Colonoscopy

• Overview
• Treatment goal
• Procedure
• Preparation and precautions
• Aftercare and recovery
• Potential complications
• FAQ

Colonoscopy procedure

Early detection and removal of intestinal polyps is crucial, as these benign growths that develop in the mucosa of the large intestine can also turn into malignant tumours over time. What makes polyps particularly insidious is the fact that they do not initially cause any discomfort, which is why they must first be identified with the help of a minimally invasive colonoscopy.

As a first step, your documentation will be examined, you will be given special clothing for the colonoscopy and an IV will be inserted, through which a sedative will later be administered. Afterwards, you will be brought to the examination room with the help of a stretcher, where you will be received by the team responsible for the examination.

The attending doctor will talk to you and answer any final questions before you are given the sedative. Once you are asleep, the gastroenterologist will first manually examine your rectum. Often, the rectum and anal canal are then assessed for abnormalities with a proctoscope.

The examination of the intestine is usually carried out on an outpatient basis using a colonoscope, which is an endoscope for intestinal examinations. It is a centimetre-wide, flexible tube consisting of a light source, a camera that transmits images from the inside of the intestine to a monitor, and a channel for surgical instruments such as forceps or loops. In addition, devices are attached to the tube, which allows, among other things, for fluid and gas in the intestine to be siphoned.

For the examination, you will lie in a relaxed position on your side. The gastroenterologist inserts the colonoscope through the anus into the rectum and carefully moves the examination device to the end of the small intestine. Finally, as the endoscope is withdrawn, the intestine is examined from the inside for abnormalities, tissue changes and intestinal polyps. The intestine is repeatedly inflated with air to expand it and improve visibility.

Tissue samples are taken from suspicious areas in the intestine, which can then be examined using the high-resolution images. For 30–40% of all people over 50 who undergo a colonoscopy, several polyps (adenomas) are found. These can be removed directly during the examination with tiny pliers and a loop, with or without high-frequency current.

Since the mucous membrane in the intestine does not contain any painful nerve receptors, a colonoscopy is largely painless. However, expanding the intestine with air is sometimes considered uncomfortable.

The actual examination usually takes about 30 minutes. The examination only takes up to 60 minutes if several polyps have to be removed at once or if the intestine is highly twisted.

Colonoscopy: preparation and precautions

Certain foods, such as whole grains, high-fibre foods or small seeds, should be avoided in the days leading up to the colonoscopy, as they can block the colonoscope’s channels and thus obstruct visibility. Additionally, certain blood-thinning medications should be discontinued in consultation with your doctor before the colonoscopy. You should also stop taking iron supplements five days before the colonoscopy.

In the evening before and in the morning of the examination day, you must drink a strong laxative with plenty of fluid so that the bowels are emptied before the colonoscopy. The attending doctor will provide you with detailed information about this measure before the examination. Immediately before the colonoscopy, you will also be given a light sedative or tranquilliser.