Colonoscopy

/Colonoscopy
Colonoscopy2019-01-08T20:50:00+00:00

PROCEDURE- FLEXIBLE SIGMOIDOSCOPY

What is this procedure?

The procedure you will be having is called a Colonoscopy.  This is an examination of your large bowel (colon).  This test is a very accurate way of looking at the lining of your of this area to establish whether there is any disease present.  The test also allows us to take tissue samples (biopsies) if necessary or remove polyps for analysis by the pathology department.

The instrument used in this investigation is called a flexible colonoscope which will passed through your anus (back passage) into your bowel. The instrument directs light onto the lining of your bowel, and pictures are relayed onto a television screen.  This means the endosocopist has a clear view and can see whether or not disease or inflammation is present.

It will allow us to help make a diagnosis for your symptoms, and allow treatment after diagnosis. It will help exclude any sinister pathology such as bowel cancer and diagnose and treat polyps

If a polyp is found, it may need to be removed because certain polyps are of the type that can turn into cancer if left untreated for a long period. Removing them when still benign (noncancerous) removes this risk but not all polyps are in this category. The Endoscopists can decide at the time of the test if the polyp should be removed.

Sometimes a biopsy may be taken and you may be rebooked for another procedure to remove the polyp. A polyp is usually removed by using a small electric current to burn through the base and remove it from the bowel wall.

Is there an Alternative to this Test?

Colonoscopy is the best test to examine the large bowel (colon). We can use alternative tests such as CT scans for some patients but these are not always as useful as a direct examination of the bowel which also has the advantage that samples can be taken at the same time. It is less accurate than a colonoscopy and if an abnormality is found then a colonoscopy will be required anyway

What are the risks of the procedure?

This is a very safe test that takes usually take 30-60 minutes. However, there are risks, whilst rare, you do need to be informed about

  • There is a very small risk of perforation (making a small hole in the lining of your bowel) of approximately 1 in 1,500. If a polyp is removed then this risk is increased to 1 in 500. Perforation allows bowel contents to escape causing severe inflammation in the abdomen (peritonitis). This nearly always needs an operation to repair the hole.
  • There is a very small risk of bleeding if samples of tissue are taken (usually minor). The risks of removing the polyp include bleeding. This can often be stopped straight away but may occasionally be more serious or even happen a few days later. Depending on the size of the polyp, the risk of bleeding is one in 200 when polyps are removed.
  • There is a small chance of a reaction to the medicines used for sedation
  • Whilst this is an accurate test there is a small chance that a significant abnormality may be missed in 1 in 500 cases (polyps or a cancer)
  • There is a small chance of a reaction to the medicines used for sedation which may effect your breathing or your heart.

How do I prepare for the test?

  • You will need an escort to take you home and stay with you overnight
  • You will be required to take bowel preparation (Moviprep) to clear your bowels for the procedure. Please follow the separate instructions to take this.
  • Make sure you drink as much water as possible up to 2 hours before the procedure
  • Take your medication – please see below section
  • ALLERGIES & WARNINGS: Please notify of any allergies to medication. Please let me know if you are on any blood thinning medication/anticoagulants/anti-platelets or if you are a diabetic or have kidney problems

What about my medication?

Please continue taking essential medication unless told otherwise.

If you are taking iron tablets you must stop these 7 days prior to your procedure.

If you are taking stool bulking agents (e.g. Fybogel, Regulan, Proctifibe) or other medicines that may affect your bowel habit e.g. Loperamide (Imodium) Lomotil or Codeine Phosphate you must stop these 3 days prior to your procedure.

If you take any mediation to thin your blood the please notify me ahead of the procedure to  advised you whether to continue or stop this medication. If you are unsure please contact the endoscopy department prior to your procedure.

If you are a diabetic taking insulin or diabetic tablets please let me know ahead of the procedure so I can advice you whether or not to take your medication.

If you routinely take medicines please continue to do so. You may take your medication in the morning with a very small amount of water

Diabetics

If you are a diabetic controlled on insulin or medication please ensure you inform the doctor before hand and let the endoscopy department is aware so that the appointment time is appropriate.  .

