For a colonoscopy to be effective the bowel must be clean to allow a good view of its surface. An oral preparation needs to be taken 24 hours prior to the procedure which encourages the bowel to empty its contents. The procedure is usually performed under sedation anaesthetic and requires a stay in hospital of only a few hours. To minimise the risk from after-effects of the anaesthetic, patients should avoid driving for the next 24 hours.
Currently, colonoscopy is the best way to visulaise the entire colon and rectum and to allow both biopsies to be taken and polyps removed. The major risk associated with a colonoscopy is perforation of the colon which, according to the National Health and Medical Research Council (NHMRC), has previoulsy been reported to occur in approximately one in every 1,000 colonoscopies in Australia. This figure is NOT true when colonoiscopies are carried out by specialist and experienced colonoscopists and would be more accurately approximately one in every 10, 000 procedures.
Perforation may be treated with or without surgery, depending on the circumstances, but if surgery is required, then on occasions it is necessary to establish a colostomy, usually as a temporary measure. Bleeding may occur after colonoscopy but this is rarely serious and will usually stop spontaneously. Bleeding may require a repeat colonoscopy or surgery. Both bleeding and perforation are more common if polyps are removed from the colon. It is essential to remove polyps when they are found since some may ultimately become cancerous if left behind.
According to the NHMRC approximately one person in 10,000 will die following a colonoscopy, usually as a result of a perforation, and usually in patients with other significant medical problems. The above explanation is not an exhaustive list of complications. Naturally, you should consider these factors carefully before proceeding with the examination. Again, most experienced specialists will have had zero (or close to zero) incidences of mortality in their practices.
Full details of the procedure and the risks involved will be detailed at your consultation with the doctor. Please ask any questions you feel are required for your understanding of the procedure.
The recommendations below reflect the work of a number of cancer organisations and other learned bodies, as outlined in the list of sources at the end of this document. The recommendations are based on an assessment of the current state of knowledge and may vary according to the circumstances of any individual person. The members of Sydney Colorectal Associates would be happy to discuss the implications of these recommendations and how they might be relevant to your own circumstances.
One male in seventeen will develop bowel cancer in Australia, and one female in twenty-three, and there is ample evidence that screening the community, as well as high risk groups can lead to a reduction in that incidence, by detecting and removing the polyps that lead to most bowel cancers.
should consider annual (optimally) faecal occult blood tests (or at least second yearly) and five-yearly sigmoidoscopy, or, alternatively, 5-10 yearly colonoscopy from the age of fifty. There may be some justification for now recommending such screening commence at (around) age 45, given the increasing incidence of bowel cancers occurring in those under 50.
should consider colonoscopy every 5 years starting at the age of fifty, or ten years younger than the youngest age at which a relative was affected.
should consider colonoscopy every four years starting at the age of fifty, or ten years younger than the youngest age at which a relative was affected, and possibly at least by forty.
.should consider colonoscopy every 3 years
should consider a colonoscopy every 2 years.
Our goal at Sydney Colorectal Associates is to deliver prompt access to appointments, diagnostic services and procedures that are tailored to your requirements.