Is a colonoscopy painful? What should I pay attention to before and after the examination?

Author: Ji Ming, Chief Physician, Beijing Friendship Hospital, Capital Medical University

Reviewer: Yao Shukun, Chief Physician, China-Japan Friendship Hospital

Colonoscopy technology has gradually matured. The single-person colonoscopy operation cannot be said to be completely painless. After the mirror is inserted, there is a little swelling and pain, which is generally tolerable. There is also a painless colonoscopy, which can be completed after waking up from a nap without any discomfort.

So don't be afraid of colonoscopy.

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1. What special preparations should be made before a colonoscopy?

The day before a colonoscopy, you should eat a low-residue diet. You can drink some porridge, but red bean porridge is not recommended as it is made of bean skin. You can eat some fermented tofu. You cannot eat high-fiber vegetables, such as celery. You can eat some starchy foods, such as potatoes. Do not eat fruits with too many seeds, such as dragon fruit, as they cannot be excreted cleanly.

In Japan, there is a kind of inspection meal, which puts low-residue food into bags, one bag for breakfast, one bag for lunch, and one bag for dinner. They are mixed with water to make a paste and eaten. They are all low-residue.

You should also drink some bowel cleansing medicine before going to bed the night before the examination. Most hospitals now use compound polyethylene glycol, one bag of compound polyethylene glycol plus 1000 ml of water.

The next morning, that is, the morning of the examination, you should also drink it to clean your intestines. It is generally required to drink it 3 hours before the examination and do a colonoscopy 3 hours after drinking it.

It is also important to note that you should not eat on the morning of the examination.

2. How long does a colonoscopy take? What should I pay attention to after the procedure?

How long does a colonoscopy take? First of all, where should the colonoscope be inserted? If you want to see the entire colon, you should go from the anus to the ileocecal part, and see the opening of the appendix. The time it takes to insert the scope varies from person to person. Some people can reach the ileocecal part very quickly.

When withdrawing the colonoscope, the time from the ileocecal region to the anus should not be less than 6 minutes, and each colon bag must be carefully observed.

Generally speaking, a colonoscopy by a skilled doctor usually takes about 20-25 minutes. You can go home after a regular colonoscopy; for a painless colonoscopy, you can go home after you are fully awake.

Because a large amount of laxatives are taken for bowel cleansing, the intestinal environment has changed and the normal intestinal flora may have changed. It is recommended to supplement with probiotics and use some drugs to regulate intestinal microecology after the colonoscopy for 2-3 days to restore the intestinal environment as soon as possible.

In addition, there is nothing special to pay attention to in terms of diet after a colonoscopy.

3. After having a colonoscopy, how long do I have to wait before having another one?

For the general public, it is recommended to start a basic colonoscopy at the age of 45, and then determine the interval based on the specific results of the examination.

For example, if the intestinal cleaning is satisfactory and the examination is thorough, no problems are found and the colon condition is normal, there will be no need for a colonoscopy within three to five years.

The intestinal preparation is not very good, the feces blocks the view, and there are a lot of bubbles that affect observation. Although no problems are found, the colonoscopy may need to be repeated every six months or a year to avoid omissions.

If a colon polyp is found during the first colonoscopy, a colonoscopy should be performed again one year after the polyp is removed. If the pathology of the polyp indicates early cancer, a colonoscopy may be performed again every six months.

4. Can colonoscopy detect early colon cancer?

Early stage colon cancer, colon adenoma and colon polyp can all be found under endoscopy. 70% of colon cancers are evolved from tubular adenomas, so as long as tubular adenomas are found, they should be removed to avoid the occurrence of colon cancer.

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Small polyps can be removed during the examination, but most colonoscopy examinations and colonoscopy treatments are separate. After a polyp is found, a pathology sample may be taken first, and then a decision on treatment will be made after the pathology is out.

The colorectum is a hollow organ. Early cancer of hollow organs generally has no symptoms. It can only be detected early through regular screening. By the time symptoms appear, it may already be in the middle or late stages. Therefore, it is recommended that everyone undergo regular screening under the guidance of a doctor.