The minimal withdrawal time for a complete evaluation of the colon has been studied and found to be 6 minutes. Though the average length of time that a colonoscopy takes is between 20 to 60 minutes.

The American Heart Association has developed guidelines for identifying need for antibiotics before endoscopic procedures. These may differ from your dentists requirement for antibiotics before dental work. Discuss your need for pre-procedure antibiotics with your doctor if you have any concerns. They are administered primarily for patients who have artificial heart valves.

The images generated during your procedure are seen on a TV monitor. We do not have the capability to videotape procedures. Your physician may store some still images in your medical record for later reference.

You will be given medication through an IV site that will cause relaxation. Many patients have no memory of their procedure when completed due to the medications’ effects.

Medicines are given in the vein through an IV port placed in your hand or arm. Medication dosage and type may vary depending on your individual needs. The anesthetic agent, Diprivan, will be administered and monitored by the anesthetist.

Upper endoscopy is generally painless except for a feeling of mild transient fullness as the scope is passed through the mouth and throat. The majority of colonoscopy patients note no discomfort during the procedure. A few patients will remember some mild cramping and discomfort during the procedure. A small number of patients will experience significant discomfort during the exam. There is usually no pain after the procedure other than mild bloating in the first hour as gas passes out of the colon.

The medicines you are given have much the same effect on the brain function as alcohol. In addition, the effects of the medicine stay in the body for several hours and will affect judgment and reaction time long after the patient feels the medicine is gone. You may take a taxi home provided you have an escort to assure that you arrive safely at your destination.

In general, all the effects of your sedation will be gone by the morning after your procedure. You will have no restrictions at that time.

Unless instructed otherwise, you should begin with liquids and advance as tolerated. Unless instructed otherwise, you will have no dietary limitations after your procedure. You should drink no alcohol for 24 hours because of the sedation medicine you were given for your procedure.

Most people are able to pass all the air out of their GI tract within 1-2 hours after the procedure. Walking about or lying on the left side may help to eliminate the air.

Colon cancer rarely shows symptoms until much later in the disease. It is the second-leading cause of cancer deaths in the U.S., which is why screening has become so important.

For details regarding colon cancer screening see the following link: http://www.cancer.gov/cancertopics/factsheet/Detection/colorectal-screening

Seeds may remain in the bowel following the preparation for colonoscopy. During the procedure they may be suctioned into the endoscope and damage the instrument. Avoiding seeds for a week before the procedure will help prevent this problem.

Your doctor will talk to you after your procedure. He will tell you at that time what was seen. If biopsies are taken, or polyps removed, you will know the results in 2-3 weeks. Our office will call you to schedule a follow-up office visit to review your pathology results. If you have not heard from us within four weeks, call the office to let us know.

After your procedure you may be alert, able to follow commands and ask questions, but you may not remember any events. Your doctor will talk with you after your exam. We encourage your escort to be with you at that time so they can hear the discussion in case you have any questions later. The day after your exam, one of our nurses will be calling to check how you are doing and can answer questions for you at that time or refer you to your physician if appropriate.

The colon is folded on itself like an accordion so it is difficult to state its length. In general, the colon is 4-5 feet long.

If you use the large volume preparation such as GoLyte, NuLyte, CoLyte, the following should be considered:

• After mixing the solution at noon, place in the refrigerator. When you start the prep in the evening, take about 2 quarts out of the refrigerator and drink as scheduled. When the 2 quarts are gone, refill the container and continue this pattern until all the prep is taken. This will keep the solution cold enough to help keep the taste from getting too salty but not so cold that it will chill your body. Occasionally, you may feel chilled.

• Ten percent of patients will have nausea and vomiting with the prep. If you are becoming nauseated, stop the liquid and wait 45-60 minutes. Restart the prep at one glass every 15-20 minutes until it is gone. If you continue to vomit, phone the doctor on call (239) 593-6201.

• The amount of time needed for the liquid to cause diarrhea varies, it can take up to 4 or more hours.

Some residual liquid in the colon is normal after preparation for colonoscopy. Since the body continues to produce bile even if you do not eat, this bile will color the liquid yellow. Small to moderate amounts of clear or cloudy yellow liquid eliminated from the rectum is normal the day of colonoscopy.

Colon polyps are small growths that develop on the inside wall of the colon. These start very small (1-2 millimeters, the size of a small ant) and slowly grow larger. Many are shaped like a mushroom or a cauliflower. It takes years for the average polyp to reach 1 cm in size (the size of a pea). The larger the polyp, the higher the cancer risk.

Most polyps cause no symptoms. Most polyps can be removed at the time of your colonoscopy. You will generally feel no pain or sensation when polyps are removed. There is a very small risk of bleeding in the colon at the polyp removal site, which could require hospitalization or blood transfusion. Rarely polyp site bleeding will require surgery.

All polyps that are removed are sent to the pathology lab for evaluation. Two types of polyps can be found. Hyperplastic polyps have no risk of recurrence or malignancy (formation of cancer). Adenomatous polyps are pre-cancerous and do tend to recur elsewhere in the colon and therefore require a follow-up exam. Your doctor cannot visually distinguish hyperplastic from adenomatous polyps, so microscopic examination is required. Your doctor will contact you by phone or letter about results if a polyp has been removed. If you have not heard from your doctor in 4 weeks, please call the office for results.

It is very unusual to have throat pain after an EGD. You may have mild soreness for the rest of the day, especially if you underwent dilatation. Severe throat pain or pain that persists for more then 48 hours should be reported to your doctor.