Colonoscopy
What is a Colonoscopy
Colonoscopy, or lower GI endoscopy, is a procedure where your gastroenterologist examines the lining of the lower part of your gastrointestinal tract, which includes the anus, rectum, colon and the ileum (last part of your small intestine).
Diagnostic colonoscopy
Colonoscopy is performed for many different reasons.
A diagnostic colonoscopy helps your gastroenterologist evaluate symptoms such as bleeding, change in bowel habit, abdominal pain, unexpected weight loss and other lower gastrointestinal symptoms. It can also be used to identify the cause of low iron, and to detect inflammation, ulcers and tumours of the colon. Your gastroenterologist might obtain biopsies (small tissue samples) to diagnose conditions such as benign and cancerous growths, microscopic colitis and inflammatory bowel disease.
A screening colonoscopy is performed to look for polyps and colorectal cancers. Polyp removal reduces the risk of developing colorectal cancer. A screening colonoscopy is performed after a positive faecal occult blood test (FOBT), or in patients at higher risk of colorectal cancer, for example due to a strong family history.
A surveillance colonoscopy is performed in patients with a personal history of colonic polyps or colorectal cancer.
Therapeutic colonoscopy
Colonoscopy is also used to treat conditions of the lower gastrointestinal tract. For example, your gastroenterologist may stretch (dilate) a narrowed area, remove pre-cancerous or early cancerous growths or treat bleeding.
Polypectomy
Most colonic polyps are less than 1cm in size and can be removed by a snare without diathermy (heat). This technique is called polypectomy and is very safe and effective.
Endoscopic Mucosal Resection (EMR)
Endoscopic Mucosal Resection (EMR) removes lesions from the mucosal (inner) layer of gastrointestinal tract using a snare. EMR is a technique used for larger colorectal polyps, and involves injection of fluid underneath the polyp prior to snare resection.
Endoscopic Submucosal Dissection (ESD)
Endoscopic Submucosal Dissection (ESD) is a technique used to remove pre-cancerous or early cancerous growths in the colon and rectum. ESD is performed using an endoscopic knife, and this allows lesions to be removed as a single specimen (en bloc). ESD typically requires a general anaesthetic and overnight hospital admission.
Bleeding management: APC and hemorrhoidal therapy
Bleeding management includes techniques like Argon Plasma Coagulation (APC) and hemorrhoidal therapy to control and treat bleeding in the digestive tract. APC uses argon gas and electrical energy to cauterize bleeding areas safely, while hemorrhoidal therapy addresses bleeding and discomfort from hemorrhoids, promoting healing and symptom relief.
Strictures
A stricture is an area of narrowing of the gastrointestinal lumen which can slow or obstruct the normal passage of food and gastrointestinal contents. Strictures can occur anywhere from the oesophagus to the rectum. The treatment depends on the underlying cause of the stricture and may involve dilating or stretching the stricture, placing a stent or injecting medications during the endoscopic procedure.
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