Colonoscopy (without anaesthesia)

Colonoscopy (without anaesthesia)

Colonoscopy is a very important procedure performed in the prevention of colorectal cancer. This cancer commonly develops for a long time without producing any symptoms. If diagnosed early, however, it offers high chances of being completely cured. Therefore, it is important to remember about regular prevention tests. In its early stages, colorectal cancer can be best detected by colonoscopy.

The examination requires a referral and prior preparation with a special drug. The prescription for the drug should be issued by the doctor referring the examination.

What is colonoscopy?

Colonoscopy is an endoscopic examination that helps to assess the rectum, the sigmoid colon, the descending colon, the ascending colon and the caecum (full colonoscopy). The examination is performed using a long, flexible tubular instrument known as the colonoscope.

Indications for the examination

As a prevention procedure for early detection of colorectal cancer, colonoscopy should be regularly performed in patients as soon as they reach the age of 50 years. Colonoscopy is also recommended in the case of:

• iron deficiency anaemia;
• inflammatory conditions of the intestines;
• constipation ;
• diarrhoea and pencil-thin stools;
• large intestine diverticulum .

Diet:

5 days before the scheduled date of the examination, it is necessary to exclude the following from the diet:

• raw fruit and vegetables – especially those with seeds, i.e. grapes, kiwi, berries, strawberries, raspberries, tomatoes, cucumbers and the like (including preparations of the above-mentioned fruit and vegetables),
• fat meals,
• groats,
• puree-like cold-pressed juices,
• vegetable soups,
• all the food and bread containing grains, linseed.

The diet may include: meat and fish (especially cooked, steam cooked, stewed, grilled), pastas, white bread, rice, coffee, tea, clear juices, jellies and kissels (without fruit), clear bullions.

The last meal should be consumed by the patients before noon on the day before the examination.

Patients on a pharmacological therapy:

All the modifications in medication use before the examination should be discussed with the referring physician.

Seven (7) days before the examination, it is necessary to discontinue any oral iron supplementation.

Patients taking anticoagulants (Sintrom, Acenocoumarol, Warfarin, Pradaxa and similar) and antiplatelet medicines (Acard, Ticlopidine, Clopidogrel) are requested to consult their attending physician and follow the instructions received, or switch to a low-molecular-weight heparin therapy 4-5 days before the examination.

In the event of therapeutic procedures such as polyp removal (the service provided at an additional charge), it is necessary for the patients to have their coagulation system examined, preferably the day before the examination, after discontinuation of the medicines above and while taking low-molecular-weight heparins.

On the examination day:

• cardiological medicines (including anti-hypertensive agents) should be taken early in the morning, according to medical recommendations, and swallowed with a small amount of water.
• Do not take any oral antidiabetic medicines or insulin on the examination day (they should be brought for the examination and taken afterwards).

ON THE EXAMINATION DAY, THE PATIENTS MUST BE ON AN EMPTY STOMACH – THE LAST MEAL SHOULD BE A LIGHT BREAKFAST THE DAY BEFORE. FOR THE LAST 6 HOURS BEFORE THE EXAMINATION, IT IS ALSO FORBIDDEN TO DRINK!

Preparation immediately before the examination:

The last meal – the day before the examination, in the morning hours (light breakfast), before taking laxatives.

The physician prescribing colonoscopy should issue a prescription for a special laxative to be taken throughout the day in recommended doses.

1. PREPARATION USING FORTRANS.

   When the examination hour has been scheduled before 12.00:

   From 2-3 p.m. on the day before the examination, it is necessary to drink 4 litres of the solution prepared from 4 sachets (one sachet dissolved in 1 litre of still water) – one litre per hour. Once your begin drinking the solution, please remember that no food can be consumed. It is possible, however, to drink water, clear juice and tea.

   When the examination hour has been scheduled after 12.00.

   On the day before the examination, drink 2 litres of water with 2 sachets of the preparation from 3-4 p.m. for 2 hours. Then, on the examination day, in the early morning, drink another 2 litres of water with 2 sachets of Fortrans. Please, remember about the time interval of approx. 5-6 hours between the end of drinking the preparation and the beginning of colonoscopy.

2. PREPARATION USING CITRA FLEET.

   When the examination hour has been scheduled before 12.00:

   On the day before the examination: at 4 pm, drink the first sachet of Citra fleet dissolved in half a glass of water, and then additionally drink at least 2 litres of water or clear juice. After 6-8 hours (9 p.m.), drink the other sachet of Citra fleet dissolved in half a glass of water, and then additionally drink at least 2 litres of water or clear juice.

