Colonoscopy
Colonoscopy is an endoscopic examination of the colon. The colonoscope can be passed through the anus or a stoma. Colonoscopy remains widely accepted as the gold standard for screening and diagnosing various colorectal pathologies, particularly malignancies. (1)
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:
- Jayasinghe M, Prathiraja O, Caldera D, Jena R, Coffie-Pierre JA, Silva MS, Siddiqui OS. Colon Cancer Screening Methods: 2023 Update. Cureus. 2023 Apr;15(4):e37509
- Rockey DC et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005;365:305-11
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