Colonoscopy, Sigmoidoscopy, and Polyps
Colonoscopy
Indications
for Colonoscopy
Sigmoidoscopy
Polyps
of the Colon and Rectum
Are polyps dangerous?
Who gets polyps?
What are the symptoms?
How does the doctor test for polyps?
Who should get tested for polyps?
How are polyps treated?
How can I prevent polyps?
Points to remember
Video References
 Colonoscopy
(koh-luh-NAH-skuh-pee) lets the physician look inside your
entire large intestine, from the lowest part, the rectum,
all the way up through the colon to the lower end of the small
intestine. The procedure is used to diagnose the causes of
unexplained changes in bowel habits. It is also used to look
for early signs of cancer in the colon and rectum. Colonoscopy
enables the physician to see inflamed tissue, abnormal growths,
ulcers, bleeding, and muscle spasms.
For the procedure, you
will lie on your left side on the examining table. You will
probably be given pain medication and a mild sedative to keep
you comfortable and to help you relax during the exam. The
physician will insert a long, flexible, lighted tube into
your rectum and slowly guide it into your colon. The tube
is called a colonoscope (koh-LON-oh-skope). The scope transmits
an image of the inside of the colon, so the physician can
carefully examine the lining of the colon. The scope bends,
so the physician can move it around the curves of your colon.
You may be asked to change position occasionally to help the
physician move the scope. The scope also blows air into your
colon, which inflates the colon and helps the physician see
better.
If anything unusual is
in your colon, like a polyp or inflamed tissue, the physician
can remove a piece of it using tiny instruments passed through
the scope. That tissue (biopsy) is then sent to a lab for
testing. If there is bleeding in the colon, the physician
can pass a laser, heater probe, or electrical probe, or inject
special medicines, through the scope and use it to stop the
bleeding.
Bleeding and puncture
of the colon are possible complications of colonoscopy. However,
such complications are uncommon.
Colonoscopy takes 30
to 60 minutes. The sedative and pain medicine should keep
you from feeling much discomfort during the exam. You will
need to remain at the physician's office for 1 to 2 hours
until the sedative wears off.
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Indications
for Colonoscopy
According to the STOP Colon/Rectal Cancer Foundation:
· Beginning at age 50, you should have a screening colonoscopy
every 10 years. If you are completely asymptomatic (without
any symptoms) and you have no history of colorectal disease,
you still need to be screened.
· Beginning at age 40
or earlier, you should have a colonoscopy if you have a personal
or family history of benign colorectal polyps, colorectal
cancer, ovarian cancer, uterine cancer, breast cancer, ulcerative
colitis or Crohn's disease.
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Sigmoidoscopy
A flexible sigmoidoscopy (SIG-moy-DAH-skuh-pee) exam is a
short colonoscopy exam, limited to the lower one third of
the colon. Sigmoidoscopy enables the physician to look at
the sigmoid colon. Physicians may use this procedure to find
the cause of diarrhea, abdominal pain, or constipation. They
also use sigmoidoscopy to look for early signs of cancer in
the colon and rectum. With sigmoidoscopy, the physician can
see bleeding, inflammation, abnormal growths, and ulcers.
 
Sigmoidoscopy takes 10
to 20 minutes. During the procedure, you might feel pressure
and slight cramping in your lower abdomen. You will feel better
afterwards when the air leaves your colon.
The discovery of a polyp
on flexible sigmoidoscopy necessitates a complete colon inspection
with a colonoscope, since at least 30 percent of these patients
will have additional polyps.
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Polyps
of the Colon and Rectum
Colon Polyps
A Polyp (POL-ip) is any
mass of abnormal tissue that bulges or projects outward or
upward from a surface of the colon or rectum by growing from
a broad base (sessile) or slender stalk (pedunculus). The
early detection and removal of polyps prevent colon
and rectal cancer.
Finding
polyps early can reduce
the risk of cancer by up to 90%
Polyps are one of the most common
conditions affecting the colon and rectum, occurring in 15-20
percent of the adult population. Although most polyps are
benign, the relationship of certain polyps to cancer is well
established.
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Are
polyps dangerous?
Most polyps are not dangerous. Most are benign, which means
they are not cancer. But over time, some types of polyps can
turn into cancer. Usually, polyps that are smaller than a
pea aren't harmful. But larger polyps could someday become
cancer or may already be cancer. To be safe, doctors remove
all polyps and test them.
