Services
Dr Douglas Samuel performs the following procedures:
What is a colonoscopy?
Colonoscopy is a procedure used to inspect the large bowelIt is used to diagnose the cause of symptoms such as diarrhoea, constipation, lower abdominal pain, occult (unseen) blood in the stool, rectal bleeding and anaemia. These complaints can be caused by a variety of disorders: Colitis(inflamed colon) Crohn’s disease, polyps, inflammatory bowel disease, bleeding or colorectal cancer.
Consent form
If you decide to have the procedure you will need to sign a consent form. Before signing, read it carefully. Alternatives to colonoscopy do exist but are diagnostic only. They do not allow your Specialist to provide treatment at the same time and may not be as accurate.
Medical History
Your Specialist needs to know your medical history. Fully disclose any health problems you may have had because some problems may interfere with the procedure, anaesthesia or recovery. This information is confidential. Document on your Medical History form and inform your Specialist if you have had any of the following: An allergy or bad reaction to anaesthetic drugs, antibiotics or any other medication, Diabetes, Prolonged bleeding or excessive bruising, recent or long term illness, endocarditis (infection inside the heart), artificial heart valve, a significant heart problem or recent artificial joint surgery.
Medications
Document on the Medical History Form ALL medication you are taking or have recently taken, including medicines & herbal medicines bought “over the counter” without prescription.IRON TABLETS should be stopped at least 5 days before your procedure. Asthma inhalers must be brought with you on the day. If you take blood thinning tablets or aspirin medication inform the admitting nurse, anaesthetist and specialist.
Instructions for patients with diabetes:
If you are a Diabetic, ensure you have an early morning appointment and bring your medication (tablets / insulin) with you.
If you are on a diabetic diet alone without medication there are no special instructions.
• If you are on oral medication, on the day prior to the procedure take half the usual morning dose of the medication. Do not take the evening dose. Do not take the morning dose on the day of your procedure. Bring the medication with you so it can be taken with food after the procedure. Monitor your blood sugar level regularly.
• If you are on insulin, you will need to see the Specialist prior to the procedure and consult your attending Physician so that the dose the day before and the day of your procedure can be tailored to the changed routine. Bring your medication with you so it can be taken with food after the procedure.
Monitor your blood sugar level regularly.
How do I prepare for a colonoscopy ?
In order for your Specialist to get the best possible view and make the colonoscopy easier, your large bowel needs to be cleansed of all waste material. You will need to follow the bowel preparation instruction sheet and diet sheet. Read very carefully and speak to a nurse at the day surgery where you are having the procedure, if you need clarification.
Is it painful?
Most patients are given a short acting anaesthetic/sedative into a vein to help relieve any discomfort
during the procedure. Usually the colonoscopy is well tolerated, and pain is uncommon. Many patients fall asleep due to the sedative and have no memory of the procedure.
What happens during the colonoscopy?
The bowel is examined for cancer, polyps and inflammation.During the procedure biopsies (small tissue samples) may be taken to assist in confirming your diagnosis and polyps (small growths) can be removed. A polyp is a small growth attached to the bowel wall and sometimes develops into cancer if left untreated. If polyps are found they are usually removed at the time of the examination. Sometimes a polyp may not be removed endoscopically because it is too large or too difficult too reach. Some polyps can be dealt with by argon beam coagulation.
What happens afther the procedure?
Following the procedure you will remain in the recovery room for one to two hours until the effect of the medication wears off. When you wake up you may feel a little bloated. This is due to the air that was inserted during the procedure. This will pass over the next hour or so. It is important that you pass the wind as soon as you wake up. Walking may also help with this. You may also pass small quantities of blood in the first stool. If larger amounts of blood are passed, contact your Specialist. Soft stools and changes in your bowel movement are common for the first day or two. You will be given coffee/tea and sandwiches. Before your discharge your specialist will see you. You will be given a written report, the original will be sent to your referring doctor.
Discharge
Following the procedure you must have a responsible adult to accompany and supervise your return home, please remember to bring a contact telephone number for your escort. If you do not comply with this advice and leave the Clinic unaccompanied you do so at your own risk and against medical advice. Due to the sedation given it is very important that you do not drive a car, travel on public transport alone, operate machinery, sign legal documents or drink alcohol on the day of the test, and you should not return to work until the next day. You should return home, rest quietly, resume a normal diet and drink water and other fluids.
What are the possible complications?
Colonoscopies are generally safe procedures but do have risks. Despite the highest standards of endoscopic practice, complications can occur. Complications are more likely if a therapeutic procedure (removing a colonic polyp, dilating an oesophageal stricture) is performed. National statistic evidence is complication at 1: 1,000 patients. However our statistical data show a significantly lower incidence. The following complications are listed to inform you and not to alarm.
- Perforation / Tear (1: 1,000) with the endoscope of the bowel wall, this will require admission to hospital, antibiotics and often surgery.
- Excessive bleeding (1:1000) is rare. A little bleeding usually occurs after a large polyp is removed or in very rare cases bleeding can occur from a biopsy. This will require admission to hospital, antibiotics and a blood transfusion may be necessary.
- Aspiration pneumonia: (1: 5,000) A patient may inhale some contents of the stomach during the procedure. This may cause a lung infection that may require hospitalisation and antibiotics.
- Colonoscopy is considered to be the most accurate test of the colon and the gold standard.
However, there is a risk that an abnormality may not be detected.
After discharge
If you have any of the following symptoms: severe chest or abdominal pain, breathing difficulties, spitting up blood, black tarry motions, persistent or increase in bleeding, weakness or dizziness, fever over 38 C or shivers & chills or other symptoms that cause you concern in the hours or days after a colonoscopy you should immediately contact your doctor or your specialist.
- pH study
- Capsule endoscopy
- Oesophageal manometry and impedance
- Anorectal physiology and biofeedback
- Urea breath test