What is the Exam? Cause Pain?


Colonoscopy is a fundamental test to screen for colorectal cancer, the third most common type in Brazil, according to the Inca (National Cancer Institute). Routinely, the procedure is indicated from the age of 45 (before, age was 50), but some people can (or should) perform it earlier because of a family history of cancer, in addition to suspicions after the presence of cancer. symptoms such as change in bowel habits, blood in the stool, excess diarrhea, weight loss, and abdominal pain.

The preparation can be really boring, but it is a quick and painless procedure, in addition to being considered a therapeutic method, since it is possible to remove the polyps (an accumulation of cells, which reproduces quickly, and looks like a wart) during the procedure itself. colonoscopy.

All about colonoscopy

What is colonoscopy?

It is an endoscopic examination performed with a microtube, with a camera at the end, which is introduced through the anus and analyzes the rectum, large intestine and the final portion of the small intestine (ileum). From this, the doctor can assess, through the images, if there are polyps (which are like small warts), diverticulitis (inflammation of the diverticulum, which are small pouches in the wall of the large intestine), tumors or bleeding in the regions where the tube passes.

What is the exam for?

The main functions of colonoscopy are to investigate symptoms or screen for colorectal cancer or possible inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. The signs that can draw attention are: constant diarrhea, bleeding in the stool, abdominal pain, weight loss and change in bowel habits (sometimes constipated, sometimes looser).

In addition, the exam has other benefits, according to Henrique Perobelli, gastroproctologist at the São Camilo Hospital Network in São Paulo. “Colonoscopy not only prevents, but also treats possible lesions that, in the future, may be cancerous to the patient,” he says. “The polyps [pequenas verrugas]for example, can be removed during the exam”, he explains.

How is colonoscopy prepared?

This is the part that patients complain the most, according to doctors. That’s because exam preparation can be boring. It involves a low-fiber diet the day before, with greater consumption of water and liquids (tea, coconut water or strained juices), in addition to the use of laxatives, which promote severe diarrhea hours before the colonoscopy. This preparation can be done at home or in the hospital or clinic, depending on the patient.

The idea, according to Denise Priollicoloproctologist and coordinator of the medical course at Faculdade Pitágoras, in Codó (MA), is that there is a total cleaning of the intestine so that the doctor can properly evaluate the regions.

“It’s in the large intestine where the feces are, so, to see the wall of it, we need to remove the contents. It’s like a house full of furniture and, to look at the walls, if there are holes or not, we need to remove all the furniture “, explains the doctor, who also specializes in gastroenterology.

According to Priolli, the ideal is to wait until the stool comes out as a yellow liquid, as if it were pee. “That way, we know that the intestine is clean and we will be able to see it. If there is feces there, something that is hidden can pass”, she explains.

From what age should it be done?

According to experts consulted by Live wellcolonoscopy is now a routine exam for people over 45 years old – before, the recommended age was 50. This means that, if she has never had the procedure before, it is from this age group that she should perform it.

“It is at this age that we start screening for colorectal cancer and colonoscopy is an excellent diagnostic test”, explains Orcina Duarte, a proctologist at HC-UFPE (Hospital das Clínicas, Universidade Federal de Pernambuco), of the Ebserh network. .

If normal, the exam can be done every 10 years, depending on the patient, or every 5 years — the recommendation may change according to medical advice.

Who else should have a colonoscopy?

People with a family history of colorectal cancer or inflammatory bowel diseases should undergo a colonoscopy before age 45, as well as patients who have symptoms, such as changes in bowel habits (sometimes constipated, sometimes with diarrhea), weight loss, blood in the stool, strong abdominal pain.

“If that person’s mother, for example, had colorectal cancer at age 40, she should have a colonoscopy at age 30, to catch the lesions before they turn into cancer,” he explains. Perobelli.

In addition, patients who underwent radiotherapy for tumors in the pelvis, ovary or prostate should undergo the examination 3 years after the end of treatment. According to the UFPE doctor, radiotherapy increases the risk of having cancer at the site. Therefore, it is important that this group has follow-up.

What can the exam identify?

Polyps (which can be removed during examination), bleeding, inflammation, tumors and diverticulitis (inflammation of the diverticulum, which are small pouches in the wall of the large intestine). With any suspicion of colorectal cancer, a material is collected and sent for biopsy.

How long does it last?

It depends on each patient, but the colonoscopy lasts an average of 20 to 40 minutes.

“There are more difficult, less flexible and elastic intestines, and this can hinder the passage of the device (microtube). Intestines of patients who have repeated diseases, inflammation crises, diverticulitis or tortuosity, which is like an accordion in the intestine, leave the passage of the device to the ileum is more difficult”, says Alexandre Marsillac, coloproctologist at Hospital São Vicente de Paulo (RJ) and head of the Brazilian College of Surgeons.

Does colonoscopy cause pain?

Not. As with endoscopy, an exam that analyzes the digestive system, patients are sedated and sleep. The most that can occur, according to experts, is discomfort with gas after colonoscopy, which is resolved with medicine (simethicone).

Despite being a minimally invasive test, there is a need to be performed in a hospital or clinic, with the assistance of an anesthesiologist. The professional who performs the examination must be an endoscopist or coloproctologist.

How does anesthesia work before the exam?

The patient is sedated to sleep and not feel any discomfort during the examination. That’s why colonoscopy should be performed in clinics or hospitals (especially when elderly), so that the person is monitored throughout the procedure.

After the exam, there is a recovery time until the person wakes up and can return home – always with a companion over 18 years old.

How is the patient after the exam?

Well. What he can feel is the feeling of gas, which can be resolved with medicine. It is also not recommended to make major decisions on this day because of the effects of sedatives, as well as driving or performing any activity that poses risks. That’s why to perform the exam, the patient must be accompanied by someone over 18 years old.


Alexandre Marsillaccoloproctologist at Hospital São Vicente de Paulo (RJ) and head of the Brazilian College of Surgeons; Denise Priollicoloproctologist and coordinator of the medical course at Faculdade Pitágoras, in Codó (MA); Henrique Perobelli, gastroproctologist at the São Camilo Hospital Network in São Paulo; and Orcina Duarteproctologist at HC-UFPE (Hospital das Clínicas, Federal University of Pernambuco), from the Ebserh network.

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