colonoscopy diagnostic therapeutic

Colonoscopy is the endoscopic examination of the large bowel and some part of the small bowel (terminal ileum) with an endoscope passed through the anus. It enables an examiner to evaluate the inside of the colon (large intestine). It can provide a visual diagnosis (e.g., ulceration, polyps), biopsy can be taken and at the same time can be therapeutic also (removal of polyp). A sigmoidoscopy allows an examination of the distal portion (about 40- 50 cms) of the colon.

Colon preparation is needed before the procedure to clean the large intestine so that one can see the inside clearly. Child will be given an oral solution to drink over 4-6 hours to help clean out the colon. This solution will lead to frequent bowel movements until there is no fecal matter left in their colon. During this preparation the child is expected to have only clear liquids orally.

Main indications of pediatric colonoscopy are:

• Chronic diarrhea
• Recurrent abdominal pain
• Bleed per rectum (Colon ulcers, rectal varices or polyps)
• Workup for weight loss or chronic constipation
• Suspecting inflammatory bowel disease

Similar to upper GI endoscopy, the procedure is done under sedation with all the precautions and is safe and is done as an outpatient setting. It takes approximately 20 to 30 minutes to complete colonoscopy. The child can be sent home in around 2 hours after the procedure once he is out of sedation. He or she can eat or drink normally after the procedure.

Virtual colonoscopy, a 3D imagery reconstructed from computed tomography (CT) scans or from magnetic resonance (MR) scans, is also possible now a days, as a totally non-invasiveimaging test. Virtual colonoscopy is less commonly done as it does not allow therapeutic manoeuvres such as polyp and tumour removal or biopsy. If a growth or polyp is detected using CT colonography, it would require removal with a standard colonoscopy.