Colonoscopy

Having a colonoscopy may seem to be scary, but really it is a very simple out-patient procedure that can potentially save your life! When colon cancer and colon cancer symptoms are found early, most of the time it can be cured.

A colonoscopy is a short, 30-minute examination that allows the doctor to visualize the lower part of the gastrointestinal tract called the colon (large intestine). Patients are sedated and a flexible endoscope is inserted slowly into the anus and ultimately through the length of the large intestine. The scope has a light, camera, and advanced tools for removing abnormal tissue for biopsies. These abnormalities, known as colon polyps (pre-cancerous growths), are removed in order to prevent them from progressing to colon cancer.

As a gastroenterologist, Dr. Arash Ari Nowain is trained to diagnose and treat conditions of the digestive tract. He also has special training in endoscopic procedures, which lowers patients’ risks of complications in endoscopic procedures like colonoscopies. To find out more information watch the colonoscopy video below or to schedule an appointment contact Dr. Ari Nowain at the Center for GI Health at (310) 657-4444.

Gastroenterologist Offers Third Eye® Colonoscopy

Dr. Nowain also performs a more detailed screening procedure known as a Third Eye® colonoscopy, which involves a backward viewing camera that helps Dr. Nowain locate more polyps than he would during a normal colonoscopy. (Patient preparation and recovery for a Third Eye colonoscopy are the same as for standard colonoscopy.)

Polyps can sometimes be missed during a standard colonoscope due to the many folds in your colon’s inner lining.  The Third Eye gives Dr. Nowain a retrograde (backward) view in addition’s the colonoscope’s forward viewing camera. This allows for more polyps to be located behind folds and curves of the colon. According to various studies, Third Eye colonoscopies locate as many as 23-25 percent more polyps. That number increases to 40% more for patients with a history of polyps, a family history, and those with worrisome symptoms.

If you would like to find out more about the Third Eye colonoscopy, contact Dr. Nowain today.

Colonoscopy Information

colonoscopy-dr-nowain

Dr. Nowain seen performing a colonoscopy.

The goal of a colonoscopy is to look for early signs of colon cancer or other problems. A colonoscopy also checks for bowel diseases or any bleeding in your colon. If colon polyps are detected and removed, colon cancer can be prevented. Colonoscopy is a safe procedure that provides information that other tests may not be able to give. Still, there are alternative colon cancer screening procedures available for anyone who does not wish to or cannot undergo a colonoscopy.

Everyone should have their colon checked once they hit 50. A select group of individuals should schedule their first colonoscopy before the age of 50. African Americans have a higher risk of developing colon cancer, so they should schedule their first screening by the age of 45. You may also be getting this done before you’re 50 if:

  • There’s a history of colon cancer in your family
  • You have a (or your doctor thinks you may have) a bowel disease like ulcerative colitis or Crohn’s disease
  • Another test your doctor ran found something that shouldn’t be in there (like blood or a polyp)

Other reasons a colonoscopy is done:

  • A big change in how you go to the bathroom
  • Bleeding
  • Pain in your belly
  • Loss of appetite
  • A condition like anemia

If you ever had polyps or colon cancer in the past, colonoscopies are done as a safety check to make sure there aren’t any new polyps, or that the cancer hasn’t come back.

Before a Colonoscopy

Believe it or not, most people say that getting ready for the colonoscopy prep is the worst part. Many people have heard terrible stories about the prep you need to drink the night before a colonoscopy, but Dr Nowain utilizes a low-volume technique and will help make sure you have a very comfortable experience. But no matter which method your doctor uses, they all do the same thing: clean out your colon.

Prep for a colonoscopy starts a week or 2 before your procedure. So make sure Dr. Nowain has all the information he needs. Let him know if you have any health conditions or allergies as well as
if you’ve ever had any surgery, especially surgery on your belly (i.e. if your appendix was taken out or if you had a hysterectomy). This is because there could be scar tissue in the area around your colon.

For your safety, give Dr. Nowain a list of everything you take. This includes:

  • Aspirin
  • All prescription and over-the-counter medications / herbal supplements
  • Vitamins
  • Recreational drugs
  • Insulin or pills for diabetes
  • Arthritis medicine
  • Blood thinners or heart medicine
  • Vitamins that contain iron

For 24 hours before your procedure, you should be on a clear-liquid diet of water, broth, jello (avoiding red or purple), apple juice, gingerale, plain coffee (no cream but sugar is okay), or tea. Some kinds of popsicles, Jell-O®, and clear juice are usually OK as well. But no solid food or dairy products (like milk).

Do NOT eat or drink anything that’s purple or red. In your colon, red and purple can look like blood and make it hard for Dr. Nowain to tell what’s what. This means no red or purple Jell-O or popsicles and no red juice (like cranberry juice).

You’ll take either a cleansing drink, pills, or laxatives. Sometimes, Dr. Nowain may also give suppositories or enemas to use at home. These also clear things out in there. If you have the cleansing drink (and most people do), make sure you drink it all down.

