Colonoscopy and Pre-Cancerous Screening

It may not be an easy decision to have a colonoscopy, but a colonoscopy can be lifesaving. The caring physicians at the Center for Colon & Rectal Health understand that many patients may fear having a colonoscopy or feel embarrassment when discussing intimate details of the colonoscopy procedure. Our physicians have completed fellowships and have advanced training to provide the best possible patient care and state-of-the-art colon and rectal services. As surgeons, the CCRH physicians are experts in both the surgical and non-surgical treatment of colorectal diseases.

All CCRH physicians are double board certified by the American Board of Colon and Rectal Surgeons and the American Board of Surgery. The caring and professional medical staff at CCRH will assist you in making an appointment and providing information about the procedure. Our physicians are available to answer any questions you may have in making decisions to take preventive measures for your health. We provide compassionate care to identify medical conditions and answer your questions before and after your colonoscopy. We strive to provide exceptional care to our patients and our community.

All of our colonoscopy procedures are performed at The Endoscopy Center at St. Mary located on the campus of St. Mary Medical Center in Langhorne, PA, at St. Mary Medical Center proper, or at Doylestown Hospital in Doylestown, PA, depending on your geographic preference.

What is a Colonoscopy?

A colonoscopy is an exam using an endoscope, which is a medical device with a light attached, to detect changes or abnormalities in the large intestine (colon) and rectum. Colonoscopy screening is for asymptomatic patients and is one of the most accurate tests available in preventing colon cancer. Surveillance colonoscopy is for follow up of known risk factors such as a personal history of polyps.  The colonoscopy takes about thirty to sixty minutes and is generally repeated every ten years if no abnormalities are found.   The entire colon is inspected during the procedure.

Depending on your personal and family risk factors, your physician at the Center for Colon & Rectal Health will advise and discuss the colonoscopy procedure and the health benefits of pre-cancerous screening. If you are concerned that you are at a higher risk for colorectal cancer, ask your primary care physician about colonoscopy screening or schedule an appointment for a consultation with one of the physicians at the Center for Colon & Rectal Health. Colonoscopy screening typically begins at age 50 in low-risk individuals. This means that if you have no family members with colorectal cancer or certain other cancers, and you have no symptoms such as rectal bleeding or a change in bowel habits, you should not need a colonoscopy before age 50.

Colorectal cancer almost always begins as a non-cancerous/benign mass of tissue or polyp which slowly turns cancerous over a period of many years. If, during the colonoscopy, evidence presents itself requiring further evaluation, polyps or other types of abnormal tissue are removed or biopsied during the colonoscopy procedure.

With offices located in Langhorne and Doylestown, the CCRH team of medical staff is available to answer any questions and accommodate your busy schedule.  Our convenient online appointment request form, located on this website, provides you with the opportunity to request an appointment at your convenience.

Colonoscopy Preparation

In preparation for a colonoscopy, a thorough cleansing of the colon is required before the test. Diet and medications may need to be adjusted. Please see our Patient Forms link for a complete listing of downloadable routine preparations and more information. The CCRH medical staff is available to answer any questions you may have about the preparation process.  On the day of your colonoscopy, intravenous sedation is given to manage any discomfort.

There are a variety of bowel preparations available to clean out the colon; both prescription and over the counter.  Lower volume preps are sometimes better tolerated, but factors such as taste, medical conditions like diabetes and kidney issues, and patient preference are all taken into account.   We will work with your particular needs to find a means of cleansing your colon that will be acceptable to you.

On the day of your procedure, you will meet with an anesthesiologist who will supervise the sedation for the colonoscopy. You are not awake and should not feel any discomfort during the procedure.   Your surgeon will discuss the findings afterwards-once you are awake.

Alternatives to Colonoscopy

Barium Enema:  A special x-ray of the colon and rectum, contrast (barium) is inserted via the rectum and fills the entire colon.  Sometimes air is also used along with the barium to see better details if polyps are found.  You are awake for the procedure.  This is a less accurate test, and any abnormalities will likely lead to a therapeutic colonoscopy afterwards.  Barium enemas are repeated at 5 year intervals since it is not as accurate at detecting polyps.

