Colonoscopy is a medical imaging procedure used to examine the interior of the large intestine (colon) and rectum. During this procedure, a colonoscope—a flexible, lighted tube—is inserted into the body through the anal region, providing a direct visual view of the inside of the large intestine. Colonoscopy is considered the gold standard for the early diagnosis of many intestinal diseases, especially colon cancer, and saves the lives of millions of people worldwide.
How Does a Colonoscopy Work?
A colonoscope is a flexible tube with a camera and light source at its tip. This camera projects images of internal organs and tissues onto a screen, allowing doctors to view the examined area in detail. During a colonoscopy, the intestinal wall is examined along its entire length; biopsies can be taken from abnormal-looking areas, and polyps can be removed. Thanks to instruments passed through the working channel at the tip of the device, diagnosis and treatment can be performed in the same session.
Modern colonoscopes are equipped with features such as high-definition digital imaging, narrow-band imaging (NBI), and chromoendoscopy; these features ensure that even small and flat polyp lesions are not missed. Evaluating the entire inner surface of the intestine allows for the removal of small adenomatous polyps before they transform into a cancerous form; this is one of the most effective preventive health practices that significantly reduces the incidence of colon cancer.
In Which Situations Is It Used?
- Screening and early diagnosis: It is the most effective method for detecting colon cancer at an early stage. Removing precancerous polyps prevents cancer development.
- Diagnosis of symptoms: Investigating the causes of conditions such as chronic diarrhea, constipation, abdominal pain, bloody stools, unexplained weight loss, and iron deficiency anemia.
- Monitoring and follow-up: Regular follow-up for patients with a history of polyps or colon cancer.
- Inflammatory bowel diseases: Diagnosis and activity assessment of Crohn's disease and ulcerative colitis.
- Evaluation of diverticular disease
- Screening for those with a family history: Recommended for individuals with a family history of colon cancer.
- Follow-up for genetic hereditary cancer syndromes (Lynch, FAP)
- Detection and treatment of sources of intestinal bleeding
- Foreign body removal
Advantages of Colonoscopy
- Opportunity to detect colon cancer at an early stage
- Ability to remove polyps and suspicious tissues in the same session
- High diagnostic accuracy through direct visual examination
- Definitive pathological diagnosis through the ability to take biopsies
- Detection and cessation of bleeding foci
- Possibility of treatment without the need for surgery
- Painless application under sedation
- Same-day discharge and quick return to normal life
- Cancer prevention effect as a preventive health service
- Early detection of diseases through regular follow-up
Polyp Removal and Therapeutic Colonoscopy
Polyps detected during a colonoscopy can usually be removed in the same session; this procedure is called a polypectomy. Hot biopsy forceps are used for small polyps, while a polypectomy snare is used for larger ones. The removed polyps are sent for pathological examination to determine whether they are benign or malignant. Since adenomatous polyps are precursor lesions of colon cancer, their removal significantly reduces the risk of developing cancer in the long term. Thanks to advanced techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), even larger and superficial lesions can be removed via colonoscopy without the need for surgery. This approach is a minimally invasive revolution in the treatment of colon cancer and saves many patients from the need for major surgery.
Colonoscopy Procedure Process
Bowel preparation is of great importance before a colonoscopy. A special diet is followed the day before the procedure, and bowel-cleansing medications are used; this is mandatory for a clear view of the inner surface of the colon. If bowel preparation is inadequate, small polyps may be missed; therefore, it is necessary to follow the physician's instructions completely. The procedure is usually performed under sedation, and the patient remains awake but relaxed. The colonoscope is inserted into the body through the anal region, and the doctor advances through the intestine to examine the intestinal wall and inner surface in detail.
During the procedure, abnormal tissues such as polyps can be removed and biopsies can be performed if necessary. The procedure usually takes 20-45 minutes; the time may be extended if polyp removal or extensive screening is required. After the effect of the sedation wears off, the patient is sent home after a short observation period. Pathology results are usually evaluated within 5-7 business days, and a follow-up plan is determined based on the results. For patients with a history of polyps, a follow-up colonoscopy may be planned at intervals ranging from 1 to 5 years.
Points to Consider
Colonoscopy is generally a safe procedure; however, in rare cases, complications such as bleeding, bowel perforation, infection, or reactions to sedation may occur. Medications used before the procedure, especially blood thinners, medical devices such as pacemakers, and known allergies must be reported to the physician. Since inadequate bowel preparation can lead to the repetition of the procedure, it is necessary to follow the physician's instructions completely. Mild bloating and gas passage after the procedure are normal. Due to sedation, one should not drive, make critical decisions, or operate machinery on the day of the procedure, and if possible, should be accompanied by a companion. Screening colonoscopy is recommended for those aged 50 and over, and at earlier ages for those with familial risk; in recent years, this age limit has been lowered to 45 in some guidelines. In special cases such as an artificial anus, advanced age, and heart or lung diseases, the approach must be individualized.
Colonoscopy at Koru Hospital
As Koru Hospital, we perform colonoscopy procedures with high comfort and safety standards, thanks to our experienced specialist staff in gastroenterology and general surgery and our modern endoscopy unit. We offer our patients a comprehensive diagnostic service with high-definition colonoscopes, NBI features, our experienced anesthesia team, and the rapid support of our pathology laboratory. Detailed information is provided regarding bowel preparation before the procedure, a painless procedure is ensured under sedation, and results are shared as soon as possible. With our patient-oriented approach, detailed interviews are conducted to reduce pre-procedure anxiety, companion information is meticulously carried out, and the post-procedure recovery process is closely monitored. In our multidisciplinary team, all findings are evaluated with a holistic perspective through the coordinated work of gastroenterology, surgical oncology, medical oncology, and pathology specialists. As Koru Hospital, our goal is to increase treatment success by detecting serious diseases such as colon cancer at an early stage and to support our patients in living a healthy life by protecting their quality of life.
