Colonoscopy

What is Colonoscopy?
A colonoscopy is a diagnostic procedure used to examine the inside of the colon and assess its lining. It is typically performed by gastroenterologists, who are specialists in colonoscopy and trained to diagnose and treat various colonic diseases. This procedure involves the use of a colonoscope-a thin, flexible tube about the width of a finger-with a camera and light attached at its tip. The colonoscope is gently inserted through the anus to visualise the entire colon and the final part of the small intestine (ileum). Real-time images of the colon are displayed on a monitor for thorough evaluation. Colonoscopy is usually performed under moderate sedation, ensuring that the patient is asleep and comfortable throughout the procedure.
PROCEDURE FOR COLONOSCOPY
During the procedure, the gastroenterologist advances the colonoscope through the anus and into the colon, carefully navigating to the beginning of the colon (caecum) and the terminal ileum. The colon is thoroughly cleaned during the examination to allow for a detailed inspection, which takes about 20 to 30 minutes. At least 10 minutes of this time is spent on meticulously examining the colon while the scope is withdrawn.
Additional interventions performed during a colonoscopy may include:
- Biopsies: Systematic tissue sampling or targeted biopsies using enhanced imaging systems.
- Polypectomy: Removal of precancerous growths (polyps) with specialised snares.
- Haemostasis: Stopping internal bleeding with heater probes, clips, or sprays.
- Foreign Body Removal: Extracting objects stuck in the colon.
- Dilation and Stenting: Addressing blockages with stents to restore normal function.
WHEN SHOULD I GET A COLONOSCOPY
A colonoscopy is recommended for investigating specific digestive symptoms and diagnosing colon diseases. Common symptoms that warrant a colonoscopy include:
- Persistent changes in bowel habits, such as diarrhoea or constipation.
- Blood or mucus in stool.
- Unexplained weight loss.
- Abdominal pain, bloating, or discomfort.
- Iron deficiency anaemia.
Colonoscopy is also a crucial tool for colon cancer screening and prevention. It reduces the risk of colon cancer by detecting and removing precancerous polyps before they become malignant. Individuals aged 45 and above, or those with a family history of colon cancer, should prioritise regular colonoscopies.
PREPARING FOR THE COLONOSCOPY
To ensure a successful colonoscopy, patients must follow specific preparation guidelines:
- Fasting: Avoid food for at least 6 hours before the procedure. Clear fluids can be consumed up to 2 hours prior.
- Bowel Preparation: Take prescribed medications to clear the bowels, following the instructions carefully.
- Medication Adjustments: Most medications can be continued, but diabetic drugs should be omitted during fasting. Blood thinners may need to be paused, as advised by your colonoscopy doctor.
- Post-Procedure Care: Avoid driving, working, or making major decisions after the procedure due to the effects of sedation. Arrange for someone to take you home.
BEFORE THE COLONOSCOPY
Before the procedure, a nurse will conduct preliminary checks and insert an intravenous line for sedation.
DURING THE COLONOSCOPY
During the colonoscopy, you will lie on your left side, and sedation will be administered to ensure comfort. Once you are asleep, the procedure begins. You will not feel or remember anything during the process.
AFTER THE COLONOSCOPY
After the procedure, you will be looked after in a recovery area or room, where medical staff will monitor you until the effects of the anaesthesia have worn off. Nurses will provide light refreshments and ensure you are ready for discharge. It is advisable to arrange for a family member to receive discharge instructions and accompany you home. You should avoid driving, working, or engaging in significant activities until the following day. Mild abdominal discomfort or bloating is normal after a colonoscopy and typically resolves within 24 hours.
Your colonoscopy doctor will schedule a follow-up appointment to review the procedure, discuss the findings, including any biopsy results, and outline an appropriate management plan moving forward.
Why Choose a Specialist for Colonoscopy in Singapore?
Choosing the right specialist and clinic for a colonoscopy is vital for accurate diagnosis and effective treatment. In Singapore, colonoscopy specialists are equipped with advanced tools and expertise to detect even subtle symptoms of colon diseases. A colonoscopy specialist will adhere to international quality standards, ensuring the highest level of care and patient safety. Beyond diagnosis, a doctor can provide personalised treatment plans based on findings during the procedure, helping to manage symptoms and conditions promptly. A colonoscopy clinic in Singapore will also offer transparent cost structures, making it easier for patients to plan their healthcare journey. With the help of a skilled doctor, patients can feel confident in their care.
SAFETY OF COLONOSCOPY
Colonoscopy is a safe procedure, with complications occurring in less than 0.1% of cases. Potential risks include bleeding, tears in the colon wall, or reactions to sedation. These risks are higher in complex cases or during therapeutic interventions, but your doctor will explain all precautions and how to handle rare complications.
QUALITY OF COLONOSCOPY
The quality of a colonoscopy depends largely on the expertise of the specialist performing the procedure. A skilled specialist ensures thorough examinations, photo documentation of landmarks, and detailed reporting. High-quality colonoscopy can detect and remove precancerous polyps in at least 25% of patients, adhering to international standards for care. Adequate bowel preparation is essential to achieve accurate and complete results.
COST OF COLONOSCOPY
A colonoscopy is considered a hospital procedure and its cost is often covered under hospitalisation plans. In Singapore, it is Medisave-deductible and covered by many private insurance plans, including corporate health benefits. Financial counselling is provided before the procedure to explain costs and help patients plan. The Ministry of Health offers fee benchmarks and publishes average costs for transparency. Patients are encouraged to confirm their coverage with their insurance providers before proceeding with a colonoscopy.