Informed Consent 📝: Patients must understand the procedure, potential benefits, risks (e.g., perforation, bleeding), and complications. Written consent is mandatory.
Bowel Preparation 🚽: Laxative prep (e.g., polyethylene glycol, sodium picosulfate) the day before clears the colon. Stress importance of hydration to avoid dehydration or electrolyte imbalance.
Sedation 💉: Light IV sedation with Midazolam ± Fentanyl (for analgesia). Monitor patient closely for respiratory depression.
Supplemental Oxygen 💨: Nasal O₂ often given, especially in elderly or those with comorbid respiratory disease, to reduce risk of hypoxia.
Procedure 📹: Colonoscope is inserted via rectum → advanced to caecum ± terminal ileum. Allows direct mucosal visualisation, biopsy, and therapeutic interventions.

📋 Indications

Colonic Disease 🔬: Investigation of chronic diarrhoea, constipation, or unexplained abdominal pain.
Screening for Polyps & Cancer 🎗: From age 50 (earlier if family history, FAP, Lynch syndrome).
Iron Deficiency Anaemia 🩸: To rule out occult lower GI bleeding.
PR Bleeding 🚨: Evaluation of rectal bleeding or suspected lower GI source.
Altered Bowel Habits 🔄: Persistent, unexplained changes in stool pattern.

🛠 Interventions

Polypectomy ✂️: Snare excision or hot biopsy. Essential for colorectal cancer prevention. Send for histology.
Biopsy 🧫: Of any suspicious or malignant-looking lesion.
Therapeutic Control of Bleeding 💡: Argon plasma coagulation or diathermy for angiodysplasia/bleeding lesions.

⚠️ Complications

Perforation 🕳: Rare but serious; more likely after polypectomy or in diverticulosis. Watch for peritonitis.
Bleeding 💉: Can be immediate or delayed (days later). Risk higher after large polyp removal.
Sedation Reactions 😴: Respiratory depression, hypotension. Continuous monitoring is essential.

🩺 Post-Procedure Care

Recovery 👀: Monitor until sedation has worn off. Observe for abdominal pain, fever, or rectal bleeding.
Activity Restrictions 🚗: No driving or operating machinery for 24 hours post-sedation.
Follow-Up 📑: Provide pathology results, arrange review, and give clear discharge instructions on red-flag symptoms.
Repeat Colonoscopy 🔄: Interval depends on findings:
- Normal colonoscopy → 10 years.
- Adenomas → 3–5 years depending on size, number, dysplasia.

💡 Clinical Notes

Ensure complete colonic examination. A withdrawal time of ≥6–10 minutes improves adenoma detection rate (ADR).
Alternative imaging: CT colonography if colonoscopy incomplete/contraindicated.
Anticoagulants/antiplatelets: assess bleeding risk, liaise with haematology/guidelines before stopping therapy.
Colonoscopy is both diagnostic & therapeutic → cornerstone of colorectal cancer screening programmes.

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Colonoscopy

🔎 About

📋 Indications

🛠 Interventions

⚠️ Complications

🩺 Post-Procedure Care

💡 Clinical Notes

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