Colonoscopy

A colonoscopy is a medical procedure used to examine the inner lining of the colon and rectum. It’s often performed to investigate gastrointestinal symptoms, screen for colorectal cancer, or monitor conditions like polyps or inflammatory bowel disease (IBD).

When do I need to do the procedure

• Screening: Detects and removes polyps before they develop into cancer.
• Diagnosis: Investigates symptoms like bleeding, abdominal pain, or changes in bowel habits.
• Treatment: Removes polyps or abnormal tissue and addresses bleeding areas.

What do I expect

1. Preparation:

• Patients follow a clear liquid diet and take a prescribed bowel prep to clean the colon.

2. During the Procedure:

• A sedative is typically given for comfort.
• A thin, flexible tube (colonoscope) with a camera is inserted into the rectum to examine the colon.
• A polypectomy may be performed during colonoscopy to remove the polyps in the colon. These usually involve a snare that is passed through an instrument channel in the colonoscope. A snare polypectomy can either be performed with or without an electric current passing through it. Generally, smaller polyps less than 10mm can be resected using cold snare polypectomy.

3. After the Procedure:

• Patients may feel bloated or pass gas.
• The resected polyps will be sent to the laboratory for histological examination to determine what type of cells make up the polyps and to grade the degree of dysplasia or the presence of cancer.
• Results will be reviewed by the doctor usually within a week when the reports are ready by the laboratory.

After the procedure

After a colonoscopy, patient will be resting in a recovery area or room in the hospital, where medical staff will continue to monitor you until the effects of the anaesthesia have worn off. The staff will also provide light refreshments and ensure the patient is ready to be discharged. It is strongly encouraged that a family member is to be with patient during the discharge process and accompany the patient home. Once the laboratory results are ready, our nurse will contact you to arrange for follow-up appointment with your doctor to review the procedure, discuss the findings, including any biopsy results, and outline an appropriate management plan moving forward.

Proper aftercare at home is essential for a smooth recovery. Here are some general guidelines:

1. Rest: Take it easy for the rest of the day. Avoid strenuous activities like heavy lifting or exercise for at least 24 hours.
2. Hydration: Drink plenty of fluids to replenish what was lost during bowel preparation. Water, clear broths, or electrolyte drinks are great options.
3. Diet: Start with light, easily digestible foods such as soup, toast, or crackers. Gradually reintroduce solid foods, avoiding anything spicy, greasy, or high in fiber for the first day.
4. Driving: Do not drive or operate heavy machinery for 24 hours due to the sedatives used during the procedure.
5. Monitor Symptoms: Mild side effects like bloating or cramping are common, but if you experience severe pain, persistent bleeding, or fever, contact your healthcare provider immediately.

If you have specific concerns, feel free to contact our centre for further advice.

Safety of the procedure

Colonoscopy is generally considered a safe and effective procedure, especially when performed by experienced specialists. It is a vital tool for detecting and preventing colorectal cancer, as well as diagnosing gastrointestinal conditions.

While complications are rare, they can include:

• Perforation: A small tear in the colon wall, which may require surgical repair.
• Bleeding: Often occurs if a polyp is removed, but it is usually minor.
• Infection: Extremely rare, but possible due to the use of medical instruments.
• Reactions to Sedation: Some individuals may experience nausea or other side effects.

Polypectomy is generally safe. However, it is associated with an overall risk of 1% including thermal injury due to electrocautery, perforation and post polypectomy bleeding. Some of the risk include the use of antiplatelet agents and anticoagulation therapy such as warfarin and also depending on the size of the polyps.

Your doctor will advise you to observe for signs of bleeding, severe abdominal pain or fever. If these happen, it is important to contact the clinic immediately.

Cost for the procedure

• A colonoscopy is a hospital procedure;it is covered under most hospitalization plans.
• The procedure is also Medisave deductible. Most of the companies’ health benefits and private health insurances cover the cost of the procedure, which may extend to the private hospitals.
• The fee benchmarks on the procedure done in different hospitals can be found in the website of Ministry of Health Singapore.
• Before the endoscopic procedure, a detailed financial counselling will be done to help the patients understand the cost breakdown in the preferred hospital.
• Patients should also check with their insurance provider on the updated policy regulations before the procedure.