How Can You Tell If You Are Cleaned Out For Colonoscopy

Endoscopic examination of the bowel

Colonoscopy
Colonoscopy being performed
ICD-9-CM	45.23
MeSH	D003113
OPS-301 code	1-650
MedlinePlus	003886
[edit on Wikidata]

Colonoscopy () or coloscopy ()^[1] is the endoscopic exam of the large bowel and the distal part of the modest bowel with a CCD camera or a cobweb optic camera on a flexible tube passed through the anus. Information technology tin provide a visual diagnosis (east.k., ulceration, polyps) and grants the opportunity for biopsy or removal of suspected colorectal cancer lesions.

Colonoscopy tin can remove polyps smaller than one millimeter. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not. It can take upwardly to 15 years for a polyp to turn cancerous.^{[ commendation needed ]}

Colonoscopy is like to sigmoidoscopy—the difference beingness related to which parts of the colon each tin can examine. A colonoscopy allows an examination of the entire colon (1200–1500mm in length). A sigmoidoscopy allows an test of the distal portion (nigh 600mm) of the colon, which may be sufficient because benefits to cancer survival of colonoscopy have been express to the detection of lesions in the distal portion of the colon.^{[2] [3] [four]}

A sigmoidoscopy is often used every bit a screening procedure for a total colonoscopy, ofttimes done in conjunction with a fecal occult blood exam (FOBT). About 5% of these screened patients are referred to colonoscopy.^[5]

Virtual colonoscopy, which uses 2nd and 3D imagery reconstructed from computed tomography (CT) scans or from nuclear magnetic resonance (MR) scans, is besides possible, as a totally not-invasive medical test. Virtual colonoscopy does non allow therapeutic maneuvers such equally polyp and tumour removal or biopsy, nor visualization of lesions smaller than 5 millimeters; if a growth or polyp is detected using CT colonography, it would crave removal during a standard colonoscopy. Surgeons take used the term pouchoscopy to refer to a colonoscopy of the ileo-anal pouch.

Medical uses [edit]

Weather that call for colonoscopies include gastrointestinal hemorrhage, unexplained changes in bowel habit and suspicion of malignancy. Colonoscopies are often used to diagnose colon cancer, but are also frequently used to diagnose inflammatory bowel disease. In older patients (sometimes even younger ones) an unexplained drop in hematocrit (one sign of anemia) is an indication that calls for a colonoscopy, normally along with an esophagogastroduodenoscopy (EGD), even if no obvious blood has been seen in the stool (feces).^{[ citation needed ]}

Fecal occult blood is a quick test which can exist done to test for microscopic traces of blood in the stool. A positive test is almost always an indication to do a colonoscopy. In most cases the positive result is only due to hemorrhoids; however, it can also be due to diverticulosis, inflammatory bowel disease (Crohn's disease, ulcerative colitis), colon cancer, or polyps. Colonic polypectomy has become a routine function of colonoscopy, allowing quick and uncomplicated removal of polyps during the procedure, without invasive surgery.^[6]

Colon cancer screening [edit]

Colonoscopy is one of the colorectal cancer screening tests available to people in the US who are 45 years of age and older. The other screening tests include flexible sigmoidoscopy, double-contrast barium enema, computed tomographic (CT) colongraphy (virtual colonoscopy), guaiac-based fecal occult claret test (gFOBT), fecal immunochemical test (FIT), and multitarget stool Deoxyribonucleic acid screening test (Cologuard).^[7]

Subsequent rescreenings are then scheduled based on the initial results plant, with a 5- or x-yr retrieve being mutual for colonoscopies that produce normal results.^{[viii] [9]} People with a family history of colon cancer are oft first screened during their teenage years. Among people who have had an initial colonoscopy that found no polyps, the gamble of developing colorectal cancer inside 5 years is extremely low. Therefore, there is no need for those people to accept another colonoscopy sooner than five years after the kickoff screening.^{[10] [eleven]}

Some medical societies in the Usa recommend a screening colonoscopy every 10 years offset at age l for adults without increased risk for colorectal cancer.^[12] Inquiry shows that the chance of cancer is low for ten years if a high-quality colonoscopy does non detect cancer, and so tests for this purpose are indicated every ten years.^{[12] [13]}

Colonoscopy screening prevents approximately ii-thirds of deaths due to colorectal cancers on the left side of the colon, and is not associated with a pregnant reduction in deaths from correct-sided disease.^[2]

Colonoscopy reduces cancer rates by detecting some colon polyps and cancers on the left side of the colon early enough that they may be treated, and a smaller number on the correct side; many of these left-sided growths would have been detected by a sigmoidoscopy procedure.^[2]

Since polyps frequently take x to xv years to transform into cancer in someone at average risk of colorectal cancer, guidelines recommend 10 years after a normal screening colonoscopy before the next colonoscopy. (This interval does not utilize to people at high gamble of colorectal cancer, or to those who feel symptoms of colorectal cancer.)^{[xiv] [15]}

