Colonoscopy

What Is a Colonoscopy? Preparation, Diet, Polyp Removal, and Aftercare

Colonoscopy, also known as lower gastrointestinal endoscopy, is a procedure that enables the effective diagnosis, treatment, and prevention of diseases of the large intestine and rectum. Today, colonoscopy is considered the gold standard method for examining the colon. At Daviva Health Group, colonoscopy procedures are performed by experienced specialist physicians in the field using modern equipment.

What Is a Colonoscopy?

Colonoscopy is a diagnostic and screening test that allows procedures such as examining the large intestine, checking the rectum, and viewing the last part of the small intestine using an instrument called a colonoscope. It is performed using an endoscope, a flexible instrument with a camera at its tip.

Colonoscopy is a procedure that diagnoses and treats conditions such as large intestinal diseases, chronic inflammatory bowel diseases, diverticula and intestinal polyps, as well as intestinal cancer.

In addition to being a key tool in the diagnosis of colorectal cancer and in colonoscopic polyp removal procedures, colonoscopy also makes it possible to treat some lesions such as intestinal polyps. Detected lesions can be partially or completely removed during the procedure for analysis. You can find what you need to know about colonoscopy preparation, diet, polyp removal (polypectomy), and aftercare in the rest of the article.

When and Why Is Colonoscopy Performed?

Colonoscopy allows examination of the large intestine and the last part of the small intestine. With colonoscopy, the internal structure of the intestines can be visualized, polyps can be surgically removed, or small vascular lesions on the intestinal lining can be treated. For this reason, this examination serves diagnostic colonoscopy, therapeutic colonoscopy, and preventive colonoscopy purposes.

Colonoscopy may be performed for many reasons. Above all, it is recommended especially for the prevention of colon cancer. People with a family history of colon cancer or polyps should undergo preventive colonoscopy starting at age 50.

Colonoscopy is useful for examining the colon if the patient has abdominal pain related to bowel movements or blood in the stool. Colonoscopy can help determine the cause of these symptoms (inflammatory bowel disease, colorectal cancer, etc.). In children, colonoscopy may also be requested for blood in the stool, diarrhea of unknown cause, abdominal pain that may result from intestinal inflammation, or to monitor a chronic intestinal problem.

Colonoscopy may be performed in the following situations:

• When specific digestive system symptoms are present, such as rectal bleeding, blood in the stool, recurrent constipation, diarrhea, and unexplained abdominal pain
• When there is a family history of colon cancer or in follow-up of Crohn’s disease or ulcerative colitis
• In colon cancer screening
• For removal of polyps (polypectomy) or treatment of small blood vessel lesions

Preparation Before Colonoscopy

To perform the examination, the large intestine, which is normally full of stool, must be thoroughly cleaned so that the walls can be seen. Colonoscopy preparation begins with a special diet to be followed a few days before the examination. This diet is planned as a low-fiber diet without fruits and vegetables.

Colonoscopy Diet

Restrictions are usually applied for 3-5 days before colonoscopy. During this period, foods high in fiber such as fruits, vegetables, and whole grains should be avoided. However, eggs, meat, fish, broth, fruit juices, purees, baby food, and small amounts of pasta and bread made from refined white flour may be consumed.

An enema should be performed the day before the examination to empty the large intestine. A completely liquid diet must be followed starting the day before colonoscopy or from the evening before. Only lean broths, water, herbal teas, pulp-free fruit juices, or tea (with sugar or honey) may be consumed. The method and timing of taking the laxative may vary depending on whether the procedure will be performed in the morning or in the afternoon.

Procedure Day and Medication Use

It is necessary to fast on the day of the procedure. Starting from midnight before the examination, no food should be eaten, no drinks should be consumed, and no smoking should occur. Some medications, such as those that slow bowel movements or blood thinners, are not compatible with colonoscopy. The patient must inform the doctor of all medications they are taking, and if necessary, some medications will be stopped a few days before the examination.

Importance of Pre-Colonoscopy Preparation

Proper preparation before colonoscopy is very important for the examination to proceed smoothly. If the intestines are not sufficiently cleaned, the intestinal surface cannot be seen clearly, which may require the procedure to be repeated.

What Should the Colonoscopy Diet Be Like?

3-5 days before colonoscopy, a low-fiber diet should be started by eliminating foods that may leave residue in the intestines. Drinking plenty of water, up to 2 liters per day, is recommended.

The following digestive-system-friendly and easy-to-digest foods should be consumed for the colonoscopy preparation diet:

• White rice
• Pasta made from refined white flour
• White meat (chicken, turkey)
• Lean fish
• Eggs
• Peeled and well-cooked potatoes
• Clear broth without vegetables and without fat

The following foods should be avoided in the colonoscopy diet:

• Raw fruits and vegetables
• Legumes
• Whole grains
• Nuts and seeds
• Foods with skins or fiber
• Cheese and butter
• Fatty foods such as red meat

Liquid Diet 1 Day Before Colonoscopy

A liquid diet should be followed 1 day before colonoscopy. Solid foods, including yogurt, should not be consumed. It is also important to take bowel-cleansing medications at the scheduled times.