The Bowel Prep Before a Colonoscopy

 

Good Vs Bad Colonoscopy Prep

This part is called the prep. The prep is what cleans out your colon and makes you go to the bathroom. When and how often you’ll go depends on which prep your doctor gives you. If you can, you’ll be more comfortable if you do your prep at home since you need to stay close to the bathroom. And some people use wet wipes, or put Vaseline® on that area to keep it from getting raw.

You will know when you’re done prepping your colon when all that’s coming out is clear, light, yellow or brownish liquid. There should NOT be anything large or solid. Also make sure to drink of all the bowel prep.

After your bowel prep is complete, you can still drink some clear liquids. Please keep in mind that you CANNOT eat or drink anything for 6 hours before your colonoscopy. The reason has nothing to do with your colonoscopy but rather the anesthesia. You’ll most likely be given something to make you drowsy for the colonoscopy, and food in your stomach can be very dangerous if you throw up. So make sure your stomach is empty! If you need to take a pill, just take it with a small sip of water.

For more information, please read the colonoscopy prep page on our website.

Your Colonoscopy Appointment

A colonoscopy takes about 30 minutes, but you should expect to be at the procedure center for about two or three hours. Dr. Nowain preform the majority of his colonoscopy appointments at a Beverly Hills outpatient surgery center known as La Peer Health Systems.

After you arrive at La Peer, you’ll go to a private area and a nurse will take your temperature, pulse, and blood pressure. They will also hook you up to some monitors and place the IV. Next, you will meet your anesthesiologist and speak with Dr. Nowain before the procedure to go over any last questions you might have. The anesthesiologist will administer your sedation to ensure that you are comfortable and that you are stable at all times. You breath on your own but are in a deep sleep such that you do not feel pain or remember having the procedure.

Once you are under anesthesia, a clean and lubricated scope is gently placed in your rectum. The scope is a long, hollow, and lighted tube that is about as big around as a finger. A tiny camera on the end sends video to a TV screen so the doctor can see the inside of your colon. The scope then blows a little air into your colon. This makes it easier to steer the scope and helps the doctor see. The goal is to move the scope all the way to where the colon meets the small intestine (see below). In most people, the scope passes through the colon just fine.

If Dr. Nowain sees anything (like a polyp or an area that looks inflamed) he’ll remove it and/or take a sample. This shouldn’t hurt. Anything Dr. Nowain removes is sent to for pathology for tissue analysis. If there’s any bleeding, a special tool is used to seal it off and stop the bleeding. You shouldn’t feel this either.

Dr. Nowain then slowly backs the scope out, taking another look at your colon along the way. Finally, the scope is gently removed, and the procedure is over.

lower GI tract

After Your Procedure

You’ll go home the day of the procedure. Because of the IV sedation, you’ll need a ride home. Your doctor may talk with you about what he saw. You may still feel groggy and a little out of it, so you may want to have someone there with you. If he removed any polyps or took samples, you will setup a follow-up appointment one week after your procedure to go over your results.

After the procedure, expect to pass gas. This is common, normal, and expected. Dr. Nowain always attempts to remove as much gas from your colon as possible, so that you do not come out of your procedure feeling excessively bloated. If you had IV sedation, you may feel a little groggy. You’ll need to rest for an hour or so until you’re fully awake. In recovery, you’ll be watched closely and may get fluids through your IV.

If you have any hemorrhoids, they will most likely not hurt after a colonoscopy. (Hemorrhoids can form around the anus when a blood vessel swells and turns into a lump.) Most of the time, hemorrhoids don’t cause pain during the procedure. Colonoscopies can sometimes cause pain, irritation, and even a little bleeding.

The rest of the day you’ll probably want to take it easy. You may feel bloated, gassy, or have mild cramps. Be sure to drink plenty of water and avoid caffeine as it can give you more cramps. Over the next week, your colon will be going through some readjusting. As a result, trips to the bathroom won’t be quite as normal as usual. Expect food to take a while to travel through your body.

Call Dr. Nowain if you have:

  • A fever of 100° F or higher
  • A lot of pain, bleeding, or large blood clots when you go to the bathroom. These can happen even many days after a colonoscopy
  • A swollen, firm, or tender belly

Are Colonoscopies Covered by Insurance?

Yes! A colonoscopy is routinely used to screen for colon cancer and other bowel disorders. It is agreed that colonoscopies are an essential diagnostic tool and covered by most insurers, including Medicare. If you are worried that it won’t be covered, we will be happy to check for you.

If you have any other question about colon cancer screenings, visit our colonoscopy FAQ page.

About Dr. Nowain

Dr. Ari Nowain is a board-certified gastroenterologist at the Center for GI Health in Los Angeles, CA. Dr. Nowain has received training in endoscopic methods and has performed thousands of colonoscopy procedures in the Beverly Hills area. Please feel free to contact Beverly Hills Gastroenterologist Dr. Nowain with any questions or to schedule a consultation!