost weight due to the fact that the colon cancer had spread throughout the body.


If colon cancer is found and treated before these symptoms develop, the opportunity to cure is 95% or better. For this reason it is advised that everyone has a screening colonoscopy at age 50. For people with a relative with colon cancer, it is recommended to have a screening colonoscopy at age 40.

  • Anorectal Manometry
  • Anorectal Compliance Testing
  • Electromyography (EMG)
  • 2-D Anorectal/Vaginal Ultrasound
  • Anorectal Neuromuscular Rehabilitation
  • Electrical Stimulation
  • Non-Surgical and Surgical Hemorrhoid Management
  • I+D or Excision of Acute Thrombotic Hemorrhoids
  • Electrodessication
  • Laser Treatment
  • Infrared Coagulation
  • Sclerotherapy
  • Rubberband Ligation
  • Sutureless Hemorrhoidectomy
  • Anal Fissure Disease
  • Medical Management
  • Chemodenervation
  • Lateral Sphincteronomy
  • Fissurectomy
  • Anal Dilation
  • Cautery/Curettage
  • Anorectal Condyloma/Anal Condyloma/Anal Dysplasianal Dysplasia (Anorectal Warts)
  • Anal Pap Smear

 


  • HRA (High Resolution Anoscopys)
  • Anorectal Biopsy
  • Surgical Excision
  • Ablation Abcess
  • Rectal Bleeding
  • Screening of Colorectal Disease
  • Rigid Sigmoidoscopy
  • Fiberoptic Flexible Sigmoidoscopy
  • Colonoscopy
  • Bowel Management
  • Diet
  • Probiotics
  • Pelvic Floor Rehabilitation

 


Share by: