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Colonoscopy – Information and Consent

Colonoscopy Procedure

colonoscopy - Dr Paul Froomes - Melbourne

 

What is a Colonoscopy and Who Performs It?

Colonoscopy is a safe, effective means of visually examining the lining of the bowel using a long, flexible, tubular instrument. It is used to diagnose colon and rectum problems and to perform biopsies and remove colon polyps.

Most colonoscopies are done on an outpatient basis with minimal inconvenience and discomfort. It is performed by a gastroenterologist who is an accredited physician and is recognised by the Royal Australian College of Physicians as specialist in diagnosing and treating disorders of the bowel. A gastroenterologist is also accredited by the Australian Gastroenterology Society as an expert in performing colonoscopy.

Who Should Have A Colonoscopy?

Your physician may recommend a colonoscopy exam if you have a change in bowel habit or bleeding, indicating a possible problem in the colon or rectum. 
A colonoscopy is also necessary to:

  • Check unexplained abdominal symptoms
  • Check inflammatory bowel disease (colitis)
  • Verify findings of polyps or tumours seen at barium enema exam
  • Examine patients who test positive for blood in the stool
  • Monitor patients with a past history of colon polyps or cancer

How Is Colonoscopy Performed?

The bowel must first be thoroughly cleared of all faeces before a colonoscopy. This is done one to two days before the exam as prescribed by your physician. [ See Colonoscopy Instructions ]. The colonoscope is inserted and when possible will be advanced to the portion of the colon where the small intestine enters. During a complete examination of the bowel, your gastroenterologist will remove polyps or take biopsies as necessary.

The entire procedure usually takes less than an hour. There is little pain because, sedation is given prior to the colonoscopy to relieve anxiety and discomfort, this will make you very sleepy. Following the colonoscopy, there may be slight discomfort, which quickly improves with the expelling of gas. Most patients can resume their regular diet later that day. Because you are sedated during the colonoscopy you cannot drive and must make plans to be driven home by a relative/friend.

What Are The Benefits Of Colonoscopy?

With colonoscopy, it is now possible to detect and remove most polyps without abdominal surgery. Colonoscopy is more accurate than a Barium enema X-ray of the colon to detect polyps or early cancer. Frequently, polyps can be removed at the same time, a major step towards the prevention of colon cancer.

What Are The Risks Of Colonoscopy?

Most people experience no problems following a colonoscopy, however rare complications have occurred.

  • Gas Bloating – You may experience some abdominal cramping and excessive flatulence following a colonoscopy for a period of an hour or so. This is due to air that has been used to distend the bowel during colonsocopy to help the doctor see the bowel more clearly.
  • Perforation  – 1 in 1500 times the bowel wall tears and a hole is left in the bowel. A perforation is repaired by an operation that sometimes requires a temporary colostomy bag.
  • Bleeding – 1 in 500 times bleeding from the bowel can occur if a sample of bowel is taken or a polyp is removed. This may require a further colonoscopy to fix or a blood transfusion or rarely surgery.
  • Aspiration – if you have not fasted properly before the colonoscopy there is a risk of inhaling stomach contents into the lung called aspiration. This can lead to pneumonia (<0.1% risk).
  • You must not drive a car for 24 hrs – if you do you will not be covered by insurance of any kind and have to pay the full costs of damages to any property or vehicle damaged in an accident whether you were at fault or not.
  • Failure – occasionally the colonoscopy may be incomplete. This is usually due to inadequate bowel preparation or to an excessively loopy bowel. If this occurs you may need to have the colonoscopy repeated after taking additional bowel preparation or you may need a CT scan.
  • Missed diagnosis – While colonoscopy is the best test for excluding bowel cancer it is not perfect and will not diagnose all cancers. There is a 4% chance that a colon cancer or polyp will be missed by this procedure. This can happen in the case of flat lesions that are particularly difficult to spot.

Informed Consent Form for Colonoscopy

I have read and understood the benefits of colonoscopy, the alternatives to colonoscopy, all the risks and all the potential complications of colonoscopy outlined in this document provided to me by Dr Paul Froomes. Having read and clearly understood the contents of this document I find nothing that would prevent me from having a colonosocpy. Therefore, I willingly consent to undergo colonoscopy on myself.

  • Your Name:
  • Witness Name:
  • Your Signature:
  • Witness Signature:
  • Date:
  • Date: