What is a Colonoscopy?
Colonoscopy is a safe, non-invasive, non-surgical procedure that allows Dr. Mantas to evaluate the lower part of your gastrointestinal tract including the terminal ileum, colon, rectum and anus.
Why would I need a Colonoscopy?
Dr. Mantas performs not only screening colonoscopies for colon polyp and colon cancer surveillance but also utilizes colonoscopies to investigate a variety of lower gastrointestinal symptoms and disorders that include but are not limited to:
- Constipation, Diarrhea or Change in Bowel Habits
- Abdominal/Anorectal Pain
- Bleeding and Anemia
- Unexplained Weight Loss
- Inflammation and Ulceration
How do I prepare for my Colonoscopy?
- 2 – 5mg Tablets of Dulcolax (Bisacodyl) Laxative (not the stool softener)
- 1 – 8.3oz/238g Bottle of MiraLAX (polyethelene glycol)
- 1 – 64oz Bottle of Gatorade
- 1 – 10oz Bottle of Magnesium Citrate
The day before your colonoscopy you may have a light meal before noon. After 12pm you will be asked to follow a surgical clear liquid diet (refer below). At noon take 2 Dulcolax tablets with 8 oz of water (do not crush or chew). Mix the 8.3oz/238g Bottle of MiraLAX (polyethelene glycol) with the 64oz Bottle of Gatorade and chill in the fridge. At 6pm begin drinking 8oz of the Gatorade/Miralax solution every 15 minutes until gone. Watery bowel movements should begin about 1-2 hours after your first glass of the Gatorade/Miralax solution and will continue for 1-2 more hours. This bowel prep is designed to clean out stool from your colon. An effective clean out is one in which the effluent that is passed from your colon is clear and looks similar to the bowel prep without any particulate matter. A clean colon is important because the presence of stool inside the colon prevents adequate visualization and removal of polyps. After you have completed the full bowel prep you will be asked to avoid eating or drinking anything after midnight anything or more specifically we ask that you avoid solid foods for at least 8 hours and refrain from drinking liquids for at least 4 hours prior to your procedure. This is to ensure that your stomach will be empty prior to the procedure allowing Dr. Mantas to visualize your gastrointestinal tract and to prevent vomiting and aspiration while sedated. Remember that good preparation allows for the safest and most effective procedure.
An alternative prescription bowel prep that Dr. Mantas may have your use is the Suprep Bowel Prep. Please refer to the following video for details on Suprep Bowel Prep.
- What is a “surgical clear liquid diet”? Clear liquid diet is designed to maintain vital body fluid, salt and mineral balance and also provide some energy though it is not adequate in calories and nutrients and should not be used for more than 5 days. Clear liquids reduce stimulation of digestive system and leave no residue in the intestinal tract.
- Allowable Liquids
- Clear Carbonated Drinks (eg. Sprite, 7-Up, Ginger Ale)
- Clear Sports Drinks (eg. Gatorade)
- Clear Fat-Free Broth or Bouillon (eg. Beef, Chicken)
- Clear Gelatins (eg. Jell-O)
- Clear Popsicles
- Clear Flavored Water (eg. Crystallite, Mio)
- Clear Pulp Free / Strained Fruit Juices (eg. Apple Juice)
- Black Coffee or Tea without Milk/Cream
- Non-Allowable Liquids
- No Purple or Red Colors
- No Milk or other Dairy Products (eg. Ice Cream, Sherbert, Yogurt)
- No Cream Soups
- No Fruit Juices with Pulp
- No Alcohol
- If you are a diabetic please drink allowable liquids with sugar in moderation throughout the day.
- Allowable Liquids
- I have not had a bowel movement and it’s 9pm or my effluent is not clear? Drink the 10oz bottle of Magnesium Citrate or repeat the prep above.
- My prep is making me nauseous? Bowel preps will cause some nausea and bloating which will alleviate once bowel movements commence but if your symptoms are significant wait 1-2 hours to allow your stomach to settle. It is sometimes helpful to rinse your mouth out and brush your teeth to clear out the taste from your mouth. In the meantime chill the prep even more and once your symptoms alleviate begin redrinking but at a slower rate. If you continue to vomit call our office to receive further instructions. If you are prone to developing nausea and vomiting please inform the office and you may be eligible for prophylactic anti-emetic (eg. Zofran).
- I have underlying chronic constipation? If you have severe underlying chronic constipation you may need an extended/modified prep including 2-3 days of clear liquids and two laxative preps.