Anticoagulant/Anti-platelets (Blood thinning Medication)

Please inform the doctor the unit if you are taking anticoagulants e.g. warfarin / Pradaxa or clopidogrel / Prasugrel/ Dipyridamole (Persantin)/Dipyridamole + Aspirin combined (asasantin Retard)/ Ticagrelor (brilligue)/ Prasugrel (Eficent)/ Acenocoumarol (Sinthrome)/ Phenindione/ Rivaroxaban/ Dabigatran Etexilate (pradaxa)

Implantable pacemaker or internal defibrillator. Please notify me ahead of the procedure

Allergies

Please inform the doctor and the department ahead of time especially if you have had previous reactions to sedation, pain killers or anaesthetics

Glucoma

If you have a diagnosis of glucoma or take eye drops to reduce the pressue in your eyes, please inform me ahead of the procedure

Heart problems including irregular heart beat

If you are any medication for your heart and have an irregular heart beat please notify me ahead of your procedure

Kidney Problems

If you are any medication for your kidneys, or have any kidney problems including under a specialist or have dialysis please notify me ahead of your procedure

What happens when I arrive?

You should expect to be in the department for approximately 1- 4 hours

You will be met by a qualified nurse who will ensure you understand the procedure and discuss any outstanding concerns or questions you may have.

You will have a brief medical assessment including measurement of blood pressure, heart rate and oxygen levels with a qualified endoscopy nurse who will also check whether there have been any changes to your health since your pre-assessment appointment. This is to ensure that you are still fit enough to have the test.

Sedation

Routinely the procedure is Intravenous sedation which consists of medication which includes a very powerful pain killer to improve your comfort during the procedure so that the endoscopist can perform the procedure successfully. This is not a general anaesthetic

The sedation will be administered via a small needle (known as a cannula) which will be inserted in the back of your hand or arm through which the medication can be administered.  This will make you more relaxed but not unconscious.  You will be in a state called conscious sedation: this means that, although you may be drowsy, you will still hear what is said to you and will be able to follow instructions during the investigation.  Sedation may make it unlikely that you will remember anything about the procedure.  You will be able to breathe quite normally throughout.

Whilst you are sedated you will be connected by a finger probe to a pulse oximeter which measures your oxygen levels and heart rate and also to a blood pressure monitor to ensure your safety during the procedure.  The nurse will also give you supplementary oxygen which is administered to you via little plastic prongs which are placed in your nostrils.

After your procedure you will need a responsible adult to accompany you home and remain with you for at least 24 hours following the procedure. Also please note that if you decide to have sedation you are not permitted to drive, drink alcohol, operate machinery, sign any legally binding documents or have care of another person for 24 hours.

What should you expect during the Procedure?

On entering the procedure room the endoscopist and the room nurse will introduce themselves and carry out some safety checks.  If required you will have the opportunity to ask any outstanding questions.

The nurse looking after you will ask you to lie on your left side and will place an oxygen monitoring probe on your finger. If you are having sedation the nurse will give you supplementary oxygen which is administered to you via little plastic prongs which are placed in your nostrils.

The intravenous medication will then be administered via the cannula by the endoscopist. A finger examination of your pack passage will be performed by the endoscopist mainly to lubricate this area and then the colonoscope will be passed through your back passage into the bowel.

The colonoscopy involves manoeuvring the colonoscope around the entire length of your large bowel (colon). There are some bends that naturally occur in the bowel and negotiating these may be uncomfortable for a short period of time. You may be asked to lie on your right side, back or stomach to aid the test and reduce discomfort.

Air/CO2 is gently passed into the bowel during the investigation to facilitate the passage of the colonoscope. During the procedure samples may be taken from the lining of your bowel or polyps removed (this is painless). These will be sent to our laboratories for analysis.  If there are any polyps then they will be assessed, biopsied or removed depending what the endoscopists feels is the best course of action

What happens after the procedure ?

