What you need to know about Colonoscopy?

Colonoscopies are generally safe and well-established, but as with most medical procedures, there are some risks involved. While the possibilities are very rare in the hands of an experienced colorectal surgeon, complications include:

• An adverse reaction to anesthesia
• Bleeding from a biopsy or polyp removal site, though this is usually minor and self-limiting
• Tears or perforations in the colon or rectal wall as a result of improper handling of the colonoscope in screening, biopsy or polyp removal

However, the chance that these might happen is 0.1% or less than 1 in 1,000.

Patients should, however, seek immediate medical attention if they experience chills, high fever, excessive rectal bleeding and severe abdominal pain after the colonoscopy.

Normal Result:The result is considered normal if no abnormalities were found in the colon. However, a normal result is not a guarantee that the patient will never have colorectal cancer. Low-risk patients (no family history of colorectal cancer) are typically advised to undergo a colonoscopy once every 10 years once they are past the age of 50.

Positive Result:If the initial colonoscopy results in the discovery of polyps or other abnormalities, the result is considered positive. Typically, polyps are removed on the spot during a colonoscopy and a biopsy will be taken to a lab for further testing to determine if they are cancerous or not.

Based on the results, the doctor will discuss with the patient how often he or she should undergo follow-up screenings and further treatment, if necessary.

With over 2,000 searches monthly, “colonoscopy Singapore” is one of the most searched terms in the country. However, there are still many misconceptions surrounding this procedure, which include:

• “I only need a colonoscopy when I have symptoms.” Colorecal cancer tend not to show any obvious symptoms until the disease has progressed to an advanced stage and caused irreparable damage. Colonoscopies can detect abnormalities at an early stage when they are still easily treatable. Polyps, for instance, can be detected and removed via a colonoscopy before they turn into cancer.
• “A colonoscopy is very painful.” Colonoscopy is typically performed while the patient is sedated, so he or she will not feel any discomfort or pain. In fact, most patients will not have a recollection of the entire procedure.
• “The procedure might damage my colon.” The screening test can only be performed by a doctor who is trained in colonoscopy, hence greatly reducing risks of complications. With a properly trained professional, the risk of bleeding is less than 1% and the probability of colon perforation is 1:1000.
• “Men are more likely to get colon cancer.” On the contrary, colorectal cancer is the #1 cancer in Singaporean men, and the #2 cancer in Singaporean women.

The fear of colonoscopies often arises from a misconception that the procedure is a painful ordeal. However, with the use of sedatives and in the hands of a reputable and skilled surgeon, colonoscopy is a quick, painless and very accurate diagnostic method. However, alternatives to examine the colon do exist, and they include:

Barium Enema:Also known as colon X-ray, a barium enema is designed to look for abnormalities in the large intestine. This procedure funnels a harmless, white liquid (barium) into the colon through the anus via a tube (enema). The barium coats the colon to produce a clear silhouette that can be captured on X-ray. Air may be pumped in to expand the colon and enhance the quality of the X-ray image. This method is performed without sedatives.

CT Colonography:This method, also called virtual colonoscopy, uses both X-rays and CT scanners to create two- to three-dimensional images of the large intestine. Before the patient enters the CT scanner, air will first be pumped into the colon via a tube inserted through the anus. Similar to a barium enema, the doctor will produce images with the patient in varying positions.

Both methods will require the clearing of the colon/bowels beforehand, and are done without sedatives. Furthermore, if the results of barium enema and CT colonography come out positive with signs of polyps and other abnormalities, a colonoscopy will still need to be done for biopsy and removal. Therefore, a colonoscopy is still the most recommended and worthwhile method.