Although widely touted in the U.s.a. as the "gold standard" of colon cancer screening, colonoscopy has never been studied equally a screening tool. Most of the potential benefits of colonoscopy have been extrapolated from randomized trials of the sigmoidoscopy. The Confirm trial, a randomized trial on colonoscopy vs. FIT is currently ongoing.^[sixteen]

Recommendations [edit]

The American Cancer Lodge recommends, beginning at age 45, both men and women follow one of these testing schedules for screening to observe colon polyps and/or cancer:^[17]

1. Flexible sigmoidoscopy every v years, or
2. Colonoscopy every 10 years, or
3. Double-contrast barium enema every five years, or
4. CT colonography (virtual colonoscopy) every 5 years
5. Yearly guaiac-based fecal occult blood test (gFOBT)
6. Yearly fecal immunochemical test (FIT)
7. Stool DNA test (sDNA) every 3 years

Medicare coverage [edit]

In the United States, Medicare insurance covers the following colorectal-cancer screening tests:^[18]

1. Colonoscopy: average risk — every 10 years commencement at historic period fifty, high take a chance — every 2 years with no age restriction^[19]
2. Flexible sigmoidoscopy — every 4 years beginning at age 50^[20]
3. Double-contrast barium enema: average risk — every iv years beginning at age 50, high risk — every 2 years^[21]
4. (CT) colongraphy: not covered by Medicare
5. gFOBT: average risk — every year starting time at age 50^[22]
6. FIT: average risk — every twelvemonth beginning at age l
7. Cologuard: average adventure — every three years beginning at age 50^[23]

Risks [edit]

Nearly 1 in 200 people who undergo a colonoscopy experience a serious complication.^[24] Perforation of the colon occurs in about 1 in 2000 procedures, haemorrhage in 2.6 per 1000, and death in 3 per 100,000,^[25] with an overall risk of serious complications of 0.35%.^{[26] [27]}

In some low-risk populations screening by colonoscopy in the absence of symptoms does not outweigh the risks of the procedure. For case, the odds of developing colorectal cancer between the ages of 20 and forty in the absence of specific risk factors are about 1 in ane,250 (0.08%).^[28]

The rate of complications varies with the practitioner and institution performing the process, and other variables.^{[ citation needed ]}

Perforation [edit]

The nigh serious complication more often than not is gastrointestinal perforation, which is life-threatening and in most cases requires immediate major surgery for repair.^[29] Fewer than 20% of cases may exist successfully managed with a conservative (not-surgical) arroyo.^[29]

A 2003 analysis of the relative risks of sigmoidoscopy and colonoscopy brought into attention that the chance of perforation after colonoscopy is approximately double that after sigmoidoscopy (consistent with the fact that colonoscopy examines a longer department of the colon), a deviation that appeared to exist decreasing.^[30]

Haemorrhage [edit]

Bleeding complications may be treated immediately during the process by cauterization using the instrument. Delayed bleeding may as well occur at the site of polyp removal up to a week afterwards the procedure, and a echo procedure can then be performed to care for the bleeding site. Even more rarely, splenic rupture can occur subsequently colonoscopy because of adhesions between the colon and the spleen.^{[ citation needed ]}

Anaesthesia [edit]

As with any procedure involving anaesthesia, other complications would include cardiopulmonary complications such as a temporary driblet in blood pressure and oxygen saturation ordinarily the result of overmedication, and are hands reversed. Anesthesia can too increment the risk of developing blood clots and lead to pulmonary embolism or deep venous thrombosis. (DVT)^[31] In rare cases, more serious cardiopulmonary events such as a heart attack, stroke, or even death may occur; these are extremely rare except in critically ill patients with multiple chance factors. In rare cases, coma associated with anesthesia may occur.^{[ commendation needed ]}

Bowel preparation [edit]

Dehydration acquired by the laxatives that are usually administered during the bowel preparation for colonoscopy also may occur. Therefore, patients must drink large amounts of fluids during the day of colonoscopy preparation to prevent dehydration. Loss of electrolytes or aridity is a potential risk that can fifty-fifty prove deadly.^[31] In rare cases, severe dehydration tin can lead to kidney damage or renal dysfunction under the form of phosphate nephropathy.^[32]

Other [edit]

Virtual colonoscopies carry risks that are associated with radiations exposure.^{[ citation needed ]}

Colonoscopy preparation and colonoscopy process can crusade inflammation of the bowels and diarrhea or bowel obstruction.^{[ citation needed ]}

During colonoscopies where a polyp is removed (a polypectomy), the risk of complications has been higher, although still low at about 2.3 percent.^[26] One of the almost serious complications that may ascend afterwards colonoscopy is the postpolypectomy syndrome. This syndrome occurs due to potential burns to the bowel wall when the polyp is removed, and may cause fever and abdominal pain. It is a rare complication, treated with intravenous fluids and antibiotics.

Bowel infections are a potential colonoscopy hazard, although rare. The colon is not a sterile environment; many bacteria that normally live in the colon ensure the well-functioning of the bowel, and the take chances of infections is minimal. Infections can occur during biopsies when too much tissue is removed and bacteria beetle in areas they practice not vest to, or in cases when the lining of the colon is perforated and the bacteria get into the abdominal cavity.^[33] Infection may also exist transmitted between patients if the colonoscope is not cleaned and sterilized properly betwixt tests.

Minor colonoscopy risks may include nausea, airsickness or allergies to the sedatives that are used. If medication is given intravenously, the vein may become irritated. Almost localized irritations to the vein leave a tender lump lasting a number of days but going away somewhen.^[34] The incidence of these complications is less than 1%.

On rare occasions, intracolonic explosion may occur.^[35] A meticulous bowel preparation is the key to foreclose this complication.^[35]

Signs of complications include severe abdominal pain, fevers and chills, or rectal bleeding (more than half a cup or 100ml).^[36]

Procedure [edit]

Preparation [edit]

The colon must be complimentary of solid matter for the test to be performed properly.^[37] For one to three days, the patient is required to follow a depression fiber or articulate-liquid-only diet. Examples of clear fluids are apple juice, chicken and/or beefiness broth or bouillon, lemon-lime soda, lemonade, sports drink, and water. It is important that the patient remains hydrated. Sports drinks contain electrolytes which are depleted during the purging of the bowel. Drinks containing fiber such as prune and orange juice should not be consumed, nor should liquids dyed red, purple, orangish, or sometimes brown; nonetheless, cola is allowed. In near cases, tea or coffee taken without milk are allowed.^[38]

The day before the colonoscopy, the patient is either given a laxative training (such as bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate) and big quantities of fluid, or whole bowel irrigation is performed using a solution of polyethylene glycol and electrolytes. The procedure may involve both a pill-course laxative and a bowel irrigation training with the polyethylene glycol pulverization dissolved into whatsoever clear liquid, such equally a sports drink that contains electrolytes.

A typical procedure regimen then would be every bit follows: in the morning of the 24-hour interval before the process, a 238g bottle of polyethylene glycol pulverization should be poured into i.ix litres (64 oz.) of the chosen articulate liquid, which and so should be mixed and refrigerated. Two bisacodyl 5mg tablets are taken 3 pm; at 5 pm, the patient starts drinking the mixture (approx. 8 oz. (0.5 litres) each 15-thirty min. until finished); at 8 pm, take two bisacodyl 5mg tablets; go on drinking/hydrating into the evening until bedtime with clear permitted fluids. The procedure may be scheduled early in the twenty-four hours and then the patient need not go without food and only limited fluids until after.^{[ commendation needed ]}

The goal of the preparation is to articulate the colon of solid matter, and the patient may be advised to spend the twenty-four hours at dwelling with ready access to toilet facilities. The patient may too want to have at hand moist towelettes or a bidet for cleaning the anus. A soothing salve such every bit petroleum jelly practical later cleaning the anus volition reduce discomfort.

The patient may be asked non to take aspirin or like products such as salicylate, ibuprofen, etc. for up to ten days earlier the procedure to avoid the hazard of bleeding if a polypectomy is performed during the procedure. A blood test may be performed before the procedure.^[39]

Investigation [edit]

Schematic overview of colonoscopy process

During the procedure the patient is often given sedation intravenously, employing agents such as fentanyl or midazolam. Although meperidine (Demerol) may exist used every bit an culling to fentanyl, the concern of seizures has relegated this agent to second choice for sedation behind the combination of fentanyl and midazolam. The average person will receive a combination of these 2 drugs, unremarkably betwixt 25 and 100µg 4 fentanyl and ane–ivmg 4 midazolam. Sedation practices vary betwixt practitioners and nations; in some clinics in Norway, sedation is rarely administered.^{[forty] [41]}

Some endoscopists are experimenting with, or routinely use, alternative or boosted methods such as nitrous oxide^{[42] [43]} and propofol,^[44] which take advantages and disadvantages relating to recovery time (especially the duration of amnesia after the procedure is complete), patient experience, and the degree of supervision needed for safety administration. This sedation is called "twilight anesthesia". For some patients it is non fully effective, so they are indeed awake for the process and can watch the inside of their colon on the color monitor. Substituting propofol for midazolam, which gives the patient quicker recovery, is gaining wider utilise, but requires closer monitoring of respiration.

A meta-analysis plant that playing music improves tolerability to patients of the procedure.^[45]

The commencement footstep is commonly a digital rectal exam, to examine the tone of the sphincter and to determine if preparation has been adequate. The endoscope is and so passed through the anus up the rectum, the colon (sigmoid, descending, transverse and ascending colon, the cecum), and ultimately the terminal ileum. The endoscope has a movable tip and multiple channels for instrumentation, air, suction and light. The bowel is occasionally insufflated with air to maximize visibility (a procedure which gives the patient the fake awareness of needing to have a bowel movement).^[46] Biopsies are frequently taken for histology. Additionally in a procedure known as chromoendoscopy, a contrast-dye (such as indigo carmine) may be sprayed through the endoscope onto the bowel wall to help visualise any abnormalities in the mucosal morphology. A Cochrane review updated in 2022 found strong show that chromoscopy enhances the detection of cancerous tumours in the colon and rectum.^[47]

In well-nigh experienced hands, the endoscope is avant-garde to the junction of where the colon and small bowel bring together up (cecum) in under 10 minutes in 95% of cases. Due to tight turns and back-up in areas of the colon that are non "stock-still", loops may form in which advocacy of the endoscope creates a "bowing" effect that causes the tip to actually retract. These loops ofttimes upshot in discomfort due to stretching of the colon and its associated mesentery. Manoeuvres to "reduce" or remove the loop include pulling the endoscope backwards while twisting it. Alternatively, body position changes and abdominal support from external hand pressure can often "straighten" the endoscope to allow the telescopic to motility forward. In a minority of patients, looping is oft cited as a cause for an incomplete test. Usage of alternative instruments leading to completion of the exam has been investigated, including use of pediatric colonoscope, push enteroscope and upper GI endoscope variants.^[48]

For screening purposes, a closer visual inspection is then often performed upon withdrawal of the endoscope over the course of 20 to 25 minutes. Lawsuits over missed cancerous lesions take recently prompted some institutions to amend document withdrawal time as rapid withdrawal times may be a source of potential medical legal liability.^[49] This is frequently a real business organisation in clinical settings where loftier caseloads could provide financial incentive to consummate colonoscopies as speedily as possible.

Suspicious lesions may exist cauterized, treated with laser lite or cut with an electric wire for purposes of biopsy or consummate removal polypectomy. Medication can be injected, e.grand. to control bleeding lesions. The process typically takes 20–xxx minutes, depending on the indication and findings; with multiple polypectomies or biopsies, procedure times may exist longer. As mentioned above, anatomic considerations may also affect procedure times.

After the process, some recovery time is normally allowed to let the sedative wear off. Outpatient recovery fourth dimension can take an estimated 30–hr. Most facilities require that patients have a person with them to aid them home afterwards (depending on the sedation method used).

One common afterwards-result from the procedure is a bout of flatulence and minor wind pain caused by air insufflation into the colon during the procedure.

An reward of colonoscopy over 10-ray imaging or other less invasive tests is the ability to perform therapeutic interventions during the test. A polyp is a growth of excess of tissue that can develop into cancer. If a polyp is found, for example, information technology can be removed by one of several techniques. A snare device can exist placed around a polyp for removal. Even if the polyp is flat on the surface it can often be removed. For example, the post-obit shows a polyp removed in stages:

• 

  Polyp is identified.

• 

  A sterile solution is injected under the polyp to lift information technology away from deeper tissues.

• 

  A portion of the polyp is now removed.

• 

  The polyp is fully removed.

Pain management [edit]

The hurting associated with the procedure is not caused past the insertion of the scope simply rather by the inflation of the colon in social club to do the inspection. The scope itself is essentially a long, flexible tube about a centimeter in diameter — that is, as big around as the little finger, which is less than the bore of an average stool.

The colon is wrinkled and corrugated, somewhat like an piano accordion or a dress-dryer frazzle tube, which gives it the large surface expanse needed for water absorption. In order to inspect this surface thoroughly, the physician blows information technology upwards like a balloon, using air from a compressor or carbon dioxide from a gas bottle (CO_ii is absorbed into the bloodstream through the mucosal lining of the colon much faster than air and so exhaled through the lungs which is associated with less post procedural hurting), in guild to get the creases out. The tummy, intestines, and colon have a then-chosen "second brain" wrapped around them, which autonomously runs the chemical factory of digestion.^[50] Information technology uses complex hormone signals and nervus signals to communicate with the brain and the rest of the body. Ordinarily a colon's job is to digest food and regulate the intestinal flora. The harmful bacteria in rancid food, for example, creates gas.

The colon has distension sensors that tin can tell when there is unexpected gas pushing the colon walls out—thus the "second brain" tells the person that he or she is having intestinal difficulties by manner of the sensation of nausea. Doctors typically recommend either total anesthesia or a partial twilight sedative to either forbid or to lessen the patient'due south sensation of pain or discomfort, or just the unusual sensations of the process. Once the colon has been inflated, the md inspects information technology with the telescopic every bit it is slowly pulled astern. If any polyps are found they are then cut out for subsequently biopsy.

Some doctors adopt to piece of work with totally anesthetized patients inasmuch as the lack of whatsoever perceived hurting or discomfort allows for a leisurely examination. Twilight sedation is, however, inherently safer than general anesthesia; information technology too allows the patients to follow elementary commands and even to watch the procedure on a airtight-circuit monitor. Tens of millions of adults annually demand to have colonoscopies, and withal many don't because of concerns well-nigh the process.^{[ citation needed ]}

Colonoscopy can be carried out without any sedation and without issues with pain, which is practised in several institutions in many countries with the patient's agreement. This allows the patient to shift the body position to assistance the doctor deport out the procedure and significantly reduces recovery fourth dimension and side-furnishings.^[51] There is some discomfort when the colon is distended with air, but this is not usually particularly painful, and it passes relatively quickly. Unsedated patients can be released from the infirmary on their ain without any feelings of nausea, able to go on with normal activities, and without the need for an escort as recommended after sedation.

