Once you are sedated (most patients feel very relaxed and drowsy, and often fall completely asleep!), comfortably positioned on your left side and covered with a blanket, the doctor will perform a brief rectal exam, using a lubricated gloved finger.
After that, the lubricated colonoscope is inserted into your anus, through the rectum and then up into the colon. Moving very slowly and gently, the doctor will move the scope up the descending colon, around the splenic flexure, across and through the transverse colon and then down the ascending colon, into the cecum (the first portion of your colon, where it connects to the small intestine). This is where the colonoscope stops.
Along the way, the doctor may need to activate the air channel, which inflates the colon a bit, creating space to gain a better view. You may also feel a bit of suction if the scope needs to remove liquid stools or blood. If the doctor sees any polyps, growths or abnormalities, he may choose to remove them there and/or take samples for biopsy. This typically does not cause the patient any pain or discomfort.
The colon is the final stop in the digestive system; it’s the place where the last of the water and salt is removed from the liquidized undigested food residue deposited there by the small intestine. FYI: your small intestine moves about two-pints of this liquidized residue into the colon each day. By the time the colon has done its work, there is only about a pint of solid matter left.
Because you will be given a sedative, it is also important that you have someone on hand to drive you home from your appointment. While you may “feel” like you’re okay, the sedative effect of your medication takes longer than you think too wear off completely and will remain in your system until the next day. So no driving that day and you will need to arrange in advance that a responsible person picks you up and drives you home. We recommend not to go to work and to avoid attending important meetings and making important decisions until the next day.
For doctors who specialize in the gastrointestinal (GI) tract, examinations are not as easy as those performed on the exterior portions of the body. Not only do we need to get a look deep into your body’s interior recesses and cavities, our examinations involve moving through tight sphincters, soft tissues and persistent valves – which require the use of highly specialized instruments.
A sigmoidoscope, used for sigmoidoscopies, is one of several innovative medical instruments that allows us to get an image of the lowest portion of your intestinal tract, with minimal discomfort on your end.
Your colon is the last section of the large intestine, and it connects directly to your rectum. The last third of the colon is called the sigmoid colon. It forms a curvy S-shape and it about 40 cm in length (just under 16-inches).
When we need to get a good look at the interior of the sigmoid colon, typically for colon cancer screening, there is an option between a colonoscopy or a flexible sigmoidoscopy. Unlike a colonoscopy, which can view the entire interior of the colon, a sigmoidoscopy can only see the left-hand portion of the colon, which has its pros and cons.
Sigmoidoscopies are becoming increasingly popular because they are simpler than a colonoscopy, and work well in combination with a fecal occult blood test (FOBT), preventing the need for all of the prep and sedation required for a colonoscopy.
Typically, a sigmoidoscopy is used to screen for:
Sometimes, these abnormalities are completely asymptomatic, meaning you won’t have any symptoms. This is especially true when progressive cell abnormalities are in their beginning stages. In other cases, you may experience signs or symptoms of colon disease, such as:
If any of these symptoms sound familiar, contact our office and schedule an appointment so we can look into the matter further. It’s much better to be given the “all clear” then to hope something will go away, only to find out later that your latent colon disease has progressed to a point where you require more dramatic treatment. Sooner is always better when it comes to diagnosis and treatment of any medical condition.
If we notice anything unusual during your sigmoidoscopy, we may take small tissue samples so the lab can analyze them. The results will tell us what, if any, treatment or further testing is required.
Have you seen a diagram of the small intestine lately? If not, take a peek at the one below and you’ll see why modern endoscopic procedures have had a difficult time getting a good look at the interior of the small intestine.
It’s a long and winding road to say the least, which makes the small intestine more challenging to view via standard endoscopy technology. For decades, GI doctors wished there was a magic pill patients could swallow so we could see the interior of this vast organ (about 23 feet in total length!!).
Due to the nature of the technology, there are some limitations of capsule endoscopy. Sometimes we aren’t able to see the images very clearly, depending on the speed the capsule is traveling when it takes the pictures. On the flip side, if the capsule moves more slowly than normal, the battery can run out at the 8-hour mark – leaving us with incomplete images. Also, we can’t always tell exactly where in the small intestine a particular issue lives, so that can make it difficult to locate if we need to perform more invasive or surgical procedures for treatment.
If the GI tract has obstructions and/or scar tissue (strictures), the capsule can potentially get stuck, requiring surgical removal. This is very rare, however. If we suspect you have strictures or obstructions that will limit capsule movement, we give you a dissolvable, dummy capsule first. If the dummy capsule gets stuck, we can locate it via X-ray and note the location of the stricture without any complications. It will dissolve and be absorbed by the body within a few days.
In the big picture, the continuing development of capsule endoscopy technology will continue to improve our ability to accurately diagnose and treat gastrointestinal disorders using the least invasive methods possible.
Contact Dr. Marcus’s office to learn more or to see whether you’re a good candidate for PillCam capsule endoscopy.
There is only one reason why your breath would test positive for higher-than-normal levels of hydrogen; the presence of very specific, anaerobic bacteria that produce hydrogen as a byproduct of eating sugar/carbs. These bacteria live in the colon. When they are exposed to unabsorbed food particles – primarily sugars and carbohydrates – they eat on them and excrete hydrogen gas.
This hydrogen, which can be tested via the breath, is a sign that something is wrong with your digestive tract – specifically the small intestine, where the bulk of nutrient absorption occurs. If your small intestine was healthy, those unabsorbed particles wouldn’t make it all the way down to the colon in the first place.
Over a period of time, as the bacteria and their hydrogen byproduct increases in number, they can actually back up into the small intestine. When this happens, the hydrogen will eventually be absorbed into the blood stream, make its way into your lungs, and is expelled when you exhale.
The result is measurable hydrogen levels, read by our hydrogen breath test, causing us to do further exploration and diagnosis so we can select the right treatment for your particular digestive issue.