Microsoft word - col 6/2011.doc

The Sydney Clinic for Gastrointestinal Diseases
COLONOSCOPY INFORMATION FOR PATIENTS & CARERS
(or colonoscopy and gastroscopy together)
The aim of this form is to provide you with important information to compare the benefits and risks of
having a colonoscopy or gastroscopy/endoscopy. Read this pamphlet very careful y, and ask your
Specialist, to explain if you have any questions.
WHAT IS A COLONOSCOPY?
Colonoscopy is a procedure used to inspect the large bowel. It 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), polyps, inflammatory bowel disease, bleeding or colorectal cancer.
CONSENT FORM
If you decide to have the procedure you wil need to sign a consent form. Before signing, read it
careful y. Alternatives to colonoscopy do exist but are diagnostic only. They do not al ow 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. Ful y 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 fol owing: !an al ergy or bad reaction to anaesthetic drugs, antibiotics or any
other medication or an al ergy to rubber/ latex. "Diabetes, #prolonged bleeding or excessive
bruising, $recent or long term il ness, %endocarditis (infection inside the heart), &artificial heart valve,
' a significant heart problem or (recent artificial joint surgery.
MEDICATION
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. If you are taking diuretics, stop medications x 2 days
prior to your colonoscopy procedure. Diuretics medications include: Natrilix, Karvezide, Co Diovan,
HCT Winthorp, HCT Avapro, HCT Sandoz, Atacand Plus, Micardis Plus, Renitiec Plus & Monoplus.

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 and/or
midday 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 wil 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 IS THE BOWEL PREPARED ?
In order for your Specialist to get the best possible view and make the colonoscopy easier, your large
bowel needs to be cleansed of al waste material. You wil need to fol ow the Clinics’ bowel
preparation instruction sheet and diet sheet. Ensure you order in advance the correct preparation
from your nearest Chemist or col ect the preparation from the Clinic. Ring to speak to a nurse at the
clinic, if you need clarification about the bowel preparation or medications.
SEDATION
Most patients are given a short acting anaesthetic/sedative into a vein to help relieve any discomfort
during the procedure. Usual y the colonoscopy is wel tolerated, and pain is uncommon. Many
patients fal asleep due to the sedative and have no memory of the procedure.
Authorised 1994, Revised 12/06/4/09,3/2010, 6/2011 OB:QM The Sydney Clinic for Gastrointestinal Diseases
PROCEDURES DURING GASTROSCOPY OR COLONOSCOPY
During the procedure biopsies (smal tissue samples) may be taken to assist in confirming your
diagnosis and polyps (smal growths) can be removed. A polyp is a smal growth attached to the
bowel wal and sometimes develops into cancer if left untreated. If polyps are found they are usual y
removed at the time of the examination. Sometimes a polyp may not be removed endoscopical y
because it is too large or too difficult too reach. Some polyps can be dealt with by argon beam
coagulation.

AFTER THE PROCEDURE / RECOVERY
Fol owing the procedure you wil 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 wil pass over the next hour or so. You wil be given
Coffee/Tea and sandwiches. Before your discharge your specialist wil see you. You wil be given a
written report, the original wil be sent to your referring doctor.
If you have any special dietary requirement eg Coeliac, Kosher – bring a snack for afterwards.
Colonoscopy / Gastroscopy patients report feeling bloated and often pass a lot of gas. Walking may
relieve this. You may also pass smal 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. If you have had a gastroscopy, you may have a sore throat for a day or two.

DISCHARGE In accordance with NSW Health Department Directives & Anaesthetic
guidelines - You must have a responsible adult to accompany you home or your procedure
may be cancelled. Remember to bring a contact telephone number for your escort. 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.

POSSIBLE COMPLICATIONS
Colonoscopies are general y 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 fol owing complications are listed to inform you and not to alarm.
Perforation / Tear (1: 7,000) with the endoscope of the bowel wal , this wil require admission to
hospital, antibiotics and often surgery. Excessive bleeding (1:5,000) is rare. A little bleeding usual y
occurs after a large polyp is removed or in very rare cases bleeding can occur from a biopsy. This wil
require admission to hospital, for antibiotics infusion 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 fol owing 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 & chil s or other symptoms that cause you concern in the hours or days after a
colonoscopy you should immediately contact the Clinic or your Specialist.
INFECTION CONTROL
Infection control guidelines set by the Gastroenterology Col ege of Australia, NHMRC, Standards for
Australia and the NSW Health Department are strictly observed. After each individual use,
endoscopes are thoroughly cleaned and disinfected with special chemical and modern automated
disinfection machines.
Please contact the Quality Manager, Director of Nursing or Practice Manager if you have any
concerns, problems or suggestions during your stay. If you wish to lodge a compliant contact any of
our staff for a complaints form and post to “Quality Manager”.
Authorised 1994, Revised 12/06/4/09,3/2010, 6/2011 OB:QM

Source: http://www.nssc.com.au/pdf/old/col_6-2011.pdf