Colonoscopy screening at the Pezim Clinic

Once it has been decided that colonoscopy is appropriate for you and you understand the risks and aims of the procedure, a time will be booked for you.  You will be given instructions to purchase the materials needed for your bowel prep.  The day before you are booked to have your colonoscopy, you will prep (cleanse) your bowel at home according to the instructions and prepare to present yourself to the Clinic on the following day (without any perfume, cologne, skin creams or scented hairspray, please).  Don’t forget that you must not eat or drink anything within 4 hours of the procedure.  If you are diabetic you will need special instructions about food or medication on the day of the test and we will try to book you first thing in the morning so that you will not have to undergo prolonged fasting.  Your blood sugar will be checked before and after the test.

Once in the Clinic, you will be carefully identified and required to sign a consent form for the procedure.  You will then be taken to the change room and instructed to put on a gown and then moved to an examination stretcher.  Once on the stretcher, an automatic blood pressure cuff will be wrapped around your left arm and cardiac monitor leads will be taped to your chest.  An intravenous line will be inserted into your arm (usually right) by a physician.  All jewelry must be removed from the arm and hand on the side with the intravenous.  A finger gauge will be placed on our left index finger to monitor pulse and oxygen levels.  A small supplement of oxygen is provided through a simple tubing that sits under the nose.  Just before the procedure begins  you will hear the staff go through a checklist of items that identifies you, the reasons for the test, and a few technical details that relate to the status checks of the equipment.  Then you will slowly be given intravenous sedation.  The physician will talk to you during this process and will continuously assess your alertness in order to provide a customized amount of sedation for you.

The colonoscopy procedure itself takes anywhere from 20 to 45 minutes, depending on the degree of difficulty. Some patients are easy to do, some are very difficult.  It all depends on the configuration of the patient’s colon.  You may or may not remember much of it.  You may choose to watch the procedure on the monitor, or not.  You may be asked to turn onto your side or onto your back one or several times during the procedure.  This helps to advance the scope into the colon.  The nurse may place her hands onto your abdomen to apply a little pressure in order to keep the colonoscope as straight as possible within the abdomen.

When the procedure is over, you will be kept on the examining stretcher for at least another 15 minutes in order for the medications to begin wearing off.  If the person taking you home needs to be contacted, the staff will make that call for you. When we feel you are ready to get up, you will be asked to sit for a few minutes.  If everything seems fine, your intravenous and monitoring attachments will be removed.  You will have been in the Clinic for about 2 hours.  When you are ready to leave, you will be given verbal as well as written follow-up instructions by Dr. Pezim.  Because you have been sedated, it is important that you not drive for the remainder of the day.  Someone else will have to drive you home.  The BC College of Physicians & Surgeons now mandates that you must be accompanied on your discharge by a responsible person.

Your last step before leaving is a discussion with the colonoscopy physician about the findings of the procedure.  Colonoscopy is a ‘real time’ procedure, so the doctor generally knows immediately if the colon is normal or if some follow-up or further testing is required.  If biopsies have been taken or a polyp removed, this will be discussed with you.  Any tissue taken will be sent to the Vancouver Hospital for microscopic analysis by a Pathologist.  It takes 10 days to 3 weeks to get the ‘Pathology Report’.  In such cases you will be asked to return or contact the Clinic in 3 weeks for another appointment in order to review the Pathology Report and to arrange for any additional testing or treatment.

Be sure to read additional information about colonoscopy in the following sections of the website:
All about screening for colon and rectal cancer
Frequently Asked Questions
Am I medically-suitable for a procedure at the Pezim Clinic?
Patient instructions and forms – Preparing for a colonoscopy

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