INDICATION & PREPARATION

COLONOSCOPY
CECILIA EVAN
PEMBIMBING :DR. RENO RUDIMAN, DR., SP.B, SUBSP.BD, M.KES,
FICS, FISC
 ONCOLOGICAL NON-ONCOLOGICAL
• COLORECTAL CANCER • SIGMOID VOLVULUS
• GASTROINTESTINAL BLEEDING
• COLONIC IMPACTIONS.
 INDICATION

DIAGNOSTIC THERAPEUTIC
• SCREENING
• ELECTIVE

Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559274/
 INDICATIONS - SCREENING

• HISTORY OF INFLAMMATORY BOWEL DISEASE

• A FAMILY HISTORY OF COLORECTAL CANCER AT AGE <60 YEARS
• HEREDITARY POLYPOSIS (SUCH AS PEUTZ JEGHER SYNDROME AND FAMILIAL ADENOMATOUS
POLYPOSIS, CAUSED BY AN APC GENE MUTATION) AND NON-POLYPOSIS SYNDROMES (LYNCH I
AND II)
• SURVEILLANCE AFTER RESECTION OF COLORECTAL CANCER.
• INDIVIDUALS WITH FIRST DEGREE RELATIVES DIAGNOSED WITH COLON CANCER ARE
ENCOURAGED TO UNDERGO THEIR FIRST COLONOSCOPY AT AGE 40, OR 10 YEARS PRIOR TO
THE AGE THE RELATIVE WAS DIAGNOSED, WHICHEVER COMES FIRST.

Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559274/
 INDICATION - ELECTIVE

• known or occult gastrointestinal bleeding or stool positive for occult blood

• unexplained changes in bowel habits, patterns
• iron deficiency anemia or weight loss in elderly patients
• persistent abdominal pain
• suspected inflammatory or infectious colitis and barium enema showing radiographic structural
abnormalities.

Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559274/
 INDICATIONS - THERAPEUTIC
• excision and ablation of lesions
• treatment of bleeding lesions
• dilation of stenosis or strictures
• foreign body removal
• decompression of colonic volvulus or megacolon
• palliative management of known neoplasms.

Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022
Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559274
 CONTRA INDICATION

• INFLAMMATION FROM TOXIC MEGACOLON, FULMINANT COLITIS, ULCERATIVE

COLITIS, CROHN FLAIRS, DIVERTICULITIS
• ABSOLUTE CONTRAINDICATIONS TO COLONOSCOPY : PATIENT REFUSAL, RECENT
MYOCARDIAL INFARCTION, HEMODYNAMIC INSTABILITY, PERITONITIS, RECENT
SURGERY WITH COLONIC ANASTOMOSIS, OR BOWEL INJURY AND REPAIR. 

Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559274/
 PATIENT PREPARATION

• SIGNED INFORMED CONSENT

• FLEETS PHOSPHOROUS SODA
• ANTIBIOTIC PROPHYLAXIS FOR HIGH RISK (E.G. HX OF
ENDOCARDITIS, PROSTHETIC VALVES, VASCULAR GRAFT-1 ST YEAR)
• CLEAR LIQUIDS DAY BEFORE EXAM AND OF EXAM
• TAKE LAXATIVE IF CHRONIC CONSTIPATION
• TAKE NORMAL MEDICATIONS (CAUTION WITH DIABETICS)

Bhagatwala J., et al. Colonoscopy-Indications and Contraindications. 2015. Screening for Colorectal Cancer with Colonoscopy:2015.
American Collage of Surgeons. Colonoscopy.2017.
 CLEAR LIQUID DIET

Beverages: carbonated, coffee, kool-aid (avoid red), tea.

Desserts: Jello, clear popsicles

Fruit: Apple juice, cranberry juice, grape juice

Soups: Beef bouillon, clear broth

Sweets: hard candy, sugar.

Bhagatwala J., et al. Colonoscopy-Indications and Contraindications. 2015. Screening for Colorectal Cancer with Colonoscopy:2015.