Sarah Johnson presents with a six-month history of intermittent abdominal pain, bloating, and changes in bowel habits. She describes the pain as crampy and localized in the lower abdomen. She has noticed that her bowel movements alternate between diarrhoea and constipation. Sarah will undergo a colonoscopy to examine the inner lining of her colon and rectum. Please explain the procedure to Ms. Johnson.
- Wash your hands
- Introduce yourself
- Confirm the patients name and date of birth
- Confirm the reason for the consultation
- Check patients current understanding
“Hi my name is …. I am one of the doctors. Can I just confirm your name and date of birth please. I have been asked to consent you for an Colonoscopy, what do you know about this procedure and why you are having it?”
Check if there is anything that the patient is particularly concerned about that you can address during the consultation.
- Idea: “What do you know already about a colonoscopy?”
- Concerns: “Is there anything that you are worried about?”
- Expectations: “Is there anything specific that you would like me to cover during the consultation today?”
What is a colonoscopy
“A colonoscopy is a test used to examine the lower part of your digestive tract. It is performed using a flexible, thin tube called a colonoscope, which has a light and a camera at its tip. The tube is passed through your back passage and guided through your digestive tract, by the operator using the camera. The test allows the lining of your digestive tract to be visualised and in some cases small samples of cells may be taken, which will be later checked in the laboratory.”
Before the procedure
“Before the procedure you will receive a letter informing you of the date and time of the procedure. The letter will give you instructions about what you need to eat and drink in the days before your test and when to stop eating and drinking. In addition, the letter will have laxatives that you will need to take before the procedure.”
On the day of the procedure
“When you arrive for your procedure the nurses will greet you. You will be asked to sign a consent form. The procedure lasts 30-45 minutes. You will be asked to lay on your side a thin, flexible tube with a small camera inside goes into your bottom. It should not hurt, but may feel uncomfortable. Air is pumped in to open your bowels, during this stage you may been bloated. After this the operator will guide the camera though the lower aspect of your digestive tract.”
After the procedure
“After the procedure you will be moved to a recovery area until you are ready to go home.
If you have had the sedation you will need someone to stay with you for 24 hours and should avoid driving, alcohol and operating heavy machinery.
Results from the biopsies/samples taken during the procedure will be available 2 weeks after the procedure. Any findings seen using the camera can be told to you on the day of the procedure”.
- Bleeding: Biopsies or the removal of polyps during colonoscopy may cause bleeding. In most cases, any bleeding is minor and stops on its own. However, severe bleeding is possible, although it is rare.
- Perforation: There is a very small risk of a perforation (a tear or hole) in the colon or rectum during the procedure. If this occurs, it may require surgical intervention to repair.
- Adverse reaction to sedation: Sedatives are often used during colonoscopy to keep the patient relaxed and comfortable. While these medications are generally safe, there is a slight risk of adverse reactions, such as an allergic reaction or respiratory problems.
- Cardiopulmonary complications: In rare cases, complications related to the heart or lungs, such as heart attack or respiratory distress, may occur during the procedure.
- Discomfort and bloating: Some patients may experience mild discomfort or bloating after the colonoscopy, which typically resolves quickly.
Alternatives to a colonoscopy include:
- A Capsule endoscopy: this is a procedure that uses a tiny wireless camera to take photos of your digestive tract.
- Is there anything that was not clear or you would like me to go over?
- Do you have any questions?
- If leaflets are available give them to the patient otherwise advise them that the NHS website has some information available.