A colonoscopy is considered a quick and safe examination. Unlike other types of cancer screening, polyps and other abnormalities can be removed right away.
A colonoscopy is due. The patient lies in a comfortable lateral position on an examination table. The doctor is standing next to him, holding a flexible tube about one and a half meters long and about one centimeter in diameter: the colonoscope.
A tiny video camera is located at the end next to a light source. The doctor gently inserts it into the patient’s anus and up to the junction between the large and small intestine.
If it is slowly pulled out again, the doctor looks at the patient’s intestinal wall on the monitor. He doesn’t feel anything from the approximately 20-minute examination – he has been given a light anesthetic beforehand and is asleep. If the doctor discovers polyps – nodular growths on the intestinal mucosa – or other conspicuous areas, he can remove them immediately.
Colorectal cancer is the second most common cancer
This is important «because the often benign structures can turn into malignant tumors over time and the patient therefore has colon cancer,» explains Prof. Thomas Seufferlein. He is a board member of the Gastro-Liga and works at the University Hospital in Ulm. Colon cancer is the second most common cancer in Germany and can be fatal. Even preliminary stages can be recognized and eliminated with a mirror.
This not only serves to prevent cancer, but also takes place if certain intestinal diseases are suspected. Prerequisite for the mirroring: «The intestine must be absolutely clean,» says Seufferlein. To do this, the patient must strictly adhere to the specified dietary rules three to seven days before the examination.
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Whole grain taboo before the examination
Anything containing grains, seeds and shells must not be eaten. «They block the working channel and make the examination more difficult,» explains Prof. Alexander Meining from the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). Wholemeal products, poppy seeds, sesame seeds, grapes, tomatoes and kiwis are taboo.
The day before the endoscopy, the patient has to clean his intestines. After a light breakfast and, if necessary, a light lunch, he is only allowed to drink tea, water, clear fruit juices or broth. «It’s important to drink a lot, because it flushes and cleanses the intestines well,» says Dagmar Mainz, board member of Germany’s professional association of resident gastroenterologists.
Laxatives are part of the investigation
The most unpleasant part: In the afternoon or evening before the outpatient examination, one to two liters of a laxative solution are drunk. This is also done again on the day of the examination.
Possible risks of the examination: There may be slight bleeding in the intestine – or the intestinal wall is damaged. «This sometimes happens when polyps are removed,» explains Meining. However, such complications are rather rare.
When the cash register pays
The intestine is often expanded with air beforehand, and slight pain or flatulence are possible temporarily. About half an hour after the mirroring, the patient is allowed to eat something again. The health insurance companies pay for the examination in the event of symptoms or suspected illness – and as part of colon cancer screening: for men from the age of 50 and for women from the age of 55.