Ultrasound [edit]

Duodenography and colonography are performed like a standard abdominal examination using B-style and colour menses Doppler ultrasonography using a low frequency transducer — for example a 2.5MHz — and a high frequency transducer, for example a seven.fiveMHz probe. Detailed examination of duodenal walls and folds, colonic walls and haustra was performed using a 7.5MHz probe. Deeply located abdominal structures were examined using 2.vMHz probe. All ultrasound examinations are performed after overnight fasting (for at least 16 hours) using standard scanning process. Subjects are examined with and without water contrast. Water contrast imaging is performed past having adult subjects take at to the lowest degree i liter of water prior to test. Patients are examined in the supine, left posterior oblique, and left lateral decubitus positions using the intercostal and subcostal approaches. The liver, gall float, spleen, pancreas, duodenum, colon, and kidneys are routinely evaluated in all patients.

With patient lying supine, the examination of the duodenum with high frequency ultrasound duodenography is performed with 7.5MHz probe placed in the right upper abdomen, and central epigastric successively; for high frequency ultrasound colonography, the ascending colon, is examined with starting point usually midway of an imaginary line running from the iliac crest to the omphalos and proceeding cephalid through the right mid abdomen; for the descending colon, the examination begins from the left upper abdomen proceeding caudally and traversing the left mid belly and left lower belly, terminating at the sigmoid colon in the lower pelvic region. Colour flow Doppler sonography is used to examine the localization of lesions in relation to vessels. All measurements of diameter and wall thickness are performed with congenital-in software. Measurements are taken between peristaltic waves.^[52]

Economic science [edit]

Researchers have establish that older patients with three or more significant health problems, like dementia or center failure, had high rates of repeat colonoscopies without medical indications. These patients are less probable to live long plenty to develop colon cancer. Gordon states, "At about $ane,000 per procedure, there'southward clearly an economic incentive".^[xv]

The Hemoccult II FOBT (combined with follow-up colonoscopy if indicated past the test) is over 5 times as cost constructive as other screening strategies, but is merely nigh 85% as sensitive. Because of this relatively low sensitivity, United states of america guidelines advocate the over v times more than expensive procedures instead, because even the relatively small increment in lives saved and 5-fold cost increase is seen as worth choosing, given US living standards.^[53]

History [edit]

In the 1960s, Dr. Niwa and Dr. Yamagata at Tokyo University developed the device. Later 1968, Dr. William Wolff and Dr. Hiromi Shinya pioneered the development of the colonoscope.^[54] Their invention, in 1969 in Japan, was an accelerate over the barium enema and the flexible sigmoidoscope considering it allowed for the visualization and removal of polyps from the entire big intestine. Wolff and Shinya advocated for their invention and published much of the early on show needed to overcome skepticism about the device's safety and efficacy.

Colonoscopy with CCD invention and market is led by Fuji film, Olympus and Hoya in Nihon.^[55] In 1982, Dr. Lawrence Kaplan of Aspen Medical Group in St. Paul, MN reported a series of 100 sequent colonoscopies and upper endoscopies performed in a complimentary-continuing dispensary miles from the nearest hospital, demonstrating the safety and cost effectiveness of these outpatient procedures. (Personal advice to the Joint Commission on Ambulatory Care, May 1983)^{[ citation needed ]}

Etymology [edit]

The terms colonoscopy ^{[56] [57] [58]} or coloscopy ^[57] are derived from^[57] the ancient Greek noun κόλον, same as English language colon,^[59] and the verb σκοπεῖν, wait (in)to, examine.^[59] The term colonoscopy is still ill-constructed,^[60] as this form supposes that the beginning part of the compound consists of a possible root κολωv- or κολοv-, with the connecting vowel -o, instead of the root κόλ- of κόλον.^[60] A chemical compound such as κολωνοειδής, like a hill,^[59] (with the additional -on-) is derived from the ancient Greek word κολώνη or κολωνός, colina.^[59] Similarly, colonoscopy (with the additional -on-) tin can literally be translated equally exam of the hill,^[60] instead of the test of the colon.

In English, multiple words exist that are derived from κόλον, such every bit colectomy,^{[57] [61]} colocentesis,^[57] colopathy,^[57] and colostomy ^[57] among many others, that actually lack the incorrect additional -on-. A few compound words such as colonopathy take doublets with -on- inserted.^{[57] [58]}

Encounter also [edit]

• Bow and arrow sign
• Esophagogastroduodenoscopy
• Polypectomy
• Rectal examination
• Postpolypectomy Coagulation Syndrome

References [edit]

