Colonoscopy guide
In order to obtain the desired result in colonoscopy, please read and implement the following carefully before colonoscopy.
Reason for prescribing colonoscopy
How to perform a colonoscopy
A colonoscope is a narrow and flexible tube that is inserted into the large intestine through the anus. This tube transmits images from the inside of the large intestine on the screen and allows the doctor to see the inside of the large intestine clearly. The result of the colonoscopy is presented to the patient about an hour after the operation and the patient is visited by the doctor. If a sample has been taken from the patient during the operation, it is necessary to deliver the sample to the laboratory and after the preparation of the sample result, in the announced intervals, the patient will be visited by the doctor along with the test results.

Preparation for colonoscopy
In order to perform a colonoscopy, the large intestine must be completely empty and clean so that the doctor can examine the intestine accurately.
Therefore, before colonoscopy, the diet and medication should be followed according to the doctor's prescription.
If the diet is not fully followed and the bowel is not completely emptied, an accurate diagnosis is not possible and the patient needs to repeat the colonoscopy and bear the cost again.
Diet the day before colonoscopy, up to 4 hours before the operation:
Filtered liquids such as water, tea, honey in water, colorless compote juice (such as pineapple juice, apple juice and pear juice) and filtered meat juice.
Consuming any solid food, milk, dairy products and thick and colored fruit juice such as carrot juice, watermelon juice, and cherry juice is prohibited.


The following medicines should be obtained from the pharmacy and taken according to the prescription:
1. 4 sachets (packages) of Nonapic powder
(Note: the following drugs are prescribed at the doctor's discretion.)
2. Dimethicone tablets
3. Ondansetron tablets
4. Bisacodyl tablets


If your appointment is in the morning:
One sachet of powder should be consumed between 8 and 10 am the day before the operation and three other sachets of powder with a time interval of every 5 hours from the first sachet.
Ten minutes after taking each sachet, one dimethicone tablet, one ondansetron tablet and two bisacodyl tablets should also be taken if prescribed by the doctor.


If your appointment is in the afternoon:
One sachet should be consumed in the evening of the previous day between 14:00 and 16:00 and the next three sachets should be consumed every 5 hours from the first sachet. Ten minutes after taking each sachet, one dimethicone tablet, one ondansetron tablet and two bisacodyl tablets should also be taken if prescribed by the doctor.


consumption instruction:
• Each sachet should be dissolved in a cup of cold water (about 150 milliliters), stirred for 2-3 minutes, and then drink the solution.
• The solution should be consumed immediately after preparation and avoid keeping the solution and consuming it after one hour.
• Avoid drinking liquids immediately after consuming each sachet, which causes further dilution of this product.
Be sure to wait for about 10 minutes after consuming each sachet, then it is recommended to drink about one and a half to two liters of clear liquids. (Avoid drinking only water.)
• Up to 4 hours before the colonoscopy, it is safe to drink liquids, but for the last 4 hours until the procedure, the patient must be completely fasting and not drink even a glass of water.
• Pay attention to drinking enough clear liquids during the diet.


Important notes:
* In case of pregnancy, drug addiction, having any heart and lung disease, diabetes and taking certain medications, the doctor should be informed before the procedure. Some medicines, such as blood thinners, should not be taken a few days before, because they cause problems with blood coagulation and bleeding may occur during the procedure.

* The patient must bring any documents related to his current or previous illnesses.
* During the colonoscopy, sedatives or light anesthesia are used under the supervision of an anesthesiologist so that the patient does not feel uncomfortable, that is why there is a need for an accompanying person.
* People who take blood pressure medicine do not need to change their use and can take their medicine according to the previous routine. Only for people with diabetes, sometimes the dose of drugs may be reduced with the doctor's opinion.
* Having any drug and food allergies should be reported to the doctor so that it can be taken into account during anesthesia.
* It can be useful to consume natural honey juice up to 4 hours before the start of the procedure to prevent blood sugar drop.
* After the operation, there is no special food avoidance and the patient can have his normal diet except in cases where the doctor diagnoses.
* On the day of the colonoscopy, avoid wearing tight clothes for the comfort of the patient. Appropriate clothing for the operation will be provided to the patient at the center.

