Rectosigmoidoscopy and colonoscopy
When is this exam indicated?
Colonoscopy and rectosigmoidoscopy are recommended when there are certain symptoms such as rectal bleeding, diarrhea, significant weight loss, severe constipation in order to investigate the main diseases affecting the colon (e.g. the presence of polyps, colon cancer, diverticula, inflammatory bowel disease or intestinal infections). Through these examinations it is also possible to perform biopsies (removal of one or more tissue fragments with forceps), the removal of colon polyps or the treatment of intestinal bleeding.
How is it performed?
Colonoscopy and rectosigmoidoscopy are performed by inserting through the anus a flexible instrument (endoscope), equipped with a camera at its end, which is made to proceed along the colon insufflating carbon dioxide to allow to stretch the walls and inspect the mucosa. The examination lasts an average of 30 minutes and is carried out by practicing sedation through intravenous drugs, to promote greater tolerance to the procedure. In order to undergo the colonoscopy, it is necessary to perform an intestinal preparation that includes a diet lack of residues (fruits, vegetables and whole foods) and the use of a laxative substance, to allow the colon to be cleansed of feces and thus allow a proper visualization of the mucosa. For the rectosigmoidoscopy instead the use of laxative enemas is sufficient.
Colonoscopy and rectosigmoidoscopy are safe procedures. However, there are complications that can occur during or after the examination, reported in only 2.8 cases per 1000 procedures. The major complications, perforation or bleeding, can be resolved in most cases during the examination by applying metal clips that close the perforation or stop the bleeding. In addition, in predisposed patients, reactions due to the use of sedation may occur, which can be reduced by proper history taking, monitoring of vital signs, and prompt intervention of healthcare professionals. Colonoscopy is contraindicated in cases of suspected perforation or acute diverticulitis.