1. ^ American Heritage Medical Dictionary
2. ^ ^{a b c} Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L (January 2009). "Association of colonoscopy and death from colorectal cancer". Ann. Intern. Med. 150 (one): one–8. doi:10.7326/0003-4819-150-1-200901060-00306. PMID 19075198. as PDF Archived Jan 18, 2022, at the Wayback Machine
3. ^ Singh H, Nugent Z, Mahmud SM, Demers AA, Bernstein CN (March 2022). "Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies". Am J Gastroenterol. 105 (3): 663–673. doi:10.1038/ajg.2009.650. PMID 19904239. S2CID 11145247.
4. ^ Brenner H, Hoffmeister M, Arndt V, Stegmaier C, Alterhofen L, Haug U (Jan 2022). "Protection from right- and left-sided colorectal neoplasms subsequently colonoscopy: population-based study". J Natl Cancer Inst. 102 (2): 89–95. doi:ten.1093/jnci/djp436. PMID 20042716.
5. ^ Atkin WS, Edwards R, Kralj-Hans I, et al. (May 2022). "One time-just flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial". Lancet. 375 (9726): 1624–33. doi:10.1016/S0140-6736(x)60551-Ten. PMID 20430429. S2CID 15194212. as PDF Archived March 24, 2022, at the Wayback Auto
6. ^ Sivak Jr., Michael V. (Dec 2004). "Polypectomy: Looking Back". Gastrointestinal Endoscopy. sixty (half-dozen): 977–982. doi:10.1016/S0016-5107(04)02380-vi. PMID 15605015.
7. ^ "Colorectal Cancer Prevention and Early Detection" (PDF). American Cancer Society. February v, 2022. pp. 16–24. Retrieved 2015-12-25 .
8. ^ Rex DK, Bond JH, Winawer S, Levin TR, Burt RW, Johnson DA, et al. (June 2002). "Quality in the technical performance of colonoscopy and the continuous quality improvement procedure for colonoscopy: recommendations of the U.South. Multi-Society Chore Force on Colorectal Cancer". The American Periodical of Gastroenterology. 97 (6): 1296–1308. PMID 12094842.
9. ^ Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. (2017). "Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Social club Chore Force on Colorectal Cancer". American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). 112 (7): 1016–1030. doi:10.1038/ajg.2017.174. ISSN 0002-9270. PMID 28555630. S2CID 6808521.
10. ^ Gmperiale, Thomas F.; Glowinski, Elizabeth A.; Lin-Cooper, Ching; Larkin, Gregory N.; Rogge, James D.; Ransohoff, David F. (2008). "5-Year Adventure of Colorectal Neoplasia after Negative Screening Colonoscopy". Northward Engl J Med. 359 (12): 1218–1224. doi:10.1056/NEJMoa0803597. PMID 18799558.
11. ^ No Need to Repeat Colonoscopy Until 5 Years After First Screening Newswise, Retrieved on September 17, 2008.
12. ^ ^{a b} Winawer, S.; Fletcher, R.; Rex, D.; Bond, J.; Burt, R.; Ferrucci, J.; Ganiats, T.; Levin, T.; Woolf, Due south.; Johnson, D.; Kirk, Fifty.; Litin, South.; Simmang, C.; Gastrointestinal Consortium, P. (2003). "Colorectal cancer screening and surveillance: Clinical guidelines and rationale—Update based on new evidence". Gastroenterology. 124 (ii): 544–560. doi:10.1053/gast.2003.50044. PMID 12557158.
13. ^ American Gastroenterological Association, "Five Things Physicians and Patients Should Question" (PDF), Choosing Wisely: an initiative of the ABIM Foundation, American Gastroenterological Association, archived from the original (PDF) on Baronial 9, 2022, retrieved August 17, 2022
14. ^ Cancerconnect, Interval between Colonoscopies May exist Shorter than Recommended Archived 2022-08-07 at the Wayback Machine (accessed 2 June 2022)
15. ^ ^{a b} Goodwin JS, Singh A, Reddy Northward, Riall TS, Kuo YF (August 2022). "Overuse of screening colonoscopy in the medicare population". Arch. Intern. Med. 171 (15): 1335–43. doi:x.1001/archinternmed.2011.212. PMC3856662. PMID 21555653. Archived from the original on 2022-09-01. Retrieved 2011-05-30 .
16. ^ "Colonoscopy Versus Fecal Immunochemical Exam in Reducing Mortality From Colorectal Cancer (CONFIRM) - Total Text View - ClinicalTrials.gov". clinicaltrials.gov . Retrieved 2019-02-25 .
17. ^ "American Cancer Society Guideline for Colorectal Cancer Screening". cancer.org . Retrieved 2020-07-02 .
18. ^ "Your Medicare Coverage: Colorectal cancer screenings". Medicare.gov. Archived from the original on 2022-12-21. Retrieved 2015-12-25 .
19. ^ "Screening colonoscopies". Medicare.gov. Retrieved 2019-06-25 .
20. ^ "Screening flexible sigmoidoscopies". Medicare.gov. Retrieved 2019-06-25 .
21. ^ "Screening barium enemas". Medicare.gov. Retrieved 2019-06-25 .
