Colonoscopy is the gold standard for examination of the
colon. This entails inserting a flexible tube through the anus and advancing it up along the rectum and colon until
it reaches the beginning.
Colonoscopy is usually done under sedation though some patients opt to be awake and watch the entire proceeding. The major advantage of colonoscopy is that it is not just a diagnostic procedure, but it also allows for removal of polyps and to take tissue samples for testing.
Most people are fearful of colonoscopy because they feel that it is a very invasive procedure and are concerned about pain. Most patients do not feel any pain or even remember about the procedure after the they wake up from sedation. The most feared complication that may occur is that of perforation where the scope results in damage and a break in the colon wall. If that happens, colorectal surgery is usually required to rectify it. The risk is usually less than 0.1%.
|Colonoscopy||Barium enema||CT colonography|
|Advantages||Accuracy- highest, especially for smaller polyps||Lower perforation risk||Lower perforation risk|
|Disadvantages||Perceived invasive test Perforation risk 0.1%||Least accurate |
Perforation risk 0.04%
|Accuracy in between barium enema and colonoscopy. Detection for polyps drop when size below 10mm Perforation risk 0.05 %|
|Sedation||Available||Not available||Not available|
|Intervention||Allows biopsy and removal of polyp||No||No|