CT (Virtual) Colonography:  Similar to a barium enema, you are awake for the procedure.  The patient drinks contrast prior to the procedure and, once enough time has passed for the contrast to move down into the colon, a catheter is inserted into the rectum and the colon filled with air as well.

Pill Camera Colonoscopy:  Not available in the United States yet but is FDA approved.  A camera is swallowed and images are taken every few minutes once the camera gets to the colon.  A bowel preparation is required prior to swallowing the camera.

Therapeutic Colonoscopy

Colonoscopy is the only screening procedure that can be therapeutic as well as diagnostic. This means that if an abnormality such as a polyp is found, your CCRH surgeon will perform a minimally invasive procedure immediately, removing both small and larger polyps as preventive measures to colon cancer.

There are times when a polyp is too large to remove at one time.  In these cases, to avoid surgery, polyps may be removed in a piecemeal fashion over a period of months.  Before removing any precancerous polyps, anything abnormal is closely evaluated via the monitor. Using a snare (a small surgical loop instrument threaded through the scope during your colonoscopy) and cautery (an electrosurgical instrument that cuts and prevents bleeding at the same time), the polyp is removed and you are evaluated for bleeding or perforation.  Endoscopic clips may be placed to close a defect left by the snare or to control bleeding.  Any tissue samples taken during the colonoscopy are tested for evidence of precancerous or cancerous tissue.

Many patients are referred for surgery when a polyp is considered too large or too risky to remove colonoscopically.  As surgeons, and having completed fellowships in colorectal surgery, most of these larger polyps can be removed colonoscopically even if the risk of complications are higher than a standard colonoscopy.  Should a perforation occur, surgery can immediately be performed, often laparoscopically.

At the Center for Colon & Rectal Health, our surgeons have gained regional recognition for providing our patients with the highest level of expertise in removing large polyps during the colonoscopy procedure, which otherwise may require a large incision. If initial testing indicates uncertainty, we may, with your consent, perform your colonoscopy in the operating room where, if we find that surgery is required, your CCRH surgeon will immediately operate so that the issue is resolved that day.

Following your Colonoscopy

You may feel bloated or pass gas for a few hours after the exam as you clear the air from your colon. The physicians at CCRH carefully evaluate the results of the colonoscopy and then share the results with you. A colonoscopy is considered negative if no abnormalities are found in the colon. A colonoscopy is considered positive if any polyps or abnormal tissue is found in the colon. If there is any concern about the quality of the view through the scope, or if the exam could not be completed, a barium enema or virtual colonoscopy may be recommended to examine the rest of your colon.

You will be called with pathology results by the office staff or your physician, and your follow-up colonoscopy appointment confirmed.  Typically this is 3 or 5 years depending on the type of polyp, but can be as much as 10 years or as little as 3 months.

After your colonoscopy, it may take an hour for the sedative to wear off but, for some patients, it may take up to a full day with rest.  Because of the sedation, recommendations will be made for patients to coordinate driving arrangements to and from the procedure.  Driving is not permitted until the following day.

Our medical staff at the Center for Colon & Rectal Health will assist all CCRH patients through every step in the colonoscopy procedure.  They are available to answer any questions prior to your colonoscopy and respond to any concerns you may have after the colonoscopy regarding your results.

A follow-up consultation with your CCRH physician may be scheduled should the results of your colonoscopy indicate further testing or evaluation is required.

More Information

Our goal is to provide you with a safe and comfortable environment. Every patient is different. We strive to offer you the most accurate and effective treatment options.

Please contact Bucks County’s premier colorectal group to schedule an appointment and to learn more.

St. Mary Medical Center
St. Clare Medical Building, Suite 130
1203 Langhorne-Newtown Road
Langhorne, PA 19047