About Endoscopy

Endoscopy, particularly gastroscopy and colonoscopy, involves the inspection of the stomach and bowel using fibreoptic or television microchip instruments, particularly for the detection and prevention of cancer.

WHAT IS A GASTROSCOPY? Gastroscopy is the passage of a small flexible, lighted fibrescope through the mouth into the stomach which allows your Doctor to visually examine the lining of the oesophagus (gullet), stomach and duodenum (small bowel).

WHAT IS A COLONOSCOPY? Colonoscopy is a procedure which allows your Doctor to visually inspect the inside of the bowel by the insertion of a fibreoptic or video flexible telescope through the back passage, this painless operation allows sampling of the lining (biopsy) or removal of small tumours or polyps. It has the advantages over the alternate method of examination, barium enema, by allowing these operative procedures and providing greater detail and accuracy.

About the procedure

Although colonoscopy requires drinking a quantity of flushing fluid the preceding evening, the procedure itself is not uncomfortable. Performed under sedation, the whole examination requires attendance at our centre of about 3 hours.

Things to know before the procedure

1. Please read ALL information carefully and as soon as possible.
   
2. Follow the bowel preparation regime given to you.
   
3. Arrange for a responsible friend or relative to collect you. You should have someone available to stay with you for a minimum of 6 hours, preferably overnight. For your safety, you will NOT be permitted to leave the centre unescorted, in a taxi without an escort, or driving a car. Cancellation of your procedure will take place if these arrangements are not made. You can expect to be at the centre for two to three hours.
   
4. It is advisable to wear loose comfortable clothing and flat shoes. For your comfort, please bring a dressing gown and slippers.
   
5. Minors (anyone under the age of 18 years) must be accompanied by a parent or guardian
   
6. Please complete the admission form, listing all medications carefully, and bring it with you on the day of your colonoscopy. Details of Health Insurance and excess, Medicare card, Veterans Affairs card or pension cards are also required.
   
7. Facility fee and extra charges are payable on the day of examination
   
8. Please do not bring valuables which could be mislaid.
   
9. A medical certificate will be issued if required.
   
10. Please read preparation instructions carefully, and use the checkboxes as a guide.
    
11. Ladies, no make-up, nail polish or jewellery please.
    

MEDICATIONS

Prior to ANY anaesthetic or sedation, it is desirable that you are as healthy as possible. This is why we advise you to take all medications as normal prior to your appointment, ESPECIALLY if you have high blood pressure, heart problems, epilepsy, asthma, or any other medical condition. There are some exceptions to this rule. Please read the following notes carefully.

1. Iron tablets should be ceased 5 days prior to your colonoscopy.
   
2. Aspirin-like drugs (anti-inflammatory) for arthritis should be ceased five days prior to the procedure.
   
3. Blood thinning tablets (anti-coagulants) may need to be ceased as directed, particularly if polypectomy is to be performed.
   
4. Diabetic medications (insulin or oral tablets) generally should be withheld on the morning of the procedure, following discussion with your Doctor. Please bring any diabetic medications to the centre. If possible, a morning blood glucose reading is advisable to be performed before attending the centre.
   
5. Contraceptive pill to be taken as normal, but extra precautions should be taken for the rest of the cycle following the procedure.
   
   

How are you prepared?

To enable a thorough and safe examination, the colon will need to be completely cleansed at home by the use of laxatives and the drinking of a quantity of lemon tasting solution, which passes right through without upsetting your body.

At Peninsula Endoscopy Centre

Admission procedures will confirm details of your past medical history and nursing staff and endoscopists will ensure that you adequately understand the procedure and instructions.

The anaesthetist will examine you and reassure you that with the use of drugs for sedation, you will find the colonoscopy comfortable and you may have no recollection of it later.

Special Considerations

Please advise nursing staff of any allergies. Female patients, any possibility of pregnancy should be revealed.

Consent Form

It will not be possible to discuss the removal of your polyps with you at the time of examination as you will be sedated. Therefore, if you agree to having any polyps found during the procedure removed, please sign the consent form. If you have any queries or reservations about this, please inform your Doctor.

What do we do?

After the anaesthetist gives sedation, the colonoscope is inserted through the rectum, the large intestine and often into the small bowel (ileum). As cancer of the large bowel arises from pre-existing polyps (benign wart like growths) it is advisable that if any polyps are found they should be painlessly removed at the time of the examination (polypectomy).

Safety and Risks

For inspection of the bowel alone, complications of colonoscopy are uncommon. Most surveys report complications in less than 1 in 1,000.

Complications which can occur include:

• intolerance of the bowel preparation solution
  
• reaction to sedatives used
  
• perforation and major bleeding are extremely rare, but if they occur, may require open surgery

Polypectomy: When polyp removal is carried out there is a slightly higher risk of perforation or bleeding from the site of polyp removal.

Sedation Complication: These are uncommon and avoided by administering monitoring oxygen during the procedure. If you wish to have full details of rare complications you should indicate to your Doctor before the procedure that you wish for all possible complications to be fully discussed.

Afterwards

On returning to our recovery lounge, you, should be alert within a few minutes. You may experience some windy pains and flatulence briefly, but you should be comfortable to leave the hospital escorted within one and a half hours after the procedure. written report will be provided on discharge, a copy of which is forward to your referring doctor. Explanation of the procedure will also be given, but due to the effects of the sedatives, you may not be able to recall details of the discussion with the Doctor. For this reason a relative or friend should escort you home and remain with you for at least 6 hours and preferably overnight. Normal work and activity can usually be recommended the following day. Contact your Doctor immediately should any of the following arise:

1. Persistent or increasing pain or abdominal distension.
   
2. Persistent or increasing bleeding from the back passage.
   
3. Any other symptoms of concern.

On arrival home please rest for the remainder of the day. As you have had medications, do not drive a motor vehicle, operate any form of machinery or make any important decisions. Whilst normal diet and fluids can be recommenced and normal medications continued, no alcohol should be taken for at least 12 hours. If you have any questions please see your local Doctor.

    Are you at risk?

• Has a family member had bowel cancer or polyps?

• Any blood with your bowel motion?

• Persistent change in bowel habits?