You will be taken from the procedure room to either recovery area or your room to recover

Following sedation you will be allowed to rest for as long as is necessary.  Your blood pressure, heart rate and oxygen levels will be observed and this may require us to administer oxygen to you.  If you are diabetic, your blood glucose will be monitored.  Once you have recovered from the initial effects of any sedation (which normally takes 30 minutes) you will be offered a snack and moved into a chair.  You may feel a bit bloated for a few hours but this will subside.

As sedation can make you forgetful it is a good idea to have a member of your family or a friend with you when you are given this information although there will be a short written report available.

If you have had sedation you may feel fully alert following the investigation.  However, the drug remains in your blood system for about 24 hours and you can intermittently feel drowsy with lapses in memory.

Before you leave the department the nurse or doctor will explain the findings and any medication or further investigations required.  They will also inform you if you require further appointments.

You will leave the department with a copy of you examination report

Results from biopsies will not be available for up to 2 weeks, so clinic appoints are made 2 weeks after the procedure

If after your procedure you experience any of the following problems: 

  • Severe abdominal pain (not cramp caused by wind)
  • A sudden passing of a large amount of blood from your back passage (a very small amount of blood take no action)
  • A firm and swollen stomach
  • High temperature or feeling feverish
  • Vomiting

You must seek medical advice immediately.

What about Fees (Price) of the Test?

Please contact your insurer prior to your admission to inform them of your treatment/tests and confirm this is covered by your policy. You will need to obtain a pre-authorisation number from your insurer for the treatment/tests. In particular, please check whether any top up fee is payable by you, if your insurer does not cover my full fee. Please also check that the hospital’s fees are covered (which are charged in addition to my estimated fee below).

I only charge within accordance/agreement with your insurance company guidelines.  These fees are freely available from your insurance company either by phone or on their website under schedule of fees. You may need the procedure codes for your examination, which are H2002 & X3510. If a polypectomy is required then the procedure codes are H2003 & X3510. If your company does not have a set schedule of fees for then please contact my secretary and I will let you know the price a advance of the procedure which will be in line with other insurance companies fees.

Fees not included in the estimate

This estimate does not include:

  • Hospital Fees
  • Anaesthetist fees. An anaesthetist is rarely required as the procedure is usually performed with conscious sedation in 99% of cases administered by myself. However, if a general anaesthetic is needed then an anaesthetist will be required, and the anaesthetic fees will be an additional cost and the level of costs will be determined by your anaesthetist.
  • The fees of other consultants. Your treatment/test will involve the services of a [describe the type of consultant/s]. This will be an additional cost and the level of costs will be determined by that consultant. [If you know the name of the other consultant/s, please also include their contact details here and explain that the patient can contact them for information about their fees.]
  • In event of unforeseen complications such as hospital admission
  • Repeat procedure for whatever reason or additional test following on from the findings of this test

For more information contact the Endoscopy Department.

Useful Websites

British Society of Gastroenterology
The NHS Website
EIDO Healthcare
Guts UK Charity
Liverpool Gastroenterology

“I was nervous! It was easy – very professional with the right touch of empathy.”

5th July 2019

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“The service I received from Dr Sarkar was excellent. The appointments were conveniant for me. There was sufficient time for me to discuss my concerns and agree to the suggested investigations. The gastroscopy and colonoscopy that I had which were carried out by Dr Sarkar went very smoothly. The service I received was first class.”

28th June 2019

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“From my initial consultation with Dr Sarkar to my endoscopy, I felt assured and relaxed about the procedure (having heard so many disturbing reports from friends). I can only compliment Dr Sarkar for his superb professionalism in every respect. I would never again be afraid if I had to undergo further investigation under his care. The procedure was carried out by Dr Sarkar and his team whilst I was under sedation and was not in any way uncomfortable or caused me any distress. I can only add two words – thank you.”

27th June 2019

Service – ★★★★★
Procedure – ★★★★★

Michael Broom

“Very pleased with treatment. Excellent sedation procedure.”

