Northumbria Healthcare NHS Foundation Trust. Your guide to having a Colonoscopy. Issued by the Endoscopy Team

Transcription

1 Northumbria Heathcare NHS Foundation Trust Your guide to having a Coonoscopy Issued by the Endoscopy Team

2 This eafet is to inform you about coonoscopy. Purpose of the treatment/procedure or investigation The purpose of this examination is to investigate your probem. The resut from this wi be used to guide your further treatment. What is a coonoscopy? A coonoscopy is an examination of the ining of the arge bowe (coon) using a fexibe tube caed a coonoscope. The tube is approximatey the thickness of your midde finger and is passed through your back passage into the bowe. What are the benefits of having a coonoscopy? Coonoscopy is used to investigate symptoms such as severe abdomina pain, diarrhoea, weight oss and beeding from the bowe. It is aso used in peope with a strong famiy history of cancer of the bowe. The resuts from this test are then used to guide your future treatment. Sometimes we take a biopsy a sma sampe of the bowe ining for examination in the aboratory. A sma piece of tissue is removed painessy through the coonoscope, using tiny forceps. It is aso possibe to remove poyps. A poyp is an abnorma projection of tissue, rather ike a wart, which the doctor wi want to examine in more detai. About your pre-assessment visit You wi have attended the Endoscopy Unit for a pre-assessment visit first, where you wi have been seen by the pre-assessment nurse, who asked you questions about your heath and gave you detaied instructions on how to prepare for the test. Sometimes it may not be necessary to attend pre-assessment, but if you have not had this test before, and have not attended pre-assessment, pease contact the Endoscopy Unit. 2

3 If you take any of the tabets isted beow, the nurse wi have asked you to foow these instructions: Iron Tabets (ferrous suphate): Stop taking iron tabets one week before your test this is extremey important. Warfarin, Phenindione, Acenocourmaro, Rivaroxaban, Dabigatran, Apixaban, Copidogre/Prasugre. A patients on these drugs must foow the instructions given at the pre-assessment visit. If you are on warfarin/phenindione we wi check your INR on the day of the procedure. Pease bring your yeow anticoaguation record book when you attend for your procedure. If after your pre-assessment appointment you are not sure what to do, contact the Endoscopy Unit for advice. Aspirin and Dipyridamoe If you are on aspirin or dipyridamoe you can continue to take these tabets as norma. If you are taking both aspirin and dipyridamoe together then you wi need to stop the dipyridamoe 48 hours before the procedure. Tabets for a other conditions such as angina, asthma and epiepsy shoud be taken as norma. If you are on an ora contraceptive pi, pease take your pi as norma. What if I am receiving treatment for diabetes? If your diabetes is controed by diet, then you need take no particuar action other than foowing the information eafet on bowe preparation given to you at the pre-assessment appointment. If you take tabets or insuin injections for your diabetes a specific information eafet with detaied guidance about fasting, diabetes medication and insuin and bowe preparation wi be given to you 3

4 at pre-assessment. The nurse wi go through the eafet which gives detais for both a morning and an afternoon appointment. After the test you can take your norma diabetic treatment and we wi give you something to eat. Pease bring your tabets or insuin with you to the Endoscopy Unit. If in doubt pease teephone the Endoscopy Unit for further advice. Preparing for your test To aow a cear view of the inside of your bowe and stomach, it is essentia that they are competey empty. At pre-assessment, you wi be suppied with a specia iquid that you drink which we ca the bowe preparation. You wi need to restrict what you eat in preparation for the test. When you are taking the bowe preparation, you wi need to stay at home within easy reach of a toiet. The bowe preparation can make you fee a bit sicky and wi give you watery diarrhoea. Both of these things are norma. You can drink cear fuids (such as water) unti 2 hours before your appointment time. What happens when I come for my test? You wi be met by a member of staff and shown into the waiting area. When your turn comes, a nurse wi check through some questions asked at pre-assessment. The doctor or nurse who is doing the test wi then tak to you. They wi expain what wi happen and give you an opportunity to ask questions. Your options for sedation and/or pain reief wi be expained to you. You can choose whether you want a sedative injection or Entonox (see beow). At this point, if you have not aready done so, you wi be asked to read and sign a form that gives your consent to the tests. It is very important that you understand the tests before signing the form so if you have any questions pease do ask. Before your tests start you may be asked to change into a hospita gown. 4

5 The sedative injection You wi be given an injection into a vein, usuay into the back of your hand, to make you more comfortabe during the test. The injection used is usuay a mixture of a painkier (pethidine or fentany) and a sedative (midazoam). Peope respond to the injection in different ways. Some peope are very drowsy and do not remember having the test afterwards, but others may be more aert and remember the examination. It is not aways safe to give more of the sedative drug. You wi be aware of what is going on and you wi not be competey knocked out. The after-effects of the injection Your abiity to think ceary and make decisions may be affected for up to 24 hours even though you may fee wide awake. For this reason you may need to have someone to accompany you drive you home and stay with you overnight. If you choose to have pain reief (fentany or pethidine) you need to be aware that it is an offence to drive under its infuence. If you do not have anyone to ook after you overnight, you can have the test with Entonox and pain reief but no sedation. This can be discussed at your pre-assessment appointment. After the test for the next 24 hours, you shoud not: Drive a vehice or motorbike Use potentiay dangerous appiances such as a cooker Have a bath without someone being there to hep you Look after chidren on your own Go to work Operate any potentiay dangerous machinery Sign any ega documents Drink any acoho 5