22. ^ "Screening fecal occult blood tests". Medicare.gov. Retrieved 2019-06-25 .
23. ^ "Multi-target stool Deoxyribonucleic acid tests". Medicare.gov. Retrieved 2019-06-25 .
24. ^ Levin TR, Zhao W, Conell C, et al. (December 2006). "Complications of colonoscopy in an integrated wellness care commitment organization". Ann. Intern. Med. 145 (12): 880–6. doi:10.7326/0003-4819-145-12-200612190-00004. PMID 17179057. S2CID 12401206.
25. ^ Reumkens, A; Rondagh, EJ; Bakker, CM; Winkens, B; Masclee, AA; Sanduleanu, S (Baronial 2022). "Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies". The American Periodical of Gastroenterology. 111 (viii): 1092–101. doi:10.1038/ajg.2016.234. PMID 27296945. S2CID 19186057.
26. ^ ^{a b} "Colonoscopy Risks". Retrieved 2010-eleven-02 .
27. ^ J. A. Dominitz, et al., American Club for Gastrointestinal Endoscopy, "Complications of Colonsocopy" ^{[ permanent expressionless link ]} , Gastrointestinal Endoscopy, Vol 57, No. 4, 2003, pp. 441-445
28. ^ Cancer of the colon and rectum (invasive). SEER Cancer Statistics Review 1975-2009
29. ^ ^{a b} Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, et al. (2013). "2013 WSES guidelines for direction of intra-abdominal infections". World J Emerg Surg (Review). viii (1): 3. doi:x.1186/1749-7922-8-3. PMC3545734. PMID 23294512.
30. ^ Gatto, NM; Frucht H; Sundararajan V; Jacobson JS; Grann VR; Neugut AI (v Feb 2003). "Run a risk of Perforation Later on Colonoscopy and Sigmoidoscopy: A Population-Based Study". Periodical of the National Cancer Constitute. 95 (three): 230–6. doi:ten.1093/jnci/95.iii.230. PMID 12569145.
31. ^ ^{a b} "What are the colonoscopy risks?: Colonoscopy Risks That Get Potential Colonoscopy Complications". iv August 2009. Retrieved 2010-04-06 .
32. ^ Lien YH (September 2008). "Is bowel grooming before colonoscopy a risky business for the kidney?". Nat Clin Pract Nephrol. 4 (11): 606–14. doi:ten.1038/ncpneph0939. PMID 18797448. S2CID 340122.
33. ^ "Bowel Infections". Archived from the original on 2022-04-02. Retrieved 2010-04-06 .
34. ^ "What to expect after a colonoscopy?". Retrieved 2010-04-06 .
35. ^ ^{a b} Ladas SD, Karamanolis G, Ben-Soussan Due east (2007). "Colonic gas explosion during therapeutic colonoscopy with electrocautery". Globe J Gastroenterol (Review). 13 (twoscore): 5295–8. doi:x.3748/wjg.v13.i40.5295. PMC4171316. PMID 17879396.
36. ^ "Colonoscopy A Guide to the Procedure". Retrieved 2010-04-06 .
37. ^ Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. (2014). "Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the U.s. Multi-Social club Task Force on Colorectal Cancer". Gastroenterology. Elsevier BV. 147 (iv): 903–924. doi:10.1053/j.gastro.2014.07.002. ISSN 0016-5085. PMID 25239068.
38. ^ Waye, Jerome D.; Rex, Douglas K.; Williams, Christopher Beverley (2003). Colonoscopy: principles and practise . Wiley-Blackwell. pp. 210–211. ISBN978-1-4051-1449-3.
39. ^ "Colyte/Trilyte Colonoscopy Preparation" (PDF). Palo Alto Medical Foundation. June 2006. Archived from the original (PDF) on Apr xiv, 2007. Retrieved 2007-06-12 .
40. ^ Bretthauer, M; Hoff G; Severinsen H; Erga J; Sugar J; Huppertz-Hauss G (twenty May 2004). "[Systematic quality control programme for colonoscopy in an endoscopy centre in Norway]". Tidsskrift for den Norske Laegeforening (in Norwegian). 124 (10): 1402–5. PMID 15195182.
41. ^ ^{[ failed verification ]}
42. ^ Rikshospitalet Academy Hospital (April 2006). "Clinical Trial: Nitrous Oxide for Analgesia During Colonoscopy". ClinicalTrials.gov. Retrieved 2007-06-12 .
43. ^ Forbes, GM; Collins BJ (March 2000). "Nitrous oxide for colonoscopy: a randomized controlled written report". Gastrointestinal Endoscopy. 51 (3): 271–7. doi:10.1016/S0016-5107(00)70354-3. PMID 10699770.
44. ^ Clarke, Anthony C; Louise Chiragakis; Lybus C Hillman; Graham Fifty Kaye (18 February 2002). "Sedation for endoscopy: the rubber use of propofol past general practitioner sedationists". Medical Journal of Australia. 176 (4): 158–161. doi:10.5694/j.1326-5377.2002.tb04345.ten. PMID 11913915. S2CID 24387384.
45. ^ Bechtold, ML.; Puli, SR.; Othman, MO.; Bartalos, CR.; Marshall, JB.; Roy, PK. (Jan 2009). "Effect of music on patients undergoing colonoscopy: a meta-assay of randomized controlled trials". Dig Dis Sci. 54 (i): xix–24. doi:x.1007/s10620-008-0312-0. PMID 18483858. S2CID 2403242.