21st June 2019

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“I have appreciated the very prompt appointment service for both consultation and examinations required. I found all staff, clinical and administrative alike to be pleasant, helpful, friendly and professional. I found no adverse effects and the examinations were both thorough and made as comfortable as possible. I found Dr Sarkar to be of the utmost consideration, skilled and professional. Results were explained thoroughly and clear advice given. I like Dr Sarkar and would consult again if necessary with confidence.”

May 2019

Service – ★★★★★
Procedure – ★★★★★

Anonymous

May 2019

Service – ★★★★★
Procedure – ★★★★★

P E Berger

“Very efficient service and care at the hospital”

May 2019

Service – ★★★★★

Philip Taylor

“Brilliant Service”

Service – ★★★★
Procedure – ★★★★

W Chambers

“Dr Sanchoy Sarkar is a friendly, approachable consultant who gave a good overview of his diagnosis, offered additional details where necessary. He made the procedure itself relaxed and as easy as possible. He was calm, professional and offered explanations throughout the procedure. An excellent all round service. ”

Service – ★★★★★
Procedure – ★★★★★

Victoria Spurole

“Mr Sarkar provided excellent quick consultations. Procedure was quick and painless. Would Highly Recommend. ”

Service – ★★★★★
Procedure – ★★★★★

H Bennet

“Seen on time. Good Communication felt given time to answer questions”

Service – ★★★★★
Procedure – ★★★★★

Mr Williams

“Excellent service for preparation and surgery’”

Service – ★★★★★
Procedure – ★★★★★

Mrs Woan

“I find Dr Sarkar extremely adept at giving you confidence in what he is doing. Explaining where necessary as the procedure proceeds. I cannot believe his expertise could be improved upon. This this my second experience with Dr Sarkar and I appreciate his approach’”

Service – ★★★★★
Procedure – ★★★★★

Kenneth Merrett

“I was treated very courteously by Dr Sarkar and the staff at Spire Liverpool. I am very grateful that my treatment was organized so quickly. Thank you so much Dr Sarkar. I can’t believe how much better I feel after being treated so quickly by the staff at the Royal Hospital.”

Service – ★★★★★
Procedure – ★★★★★

M Pearson

“Dr Sarkar is a terrific professional. He explains all of the issues clearly and sensitivity. I have absolute faith in him. The procedure was very professional and carried out with minimum fuss”

Service – ★★★★★
Procedure – ★★★★★

Anthony Coyne

“The procedure adopted by Dr Sarkar saved me from having to undergo bowel surgery. Skills were immaculate”

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“I have rated the overall service as 5 stars because everything was explained exactly what to expect. I was dealt in a professional manor. The procedure was quick and painless with thanks to all who carried out the procedure.”

Service – ★★★★★
Procedure – ★★★★★

S. Chadwick

“Service Excellent. Was able to see the consultant quickly and have the procedure quickly. All the staff was very nice and reassuring. The only minor negative was that I was sent something via email with a secure link and I was not able to open this on my computer so I never read it. Procedure was very comfortable. No negatives to the procedure I experienced, was able to have the procedure quickly with no discomfort Felt Dr Sarkar was very approachable and professional. Thank you”

Service – ★★★★★
Procedure – ★★★★★

Lucy Wigley

“Excellent care. Considerable time taken due to nature of the procedure, diagnosis and anxiety.Procedure- absolutely excellent. Put at ease. Procedure was painless and very little discomfort if any.”

Service – ★★★★★
Procedure – ★★★★★

Veronica Jones

“5 start service and speedy treatment.Consultant Mr Sarkar very professional and puts you at ease. Treatment options and procedure fully explained which helps a great deal at the consultation stage. Would highly recommend Mr Sarkar. Procedure- excellent. Endoscopy suite team were brilliant. Procedure over in 10 minutes. Sedation was great- no recollection of anything. If you have any worries about this procedure, please don’t worry- very safe hands looking after you!”

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“Mr Sarkar provided excellent, quick consultations. I would highly recommend.”

Service – ★★★★★
Procedure – ★★★★★

Anonymous

“Dr Sarkar was very professional and courteous. I was treated with kindness and sensitivity during a very difficult time.”

Service – ★★★★★

Anonymous
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