6 What is Entonox? Entonox is a coouress and odouress gas made up of 50% nitrous oxide and 50% oxygen. It has been used for pain management for many years and you may be more famiiar with hearing it caed gas and air. You wi administer the Entonox yoursef by breathing into a mask or mouthpiece. You wi be asked to use it for about 5 minutes before starting the coonoscopy. As you continue to use it you wi become reaxed and maybe drowsy and wi need to continue breathing the gas unti the procedure is finished. There are no ong-asting effects and you wi be abe to drive afterwards. Pain may be reieved but not necessariy remove it competey. If you need further pain reief, just ask. Who wi do your coonoscopy? A doctor or nurse-endoscopist wi perform your coonoscopy. We aso have quaified doctors who are being trained in coonoscopy. You can be assured that whoever does your coonoscopy, he or she has been trained to a high degree and is being supervised at an appropriate eve. We may ask if you mind whether medica students can observe your coonoscopy but this is vountary. What happens during the test? You wi ie comfortaby on your eft side on a couch. The tube wi be inserted into your back passage. The tube is then passed around the bends in your bowe. This can take anything between 10 and 45 minutes, depending on the ength of your bowe and what we find on the way. A nurse wi stay with you throughout the test. 6

7 Wi it be painfu? What patients say about the coonoscopy test is very variabe. Many patients are drowsy during the test and do not remember anything about it afterwards. However, some patients do experience discomfort and pain. We try to minimise the pain that you experience, but if it is too much for you, we can stop the test at your request. The discomfort and pain shoud ony ast for a short time. What happens after the test? If you have had sedation or pain reief medication, the doctor or nurse wi tak to you when you are more aert. It is best to have a friend or reative isten to this because even though you fee awake you wi not remember much of what you are tod. When you eave the Endoscopy Unit it is essentia that: You have someone with you and that they stay with you unti the next day. You do not go home aone, even in a taxi. You do not drive or work unti the next day after the test. A nurse wi aso tak to you about any foow-up appointment and expain when you wi get the resuts. You may experience some mid to moderate windy pains in your stomach. If you had a poyp removed or a biopsy performed you may experience a itte beeding. Athough unpeasant, these are norma and shoud stop within 24 hours. When wi I get the resuts? The doctor or nurse wi speak to you before you eave and expain what was seen and done during your test. 7

8 Are there any risks in having a coonoscopy? Like a medica procedures, there are some (sma) risks from having a coonoscopy. Minor side-effects such as a windy and sore stomach are quite common. It may take you severa hours to get rid of a the wind. Serious side-effects are extremey rare from simpe coonoscopy and occur in approximatey 1 in 1000 peope. If we perform treatment during coonoscopy, particuary if we remove poyps, the risks are higher (approximatey 1 in 500) and you shoud regard this as being ike a surgica procedure. The main risks are that there wi be beeding afterwards or that there wi be damage to the bowe wa causing a perforation (tear)of the bowe. Both of these compications are rare and mosty get better by themseves. If a compication shoud occur you may need to spend a few days in hospita whie the bowe repairs itsef. Very occasionay we have to perform a surgica operation to sort the probem out. Like a medica procedures there is a very sma risk of death if a compication does occur, but this is extremey rare (ess than 1 in 10,000 endoscopies). Aternatives / options for treatment There are a number of ways in which we investigate bowe symptoms, such as a specific form of x-ray caed a CT coonography. The use of these tests depends on factors which incude your specific symptoms, age, eve of fitness and how ikey it is that you have something seriousy wrong. 8

9 Contact Us If you have any queries pease contact us: North Tyneside Genera Hospita Monday to Saturday, 8am - 6pm Wansbeck Genera Hospita Monday to Friday, 8am - 6pm Hexham Genera Hospita Monday to Friday, 8am - 6pm Anwick Infirmary Monday to Friday, 8am - 6pm Berwick Infirmary Pease note this unit is not open daiy, if there is no response pease contact Anwick Infirmary. If you need urgent care outside of these hours ca 111 or go to: your oca 24 hour wak-in service at Hexham, North Tyneside or Wansbeck your oca minor injuries unit if you ive in Anwick, Berwick, Byth or Hatwhiste If you need emergency care dia 999 or go to the Northumbria Speciaist Emergency Care Hospita, Northumbria Way, Cramington, NE23 6NZ. 9

10 "! 10

11 "! 11

12 PIN 074/V6 Review date: June 2018