Care for your colon

Dr. M P Madhu, Consultant – Medical Gastroenterology, Aster RV Hospital

Ever wondered how digestion happens in the body? The food we eat transverse through four tubes – the oesophagus, stomach, small intestine and finally through the large intestine which is also called the colon. A colonoscopy is a test to diagnose the problems of the large intestine.

When do you need a colonoscopy?

1. If you have altered bowel habits.
2. Loose stools not improving even after four weeks of treatment.
3. If you find blood in stools.
4. Recent onset of constipation.
5. If you have low haemoglobin.
6. If you have recurrent pain in the abdomen.
7. If you notice significant weight loss – and suspect colon cancer.
8. Screening colonoscopy of normal individuals – if a family member has colon cancer.
9. Suspected intestinal diseases like tuberculosis, Crohn’s disease and IBS – Irritable Bowel Syndrome.

At what level of haemoglobin is colonoscopy required?

Normally men should have hemoglobin of 13gm and women, 11gm. Any level below that needs to be evaluated. We do see patients just taking iron tablets or iron injections for low haemoglobin and not getting tested. They are found to have colon cancers at a later date. So it is always better to get a colonoscopy done before taking iron tablets.

Generally, people have the perception that it’s a painful procedure. But that’s not the case. With the availability of advanced colonoscopes, improving skills and the use of CO2 (carbon dioxide) instead of air during the procedure – it can be performed with minimal discomfort. Conscious sedation also makes the procedure more comfortable. General anaesthesia is usually not required for colonoscopy.

We see the whole of the large intestine and a small portion of the small intestine called the terminal ileum during the procedure. Procedure time varies from 15 to 30 minutes depending on the complexity of the large intestine. We may see an ulcer, a polyp – small extra growth, a tumour – larger extra growth and a haemorrhoid (piles). Later, we take a biopsy from an ulcer or polyp. Small polyps are also removed during the procedure and sent for examination by a pathologist.

What is a biopsy and why is it done?

A biopsy is a medical procedure where a part of tissue is removed and sent for examination under a microscope. It is done to diagnose infection, inflammation, cancer and type of polyp.

What happens after colonoscopy?

We tell individuals to use restrooms to pass out the gas and stool. If a procedure is done under sedation – an individual is observed in the hospital for two hours. Then one can have normal food.

Follow-ups

The doctor will call you after four-five days if any biopsy is taken and any polyp is removed during the procedure.