   When the examination hour has been scheduled after 12.00:

   On the day before the examination: at 4 pm, drink the first sachet of Citra fleet dissolved in half a glass of water, and then additionally drink at least 2 litres of water or clear juice. On the examination day, in the early morning, drink the other sachet of Citra fleet dissolved in half a glass of water, and then additionally drink 2 litres of water or clear juice. Please, remember about the time interval of approx. 5-6 hours between the end of drinking and the beginning of colonoscopy.

3. PREPARATION USING EZICLEN

   When the examination hour has been scheduled before 12.00:

   At 2-3 p.m. drink 1 bottle of the preparation diluted with water up to the line in the cup provided, for 30-60 minutes. Then, it is necessary to drink at least two cups as above – water or clear juice. After 6-8 hours, around 9 p.m., drink the other bottle of the preparation, repeating all the steps above.

   When the examination hour has been scheduled after 12.00:

   In the evening, drink 1 bottle of the preparation diluted with water up to the line in the cup provided, for 30-60 minutes. Then, it is necessary to drink at least two cups as above – water or clear juice. On the examination day, in the early morning, drink the other bottle of the preparation repeating all the steps above. Please, remember about the time interval of approx. 5-6 hours between the end of drinking the preparation and the beginning of colonoscopy.

4. PREPARATION USING MOVIPREP

   When the examination hour has been scheduled before 12.00:

   At 3 p.m. take one package – sachets A and B – dissolve in one litre of still water and drink the solution within 1 hour. Next, it is necessary to drink at least 1 litre of water or clear juice. At 8-9 p.m. take the other package – sachets A and B – dissolve in one litre of still water and drink the solution within 1 hour. Next, it is necessary to drink 1 litre of water or clear juice.

   When the examination hour has been scheduled after 12.00:

   At 4 p.m. take one package – sachets A and B – dissolve in one litre of still water and drink the solution within 1 hour. Next, it is necessary to drink at least 1 litre of water or clear juice. On the examination day, in the early morning, take the other package – sachets A and B – dissolve in one litre of still water and drink the solution within 1 hour. Next, it is necessary to drink 1 litre of water or clear juice. Please, remember about the time interval of approx. 5-6 hours between the end of drinking the preparation and the beginning of colonoscopy.

The examination is performed without anaesthesia.

However, if you wish to be examined under anaesthesia, please contact our hotline at 22 566 22 22 – it will then be necessary to consult, amongst others, the anaesthesiologist, and undergo the prescribed tests/examinations (if any).

If the examination reveals the presence of polyps, they can be removed during the colonoscopic procedure. The removal of polyps is paid for separately (according to the current pricelist of Damian Medical Centre). Histopathological examination of the polyp removed is paid for separately (according to the current pricelist of Damian Medical Centre).

JIf the examination reveals the presence of lesions from which it is necessary to collect specimens for histopathological examination, this service can be performed during colonoscopy but is provided at an additional charge (according to the current pricelist of Damian Medical Centre).

The price of the examination does not include coagulation of pathological vascular lesions.

During colonoscopy, it is also possible to perform coagulation of pathological vascular lesions with argon plasma in the area of the gastrointestinal tract. There is an extra charge for this service (according to the current pricelist of Damian Medical Centre).

The procedure is indicated in the event of manifest or latent bleeding into the gastrointestinal tract, primarily from post-radiation lesions (caused by radiotherapy), cancers of the pelvis minor (prostate cancer, endometrial cancer, rectal cancer) and angiodysplasias that might be present in every single part of the GI tract.

• The examination may only be performed in adults.
• It is required to have a medical prescription for the examination. In accordance with legislation in force concerning endoscopic examination, the prescription should include the names of drugs the patient takes; if there is no such information from the physician, the patient should bring along all the currently-used medicines.
• The price of the examination does not include the excision of polyps.
• The price of colonoscopy does not include histopathological examination.
• The price of the examination does not include coagulation of pathological vascular lesions.
• During the examination, it is not possible to collect samples for culture with an antibiogram.
• We do not perform the examination is a video version.
• The physicians performing the examination do not issue sick notes.
• In connection with the SARS-CoV-2 pandemic, the cost of the test is increased by: additional payment for personal protective equipment and additional payment for medical materials, according to the current price list at the facility.