COLONOSCOPY IS THE COMPLETE examination of the large bowel, rectum and colon with a thin, flexible fibre-optic scope. An indispensable investigative tool for the diagnosis of colorectal diseases in patients with symptoms such as blood in stool, change in bowel habit, abdominal pain and weight loss, colonoscopy can be used in all age groups, from the newly born to the very old. It is also the key to screening and prevention of colorectal cancer.
THIS Quarterly had the chance to speak to renowned colorectal surgeon Dr Goh Hak Su and ask him some of our reader’s most frequently asked questions about colonoscopy
How accurate is colonoscopy for the detection of colorectal cancers?
It is the gold standard for the detection and prevention of colorectal cancer. In addition to direct visualisation, colonoscopy also allows biopsies to be taken at the same time for testing and confirmation.
Apart from colorectal cancer, are there other problems that a colonoscopy could detect?
Colonoscopy is very effective in detecting nearly all types of colorectal diseases. Apart from cancers and polyps, it can detect infection, inflammation, bleeding, poor blood supply, diverticular disease as well as the narrowing or gross distension of the colon. During the colonoscopy, polyps that are detected can also be routinely removed to prevent cancer from developing.
Equally important, it also allows us to confidently exclude major diseases such as cancer when the examination is normal. This can be very reassuring to patients who often fear the worst whenever some symptoms present themselves.
What does the procedure involve?
Colonoscopes are very flexible and has a camera at the tip. It is inserted through the anus and carefully negotiated through the whole length of the colon until it reaches the caecum. If necessary, the colonoscope can also be extended into the end part of the small intestine, although this is not commonly done. |
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Aside from the camera, colonoscopes also have air, water and suction channels to allow the doctor to view every part of the colon clearly. If any suspicious lesions are seen, it can be immediately biopsied and extracted for further examination. If a polyp is found, it can also be immediately removed and cauterised to stop any bleeding.
The entire procedure takes about 15 to 20 minutes on average. Typically, the patient will be sedated so as to minimise any pain or discomfort; indeed, many times patients do not even remember the procedure due to the sedation.
Why do I feel bloated after a colonoscopy?
In some cases, a patient may experience a feeling of bloatedness in their tummy after the procedure. This is because air is pumped into the colon so as to expand the area, allowing the colonoscopist to have a better look. A well-trained colposcopist will however be able to minimise this by sucking out as much air as possible when withdrawing the colonoscope
Will I need a few days off work to have this done?
No. You only need one day off work. Some people feel well enough to return to work a few hours after the colonoscopy. However, you need to take plenty of fluids before and after the procedure as the preparation required for the colonoscopy can be very dehydrating
Is the procedure MediSave claimable?
It is claimable if it is used to investigate or diagnose a colorectal disease. If used for screening purposes, it is only claimable if the guidelines from the Ministry of Health are strictly observed.
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