* Avoid activities that require concentration such as driving and working with dangerous machines for 6 hours after the operation.
* Women's menstrual period does not interfere with endoscopic surgery and does not cause any problems.
* Do not bring gold, jewelry, ornaments, phone, false teeth and any other valuable items into the operating room.
* In case of swelling and bruising at the serum injection site, cold water compress should be used in that area.


Frequently Asked Questions
1. Can the patient eat anything after the endoscopy procedure?
Yes. There is no problem.
2. Does the patient have to do anything special after the endoscopy operation?
He can do all his daily tasks (except for working with high-risk equipment and things that require concentration, such as: driving up to 6 hours after the operation).
3. Should the patient take medicine after the endoscopy procedure?
No, there is no need to take any special medicine. If needed, the medicine is prescribed by the doctor.
4. Is the result provided to the patient the same day after the endoscopy?
Yes, the endoscopy result is presented to the patient about an hour after the operation and the patient is visited by the doctor.

If a sample is taken from the patient during the operation, it is necessary to submit the sample to the laboratory and after the result is ready, the patient should return to the center and be visited by the doctor in the announced time intervals.

Complications after colonoscopy
Colonoscopy has few risks and rarely serious risk may occur, however some complications of colonoscopy may appear as follows:

- Adverse reaction to the sedative used
- Bleeding from the site where a tissue sample (biopsy) was taken or a polyp or other abnormal tissue that was removed
- Rupture in the colon wall (perforation)
If you experience the following symptoms in the first 24 hours after colonoscopy, immediately discuss the issue with your doctor.
- Fever or chills
- Rectal bleeding that is more than a tablespoon.
- Bloating or severe heartache. Bloating or mild pain is normal.
- Vomit
- Abnormal heartbeat (arrhythmia)


Colon polypectomy
Colon polypectomy is sometimes performed at the same time as colonoscopy and sometimes in a separate session.
If the doctor finds a polyp during the colonoscopy, he can perform a polypectomy at the same time.
There are different methods through which a polypectomy can be performed, depending on the size of the polyp in the large intestine, one of them is used.
For small polyps (diameter less than 5 mm), biopsy forceps can be used to remove the polyp. To remove larger polyps, the doctor places a ring at the base of the polyp and uses heat to cut the polyp, then the tissue or stem of the polyp is cut.


Preparation for polypectomy:
1. The colonoscopy diet must be followed and the patient's bowels must be completely emptied.
2. The patient should not carry any metal items such as gold and rhinestones, pressings, metal headbands, clothes pins, underwear pins, etc.
3. The patient should inform the doctor if he has a heart battery or any type of metal in his body.
4. Before the polypectomy operation, the patient must inform the doctor about the use of any of the drugs that increase the risk of bleeding (for example: Aspirin, Plavix, and anticoagulants) and stop using the drugs according to the doctor's opinion.
5. Before polypectomy, it is necessary to perform coagulation tests to check the possibility of bleeding.


Polypectomy postoperative care (recovery period)
Some bleeding and pain may occur following a polypectomy. The patient should consult a doctor in case of excessive bleeding or severe and unbearable pain.
The patient should not drive for 24 hours after surgery.
Postoperative recovery is generally quick, and minor side effects such as swelling and pain usually resolve within 24 hours of the procedure.
The complete recovery time may vary between one to several days depending on the type of operation.
Like all surgeries, this surgery also has some complications, these include:
• Bleeding: Sometimes a wound does not heal properly and it bleeds.
• Infection: Any wound can become infected. When patients ignore the doctor's advice or are not in good health, there is a possibility of infection.
• Incomplete removal: sometimes, depending on the size and shape of the polyp, it is not possible to completely remove the polyp in the first operation, and this requires a second polypectomy.
• Organ perforation: In very rare cases, the operated organ may be perforated.


Dear patient:
The announced date and time is for you, so in order to avoid violating the rights of other patients, please be present at the announced time. The announced time for your attendance may vary according to the conditions, so expect a waiting time of about 1 and a half hours.

Address:
Novin Farabi Gastroenterology Clinic, 2nd Floor, Farabi Doctors Building, between 2nd and 4th North Kosar St., Vakil Abad Blvd., Mashhad, Iran
Phone: +985138704066 +985138704067
Mobile number for emergencies only: +989020069902