colonoscopy

Last reviewed 01/2018

Colonoscopy is an endoscopic examination of the colon. The colonoscope can be passed through the anus or a stoma.

Indications to undertake colonoscopy include:

  • symptoms suggestive of colonic malignancy with normal radiological findings
  • follow-up of patients with resected malignancy
  • biopsy for inflammatory bowel disease
  • estimation of extent of ulcerative colitis
  • ulcerative colitis surveillance
  • investigation of pseudo-obstruction
  • investigation of gastrointestinal bleeding
  • investigation of ischaemic or pseudomembranous colitis
  • examination for malignant change in surgical resection lines

Therapeutic indications:

  • decompression of volvulus and other obstructive lesions
  • diathermy of angiodysplasia
  • polypectomy
  • fulguration of tumours
  • dilate strictures
  • stop bleeding
  • remove foreign bodies

A prospective study has revealed that, in patients at high risk of colonic neoplasia, colonoscopy was more sensitive and specific than air contrast barium enema or computed tomographic colonography for detecting large colonic polyps (2).

Reference:

  1. Hershman, M. Colorectal surgery. In: Minimal access medicine and surgery. Principles and techniques. Ed. Rosin, D. (1993). Radcliffe Medical Press.
  2. Rockey DC et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005;365:305-11