46. ^ "- YouTube". www.youtube.com.
47. ^ Brown SR; Baraza Due west; Din S; Riley Southward (2016). "Chromoscopy versus conventional endoscopy for the detection of polyps in the colon and rectum". Cochrane Database of Systematic Reviews. 4: CD006439. doi:10.1002/14651858.CD006439.pub4. PMID 27056645.
48. ^ Lichtenstein, Gary R.; Peter D. Park; William B. Long; Gregory Chiliad. Ginsberg; Michael 50. Kochman (18 August 1998). "Apply of a Button Enteroscope Improves Ability to Perform Full Colonoscopy in Previously Unsuccessful Attempts at Colonoscopy in Adult Patients". The American Journal of Gastroenterology. 94 (one): 187–ninety. PMID 9934753. Note:Single use PDF copy provided gratis by Blackwell Publishing for purposes of Wikipedia content enrichment.
49. ^ Barclay RL, Vicari JJ, Doughty Equally, et al. (2006). "Colonoscopic withdrawal times and adenoma detection during screening colonoscopy". New England Journal of Medicine. 355 (24): 2533–41. doi:10.1056/nejmoa055498. PMID 17167136.
50. ^ "Our Second Brain: The Stomach". May 1999. Retrieved 2010-06-29 .
51. ^ Zhang, Kaixian; Yuan, Qianqian; Zhu, Shuguang; Xu, Daheng; An, Zhe (2018). "Is Unsedated Colonoscopy Gaining Ground Over Sedated Colonoscopy?". Periodical of the National Medical Clan. 110 (2): 143–148. doi:ten.1016/j.jnma.2016.12.003. ISSN 0027-9684. PMID 29580447.
52. ^ Njemanze PC, Njemanze J, Skelton A, et al. (July 2008). "High-frequency ultrasound imaging of the duodenum and colon in patients with symptomatic giardiasis in comparison to amebiasis and healthy subjects". J. Gastroenterol. Hepatol. 23 (seven Pt 2): e34–42. doi:10.1111/j.1440-1746.2007.05056.x. PMID 17645477. S2CID 25370999.
53. ^ Zauber AG (2010). "Toll-effectiveness of colonoscopy". Gastrointest Endosc Clin N Am. 20 (four): 751–lxx. doi:10.1016/j.giec.2010.07.008. PMC4145837. PMID 20889076.
54. ^ Wolff WI. (September 1989). "Colonoscopy: History and development". Am J Gastroenterol. 84 (ix): 1017–25. PMID 2672788.
55. ^ Wolff WI, Shinya H (September 1974). "Earlier diagnosis of cancer of the colon through colonic endoscopy (colonoscopy)". Cancer. 34 (Supplement S3): 912–931. doi:10.1002/1097-0142(197409)34:3+<912::Help-CNCR2820340720>three.0.CO;2-P. PMID 4851470.
56. ^ Dorland, W. A. North. & Miller, Due east.C.50. (1948). The American illustrated medical dictionary. (21st edition). Philadelphia/London: W.B. Saunders Visitor.
57. ^ ^{a b c d e f one thousand h} Dirckx, J.H. (Ed.) (1997).Stedman'due south concise medical dictionary for the health professions. (3rd edition). Baltimore: Williams & Wilkins.
58. ^ ^{a b} Anderson, D.M. (2000). Dorland's illustrated medical dictionary (29th edition). Philadelphia/London/Toronto/Montreal/Sydney/Tokyo: W.B. Saunders Company.
59. ^ ^{a b c d} Liddell, H.Thousand. & Scott, R. (1940). A Greek-English Lexicon. revised and augmented throughout past Sir Henry Stuart Jones. with the help of. Roderick McKenzie. Oxford: Clarendon Press.
60. ^ ^{a b c} Anastassiades CP, Cremonini F, Hadjinicolaou D (2008). "Colonoscopy and colonography: back to the roots". Eur Rev Med Pharmacol Sci. 12 (six): 345–vii. PMID 19146195.
61. ^ Foster, F.D. (1891-1893). An illustrated medical lexicon. Being a dictionary of the technical terms used by writers on medicine and the collateral sciences, in the Latin, English, French, and German languages. New York: D. Appleton and Company.

Further reading [edit]

• Gupta S, Lieberman D, Anderson JC, Shush CA, Dominitz JA, Kaltenbach T, et al. (March 2022). "Recommendations for Follow-Upwards After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer". Gastroenterology. 158 (4): 1131–1153.e5. doi:ten.1053/j.gastro.2019.ten.026. PMC7672705. PMID 32044092.
• Gupta S, Lieberman D, Anderson JC, Burke CA, Dominitz JA, Kaltenbach T, et al. (March 2022). "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer". Am J Gastroenterol. 115 (three): 415–434. doi:10.14309/ajg.0000000000000544. PMC7393611. PMID 32039982.

External links [edit]

• Colonoscopy. Based on public-domain NIH Publication No. 02-4331, dated February 2002.
• Patient Pedagogy Brochures. American Guild for Gastrointestinal Endoscopy data
• Colorectal Cancer Incidence and Screening — United States, 2008 and 2022 Centers for Disease Control and Prevention

Source: https://en.wikipedia.org/wiki/Colonoscopy

Posted by: hatfieldplancionsing.blogspot.com

Share this post