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Colonoscopy is an investigation looking into the large bowel, carefully examinaing the interior. It uses a sophisticated instrument that is steerable, has in-built lighting, video camera and screen washer with a channel that can pass down instruments for treatment or diagnosis.
The bowel has to be cleaned out over a few days at home - the 'bowel prep' - once the bowel is clean the person is admitted into an endoscopy unit and in most cases has an anaesthetic and sleeps through the procedure. The colonoscope in passed through the back passage and through the entire length of the back passage and colon - often it can be inserted into the small bowel to check the ending of that. It usually takes around 15 minutes for a complete examination.
After the examination is finished the patient transfers to recovery and wakes up over the next 10 minutes or so. Depending on how fast someone recovers it is usual to spend 30-60 minutes in recovery before being allowed home.
The majority of people have minimal, if any, belly aches or diarrhoea after the examination and can usually tolerate a normal diet.
The anaesthetic is delivered by injection using a mixture of drugs commonly propofol, fenatyl and midazolam. During the anaesthetic oxygem is delivered by a mask or nasal tubes and condition carefully monitored evaluating levesl of anaesthetic, pulse, blood pressure and oxygen and CO2.
We strongly recommended not to drive or operate in hazardous condition for at least 12 hours after an injectable anaesthetic due to possible impairment of judgement and legal liability concerns.
Polyps are protrusions into the bowel lumen arising from the lining of the bowel wall. Nearly all are benign but some have the potential to change into cancers and a very small percentage are malignant. Noosa Surgical & Surgical Centre in Noosaville offers a quality and efficient service to detect and treat colon polyps.
By and large colonoscopy, performed by skilled operators in appropriate cirucmstances is very safe and complications are fortunately rare. However people can rarely react adversely to the bowel preparation or anaesthetic. During the procedure damage can occur to the bowel or the surrounding organs and this is more likely if polyps are removed. Removal of polyps may be incomplete or cause bleeding from the bowel wall or even perforation. Risk factors include the size of the polyp, where it is located and whether the person has been taking blood thinners. Almost invariably these problems can be successfully fixed up and most people make a full recovery but because of the potential for harm it is important to make sure that the benefits of the examination substantially outweigh the risks - these are individually assessed by reviewing the referral, health questionnaire and in cases of concern seeing and discussing before the procedure.
There is a lot of useful information on screening for bowel cancer on the Australian Cancer Council website
As from November 2019, Medicare introduced requirements for benefits to be paid out for colonoscopy under the Medicare Benefits Scheme (MBS) - in short they will no longer subsidise colonoscopies done for 'screening' purposes unless the person fits into defined categories - these are broadly in line with the reasons for having colonoscopy cited above but they specify in detail the conditions they will cover and how often they will cover it. Details can be found on the Medicare Web Site or summarised from a chart available in our 'Downloads Section"
If you are not covered by Medicare you will be responsible personally for all costs, medical and hospital, associated with the procedure and Health Funds won't pay out on items not covered by Medicare
Depends on who you ask ! - if friends and neighbours hear you are having a colonoscopy you can be sure that horror tales of the bowel prep will be forthcoming ;) - The truth is that most people tolerate it very well and less than 1% are intolerant of it - we use Fleet Phospo Soda principally because it is a small volume to drink. An alternative we use are Pico-Prep sachets but these don't work quite as quickly and hang around a bit longer - they are better for people with known kidney impairment,
People sometimes ask if a capsule or tablet is available - there are capsule bowel preps containing magnesium sulphate (Epsom Salts) but you have to swall ow over 60 of these !!