Lower endoscopy is a common medical procedure that examines the lower digestive tract, specifically the large intestine, colon, and rectum. It uses a flexible, lighted tube to visualize the inside, serving both diagnostic and therapeutic purposes.
Defining Lower Endoscopy
A lower endoscopy uses a slender, flexible tube with a camera, called an endoscope. This allows a healthcare provider to view the large intestine lining and identify changes like irritated tissues, polyps, or other abnormal areas.
The two main types are colonoscopy and flexible sigmoidoscopy, differing in the extent of bowel examined. A colonoscopy views the entire large intestine, from the rectum to the cecum. A flexible sigmoidoscopy focuses on the lower colon, specifically the rectum and sigmoid colon. Both procedures can take tissue samples (biopsies) or remove polyps.
Reasons for the Procedure
Healthcare providers recommend lower endoscopy to investigate unexplained symptoms or as a screening tool. It helps explore causes of abdominal pain, rectal bleeding, or persistent changes in bowel habits like chronic diarrhea or constipation. Unexplained weight loss can also indicate the need for this examination.
A primary role of lower endoscopy is colorectal cancer screening, especially for individuals aged 45 or older. It is also used for surveillance in those with a family history of colon polyps or colorectal cancer. Additionally, it monitors chronic conditions such as inflammatory bowel disease. This helps detect and remove growths that could become cancerous.
Preparing for Your Lower Endoscopy
Thorough bowel preparation is necessary for a successful lower endoscopy, ensuring a clear view of the colon lining. This begins several days before with dietary modifications. Patients follow a low-fiber diet, avoiding foods like whole grains, nuts, seeds, and raw fruits and vegetables for two to three days prior.
The day before, a clear liquid diet is required, including water, clear broths, and clear juices, while avoiding red or purple liquids. Bowel preparation involves consuming prescribed laxative solutions, often in split doses, to completely empty the colon. Patients must discuss medication adjustments, especially for blood thinners or diabetes medications, with their provider in advance. Arrange for transportation home, as sedation prevents driving.
What Happens During the Procedure
On the day of the procedure, patients receive sedation for comfort, ranging from conscious sedation to general anesthesia. Once sedated, the patient lies on their side, often with knees drawn towards the chest. The endoscope, a long, flexible tube with a camera and light, is gently inserted into the rectum and advanced through the colon.
Air or carbon dioxide is introduced through the scope to inflate the colon, providing a better view. This may cause a feeling of fullness or cramping. The provider examines the colon lining on a monitor. If suspicious areas like polyps or inflamed tissue are identified, small instruments can take tissue samples (biopsies) or remove polyps. The procedure lasts between 30 to 60 minutes.
After Your Lower Endoscopy
Following a lower endoscopy, patients move to a recovery area as sedation effects wear off. Some bloating, gas, or mild abdominal cramping is common for a few hours due to introduced air; passing gas helps alleviate this. Patients should rest for the day and avoid driving, operating machinery, or making important decisions for at least 24 hours.
Normal dietary intake can resume unless specific instructions are provided. Preliminary findings may be shared immediately, but full biopsy results take several days to a few weeks. While complications are infrequent, contact your provider for severe or worsening abdominal pain, heavy or persistent rectal bleeding, or a fever and chills.