Colon polyp
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Who
gets polyps?
You may also be more likely to get polyps if you
· eat a lot of fatty foods
· smoke
· drink alcohol
· don't exercise
· weigh too much
Find out
if someone in your family has had polyps.
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What
are the symptoms?
Most small polyps don't cause symptoms.
Often, people don't know they have one until the doctor finds
it during a regular checkup or while testing them for something
else.
But some people do have symptoms like
these:
· bleeding from the anus. You
might notice blood on your underwear or on toilet paper after
you've had a bowel movement.
· constipation or diarrhea that lasts more than a week.
· blood in the stool. Blood can make stool look black,
or it can show up as red streaks in the stool.
If you have any of these symptoms,
see a doctor to find out what the problem is.
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How
does the doctor test for polyps?
The doctor can use four tests to check
for polyps:
· Digital rectal exam. The
doctor wears gloves and checks your rectum, the last part
of the large intestine, to see if it feels normal. This test
would find polyps only in the rectum, so the doctor may need
to do one of the other tests listed below to find polyps higher
up in the intestine.
· Barium enema. The doctor puts a liquid called barium
into your rectum before taking x rays of your large intestine.
Barium makes your intestine look white in the pictures. Polyps
are dark, so they're easy to see.
· Sigmoidoscopy. With
this test, the doctor can see inside your large intestine.
The doctor puts a thin flexible tube into your rectum. The
device is called a sigmoidoscope, and it has a light and a
tiny video camera in it. The doctor uses the sigmoidoscope
to look at the last third of your large intestine.
· Colonoscopy. This
test is like sigmoidoscopy, but the doctor looks at all of
the large intestine. It usually requires sedation.
Colonoscopy or sigmoidoscopy testing
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Who
should get tested for polyps?
Talk to your doctor about
getting tested for polyps if
· you have symptoms
· you're 50 years old or older
· someone in your family has had polyps or colon cancer
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How
are polyps treated?
The doctor will remove the polyp.
Sometimes, the doctor takes it out during sigmoidoscopy or
colonoscopy. Or the doctor may decide to operate through the
abdomen. The polyp is then tested for cancer.
If you've had polyps, the doctor may
want you to get tested regularly in the future.
Polyp removal
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How
can I prevent polyps?
Doctors don't know of any one sure way to prevent polyps.
But you might be able to lower your risk of getting them if
you
· eat a high
fiber diet, (i.e. more fruits and vegetables) and less
fatty food.
· don't smoke
· avoid alcohol
· exercise every day
· lose weight if you're overweight
Eating more calcium and folate can
also lower your risk of getting polyps. Some foods that are
rich in calcium are milk, cheese, and broccoli. Some foods
that are rich in folate are chickpeas, kidney beans, and spinach.
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Points
to remember
· A polyp is extra tissue that grows inside the body.
Most polyps are not harmful.
· Symptoms may include constipation or diarrhea for
more than a week or blood on your underwear, on toilet paper,
or in your stool.
· Many polyps do not cause symptoms.
· Doctors remove all polyps and test them for cancer.
· Talk to your doctor about getting tested for polyps
if
· you have any symptoms
· you're 50 years old or older
· someone in your family has had polyps or colon cancer
Most colon examinations using the
flexible colonoscope, including polyp removal, can be performed
on an outpatient basis with minimal discomfort. Large polyps
may require more than one treatment for complete removal.
Some polyps cannot be removed by instruments because of their
size or position; surgery is then required.
Once a polyp is completely removed,
its recurrence is very unusual. However, the same factors
that caused the polyp to form are still present. New polyps
will develop in at least 30 percent of people who have previously
had polyps. Patients should have regular exams by a physician
specially trained to treat diseases of the colon and rectum.
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Video
References
1. Video: Colonoscopy
exam and polyp removal - at the Mayo Clinic
rtsp://a1292.r.akareal.net/ondemand/7/1292/1598/982096739/
hoasis.download.akamai.com/1598/02132001/mc000/digest_test_colonoscopy.rm
2. Video: Colonoscopy
Tutorial - The National Library of Medicine
http://www.nlm.nih.gov/medlineplus/tutorials/colonoscopy/htm/index.htm
3. Video: Sigmoidoscopy
Tutorial - The National Library of Medicine
http://www.nlm.nih.gov/medlineplus/tutorials/sigmoidoscopy/htm/index.htm
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