Procedure FAQs

What is a colonoscopy?

Colonoscopy is the visual examination of the lining of the colon and rectum. A colonoscopy is performed to diagnose colon and rectal problems, perform biopsies and remove colon polyps. Most colonoscopies are performed on an outpatient basis.

Who should have colonoscopy?

If you have a change in bowel pattern or bleeding, your physician may recommend a colonoscopy. Colonoscopies are also performed to check unexplained abdominal symptoms; to check inflammatory bowel disease (colitis); to verify identification of polyps or tumors located with a barium enema exam; to examine patients who test positive for blood in the stool; and to monitor patients with a past history of colon polyps or cancer.

How is colonoscopy performed?

After a patient’s bowel is thoroughly cleaned (as prescribed by the physician), the colonoscope is inserted into the anus and gently advanced around the bends of the colon to where the small intestine enters. Polyps can be removed as necessary and biopsies may be taken. The procedure usually takes less than an hour and there is little pain. Intravenous sedation is usually given. Occasionally patients may experience slight discomfort following the procedure, which is often improved by expelling gas.

What is colorectal cancer?

Colorectal cancer is the second most common cancer in the United States (for both sexes combined), striking 140,000 people annually, and causing 60,000 deaths. However, if diagnosed in the early stages, this disease is highly curable.

Who is at risk for colorectal cancer?

While more than 90% of patients with colorectal cancer are over the age of 40, the disease can occur at any age. Family history of colorectal cancer and polyps and a personal history of ulcerative colitis or Crohns’ Disease, colon polyps or cancer of other organs, especially of the breast or uterus, are other contributing risk factors.

How does colorectal cancer start?

Nearly all colon and rectal cancers begin in benign polyps. This fact offers an opportunity to prevent colon cancer by removing polyps in the pre-cancerous stage.

What are the symptoms of colorectal cancer?

Rectal bleeding and changes in bowel habits are the most common symptoms. Abdominal pain and weight loss are usually late symptoms, possibly indicating extensive disease. After the age of 40, your routine physical should include colorectal detection procedures and methods, since many polyps and early cancers do not produce symptoms.

How is colorectal cancer treated?

In nearly all cases, surgery is required for a complete cure. Sometimes radiation and chemotherapy are used in addition to surgery. If the cancer is detected and treated in the earliest stages, 80-90% of patients can be cured. If diagnosed in the later stages, 50% or less are cured, and less than 5% require a colostomy (the surgical construction of an artificial excretory opening from the colon).

Can colorectal cancer be prevented?

Steps you can take to lower the risk of colorectal cancer include: having benign polyps removed by colonoscopy; being aware of changes in your bowel habits; and having regular bowel examinations as part of routine physicals at an earlier age. Additionally, a diet which is high in fiber and low in fat may be important in prevention of colorectal cancer.

Colon Cancer Screening

Colon cancer screening is recommended if you are experiencing any of the following symptoms:

• Persistent change in bowel habits
• Bleeding with bowel movement
• Abodminal pain

If you do not have any of the symptoms above.

• An outpatient colonoscopy is recommended every 10 years. Discuss screening options with your physician.
• And/or a fecal occult blood test each year & flexible sigmoidoscopy every 5 years.

What is EGD?

Endoscopy is typically a 10 minute procedure used to visually examine your upper digestive system with a tiny camera on the end of a long, flexible tube. We perform EGDs at our Joint Commission accredited Endoscopy Center, and Baptist Physicians Surgery Center, located within Central Baptist Hospital in Lexington, Kentucky.

What is the purpose of an EGD?

An EGD helps to diagnose acid reflux disease, ulcers, gastritis with or without H. pylori infection, growths, causes of bleeding or pain, and cancer.

What you can expect during an EGD?

During your endoscopy procedure, you’ll be asked to lie down on a table on your back or your side. Monitors often will be attached to your body to allow your health care team to monitor your breathing, blood pressure and heart rate during the procedure. You will receive intravenous sedation that helps you relax during the endoscopy. The scope is thinner than most pieces of food that you swallow. Your doctor then passes the endoscope down your esophagus toward your stomach. You will also need to bring an adult with you that is willing to accept the responsibility of your care to drive you home.

What is ERCP?

ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject contrast into the ducts in the biliary tree or pancreas so they can be seen on x-rays.

Who should have an ERCP?

ERCP is most commonly performed to treat conditions of the pancreas or bile ducts or to further clarify abnormal results from blood tests or imaging test such as ultrasound or CT scan. The common reasons to do ERCP include: to remove gallstones from the bile duct or to relieve a blocked bile duct.

How is ERCP performed?

During your endoscopy procedure, you’ll be asked to lie down on a table on your side. Monitors often will be attached to your body to allow your health care team to monitor your breathing, blood pressure and heart rate during the procedure. You will receive intravenous sedation that helps you relax during the endoscopy. During ERCP, your doctor will pass an endoscope through your mouth, esophagus and stomach into the duodenum (first part of the small intestine). An endoscope is a thin, flexible tube that lets your doctor see inside your bowels. After your doctor sees the common opening to the ducts from the liver and pancreas, called the major duodenal papilla, your doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor will inject a contrast material (dye) into the pancreatic or biliary ducts and will take X-rays.

What are polyps?

Polyps are abnormal growths that form on the inside lining of the colon. Polyps are one of the most common conditions affecting the colon and rectum. Although most polyps are benign (non-cancerous), the relationship of certain polyps to cancer is well established. Since there is no way of predicting whether or not a polyp is or will become malignant, total removal of all polyps is advised.

How are polyps diagnosed?

Polyps are diagnosed either by looking at the colon lining directly (via endoscopy) or by x-ray study (barium enema). There are 3 types of colorectal endoscopy:

• Rigid Sigmoidoscopy (examines the lower six to eight inches of the rectum).
• Flexible Sigmoidoscopy (examines the lower one-fourth to one-third of the colon).
• Colonoscopy (examines the entire length of the colon).

Both the rigid and flexible sigmoidoscopies can be performed in the doctor’s office. The discovery of one polyp necessitates a complete colon inspection. Once a polyp is completely removed, its recurrence is very unusual; however, new polyps will develop in at least 40% of people who have previously had polyps. These patients should therefore have regular exams.

How are polyps removed?

Most polyps can be removed by snaring them with a wire loop passed through the instrument. Small polyps can be destroyed by touching them with a coagulating electrical current, whereas large polyps may require more than one treatment for complete removal. If polyps cannot be removed by instruments because of their size or position, surgery may be required.