Only the following drinks and foods may be consumed:

• Water
• Tea or herbal tea (without sugar or with little sugar)
• Clear lean broth
• Pulp-free fruit juices (e.g., apple juice or white grape juice)

Proper application of the diet and medications is critically important for correct bowel cleansing and for the colonoscopy procedure to be successful.

How Long Does Colonoscopy Take?

Colonoscopy is an examination usually performed under sedation (light sleep) and takes about 30 minutes. The duration of colonoscopy may vary depending on the patient and the procedures to be performed. If removal of polyps (polypectomy) is necessary, this is also done during colonoscopy, which may lengthen the procedure.

In most cases, colonoscopy is performed as a same-day treatment. The patient is kept under observation for a few hours after the procedure and can go home if everything goes well. However, driving or working is not recommended after the procedure. In the case of polypectomy (polyp removal), observation is usually 24 hours.

Are There Risks of Colonoscopy?

After colonoscopy, some side effects such as mild abdominal pain or passing gas may occur. However, these symptoms last only a few hours.

The most important complication of colonoscopy that constitutes a medical and surgical emergency is the risk of perforation of the bowel wall. There is also a risk of bleeding after polyps are removed. Sedation or tranquilizers may sometimes cause side effects such as dry mouth and blurred vision in addition to drowsiness.

If the following symptoms occur after colonoscopy, you should contact your doctor or go to the nearest emergency department:

• Significant rectal bleeding
• Severe abdominal pain
• Shortness of breath or chest pain
• Fever or chills

What Should Be Considered After Colonoscopy?

In most cases, colonoscopy is performed as a same-day treatment. The following should be considered after colonoscopy;

The patient is kept under observation for a few hours after the procedure, and if everything goes well, the patient can go home. However, driving or working after sedation is not recommended. In the case of polypectomy, the observation period is usually 24 hours.

After colonoscopy, some side effects such as mild abdominal pain and passing gas may occur. These symptoms usually last about 12 hours.

Because the sedative effect of the medications given before colonoscopy may slow reflexes, the patient must come to the clinic with an accompanying person and should not drive home alone.

What Is Virtual Colonoscopy?

Virtual colonoscopy consists of a low-dose computed tomography (CT) scan that produces three-dimensional images of the intestines. Although it is a reliable test, it cannot detect polyps smaller than 5 millimeters or flat lesions. In addition, this type of test cannot immediately remove detected polyps, and biopsy can only be performed with a standard colonoscopy.

What Is Video Capsule Endoscopy?

Video capsule endoscopy (VCE) is not an alternative to colonoscopy or gastroscopy. It allows visualization of the small intestine and is used diagnostically, especially for Crohn’s disease, small bowel tumors, or vascular anomalies that may cause anemia. To perform the test, the patient is asked to swallow a disposable video capsule equipped with a microcamera; as the capsule passes through the digestive system, it transmits the images collected.

Is Pain Felt During Colonoscopy?

Colonoscopy is a procedure performed under sedation. If abnormalities are detected during colonoscopy, a biopsy may be performed for analysis or intestinal polyps (polypectomy) may be removed to prevent malignant transformation. These procedures are completely painless. Mild or moderate abdominal pain may occur after colonoscopy.

Are Polyps Removed During Colonoscopy?

Colonoscopy also allows removal of intestinal polyps (polypectomy) to prevent malignant transformation. For this reason, colonoscopy is a diagnostic, therapeutic, and preventive procedure.

Frequently Asked Questions About Colonoscopy

How Is Colonoscopy Performed?

The colonoscopy procedure is performed using a thin and flexible tube called a colonoscope, approximately 130-150 cm long and 12 mm in diameter, combined with optical fibers, a miniature camera, and a light source. The entire setup is connected to a monitor and provides direct and detailed imaging of the intestines during the examination.

Colonoscopy is usually performed under light sedation to ensure patient comfort. The patient lies on their left side for the procedure, and the doctor advances the colonoscope through the anus into the rectum and along the colon. During the procedure, the intestines are inflated with air to expand the bowel wall and increase visibility, allowing the inner surface to be seen clearly.

If abnormalities are detected during colonoscopy, a biopsy may be performed. This procedure is completely painless and is carried out using small forceps inserted through the endoscope. In addition to biopsies, colonoscopy also allows removal of intestinal polyps (polypectomy) to prevent malignant transformation.

What Is Colonoscopy Used For?

Colonoscopy is an endoscopic examination that is vital for the diagnosis and prevention of colorectal diseases, including colorectal cancer. Colonoscopy allows visualization of the inner surface of the large intestine and rectum; detection of abnormalities such as polyps, inflammation, ulcers, or tumors; and, if necessary, biopsy or polypectomy.

How Many Minutes Does Colonoscopy Take?

The duration of colonoscopy may vary depending on the patient’s characteristics and the procedures to be performed. Colonoscopy usually takes 20-30 minutes.

Who Can Have a Colonoscopy?

Colonoscopy is generally recommended for people over 45-50 years of age. In this way, colon cancer can be detected at an early stage, and polyps can be found and removed before symptoms appear.