- I am prone to anal skin irritation? Your anal skin will likely become irritated following a bowel prep and can be treated with a variety of over the counter remedies including hydrocortisone cream and baby wipes.
After your visit with Dr. Mantas his staff will provide you with more detailed instructions regarding preparation for your colonoscopy. Please contact Dr. Mantas’ office, endoscopy center, or hospital GI lab if you have any questions.
What medications can I take or not take before my Colonoscopy?
Most prescription and non-prescription medicines including herbals, vitamins and supplements can be taken up to the day of your procedure with a sip of water. However, the medications listed below may need to be modified. Please contact Dr. Mantas’ office, endoscopy center, or hospital GI lab if you have any questions or need to review your medication list.
- Anti-Coagulants aka Blood Thinners (eg. Coumadin, Pradaxa, Xarelto, Eliquis)
- Anti-Platelets (eg Aspirin, Plavix)
- Diabetic Medications (eg. Insulin, Metformin, Glyburide)
What else should I do because I am a diabetic?
Special pre-procedure instructions will be given to you if you are a diabetic. Please provide a detailed list of your diabetic medications including pills and insulin. You should check your blood sugar frequently during the day before and after your procedure. Since you will be on a clear liquid diet your blood sugar may drop faster than normal. To avoid this be sure to include some liquids with sugar in your diet. If you blood sugar is low then dissolve (do not chew) a piece of hardy candy in your mouth.
Will I be able to drive home after my procedure?
For the procedure, you will be given a fast acting sedative, which will put you asleep for the duration of the procedure. Although you will wake up quickly, the sedative medicines cause temporary changes in reflexes and judgment so someone will need to drive you home after your procedure.
What happens the day of the procedure?
We understand that undergoing a GI procedure can cause some apprehension but be rest assured that you are in the best of hands in a state-of-the-art facility. Your comfort, well-being and peace of mind are paramount and we hope that the following description of your procedure day will alleviate some of your fears.
Upon arrival at our endoscopy center or hospital GI lab, our staff will answer any questions that you may have and review the procedure including possible complications and will ask you to sign a consent form if you have not already done so. Afterwards you will change into a gown and a trained nurse will start an IV for administration of sedatives.
Shortly thereafter you will be transferred to the endoscopy suite where you will meet Dr. Mantas. There you will lay on your left side and then an anesthetist will then provide safe, fast-acting sedatives through your IV to make you comfortably asleep during the procedure. During this entire process your vital signs will be continually monitored.
When asleep Dr. Mantas will slowly pass a small flexible high definition camera thinner than the size of your finger called a colonoscope and evaluate your anus, rectum, colon and, in some, cases lower small intestine. During the procedure abdominal pressure and repositioning may be performed by a technician to facilitate safe passage of the colonoscope. Dr. Mantas will then take pictures of your anatomy and will remove polyps when identified using forceps or snare. Dr. Mantas is also trained in various advanced techniques including medication injection, dilation, vessel clipping, vessel ablation and mucosal resection which will be performed if deemed medically necessary. Total procedure time varies from 30 to 90 minutes.
After the procedure you will be observed in a recovery area and once awake Dr. Mantas and his staff will discuss his findings with you or your family. Although you will quickly awake, the sedatives used will cause temporary changes in your reflexes and judgment so you will need someone to take you home after your procedure. We encourage you to take it easy and ask that you not return to work or drive the rest of the day. Unless otherwise specified you are able to resume a normal diet once you are awake.
Before discharge you will be instructed on when to restart medicines. Pathology is typically available within one week of your procedure. For normal screening colonoscopies Dr. Mantas will contact you if there are any unusual findings otherwise if you do not hear from Dr. Mantas then you should assume that your polyps were normal. For diagnostic colonoscopies Dr. Mantas will meet with his patients one week after the procedure to discuss findings in detail and further treatment.
(ADD COLONOSCOPY IMAGE)
What are the possible complications?
Following the procedure it is normal to experience some cramping, bloating and gas for a few days. Aside from these anticipated side effects colonoscopy is one of the safest gastrointestinal procedures and complications are very uncommon.
Some potential complications are listed below:
- Bleeding (most commonly stops on its own and is minor)
- Perforation (requires admission to hospital and possible surgical repair)
- Damage to abdominal organs
- Reaction to sedative medication
- Aspiration of gastric contents into lungs
You should seek immediate medical attention if your experience any of the following:
- Severe Pain
- Difficulty Breathing
- Worsening Swallowing