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How to undergo colonoscopy

Some notification
  • Slight dietary restrictions are necessary for several days before the examination.
  1. On the day of the examination, you drink 1,800ml of an intestinal lavage fluid within one hour in the clinic. Endoscopy can be performed after the discharge from the large intestine has become almost transparent and contains very little floating matter.
  2. After injection of an anti-cholinergic and a tranquilizer, you put on examination underpants and lie on the examination table.
  3. You lie on your left side. Anesthesia of the anal region is performed. Because abnormalities in the perianal region tend to be overlooked during barium study and endoscopy, this region is checked with the fingers before endoscopy is performed.
  4. The endoscope is now inserted into the anus. As a rule, it's advanced to the cecum or the distal end of the ileum. The time needed for this examination varies depending on the degree of bends and the length of the large intestine.
    yrectum and sigmoid colonz
    Endoscope insertion is easy unless this area is bent too much.
    ysigmoid-descending colon junctionz
    The junction area is fixed on the retroperitoneum. The passage of the endoscope through this area is most difficult for physicians and causes the greatest pain in you. In many cases, an N- or -loop is created in the endoscope when passing through this area. The sigmoid colon is made linear after its passage as shown in the figure below. yFigure2z
    yFigure2z
    ydescending colonz
    If the junction area can be made linear, the passage of the endoscope through the descending colon is easy.
    ytransverse colonz
    When passing the endoscope through the splenic flexure, it's most important to avoid re-curving of the linear sigmoid colon and to avoid intense bending of the endoscope tip in a stick-like manner when it passes through the splenic flexure. To avoid the former problem, manual compression is useful as shown in "a" of the figure below. The manual compression techniques shown in "b" and "c" are useful in avoiding the latter problem. During the passage of the endoscope through the transverse colon, the nurse or the endoscopy technician manually compresses your abdomen.yFigure3z
    yFigure3z

    quoted from Technique Manual of Gastrointestinal Endoscopy(Nankodo)
    yhepatic flexurez
    When it's necessary to hook the endoscope tip at the hepatic flexure, you're occasionally advised to inhale deeply so that the liver pushes down the hepatic flexure to make a dull angle.
    yascending colon, cecum and ileocecal valvez
    Once the endoscope has passed through the hepatic flexure, its insertion into the ascending colon is usually easy.
  5. Upon arrival of the endoscope in the cecum or the distal end of the ileum, the endoscope is slowly withdrawn, while checking for lesions. If any lesion is detected, biopsy, polypectomy or "Strip Biopsy" is performed. (See the chapter "Colorectal Tumor" of "Digestive Diseases and Treatments" for detailed procedures).
  6. Upon completion of the examination, the endoscope is withdrawn and your general conditions are checked. If no abnormalities are found, you stand up slowly. Well done!