Colonoscopy Consent ๐Ÿ’ฉ

๐Ÿ” Procedure

  • Colonoscopy โ€“ visual inspection of the entire colon using a flexible camera inserted via the rectum.

๐Ÿ’ก Indications

  • Investigation of rectal bleeding, anaemia, or change in bowel habit
  • Colorectal cancer screening or surveillance in high-risk patients
  • Biopsy of lesions or removal of polyps

๐Ÿงพ Procedure Walkthrough

  • Performed under sedation ยฑ analgesia. Patient lies on left side.
  • Patient must follow a strict bowel preparation the day before the procedure to ensure clear views โ€” this may involve laxatives and a special diet.
  • A flexible camera is inserted via the rectum to visualise the entire colon.
  • COโ‚‚ or air is insufflated to distend the colon for better visualisation.
  • Procedure takes ~30 minutes; biopsy or polyp removal may be performed.
  • Patient monitored post-procedure until safe for discharge.

โš ๏ธ Risks & Complications

  • Common (1 in 10): Abdominal bloating, discomfort, minor bleeding from biopsy/polyp site
  • Less Common (1 in 100): Incomplete procedure, sedation-related issues such as drowsiness, nausea, or breathing difficulties
  • Rare (1 in 1,000): Bowel perforation, heavy bleeding requiring intervention
  • Very Rare: Anaesthetic complications, infection

๐Ÿ’ฌ Common Patient Questions

  • Will it hurt? โ€” Some cramping or bloating is expected, but sedation is given for comfort.
  • Will I be asleep? โ€” Most are drowsy but awake; general anaesthesia is not usually required.
  • Can I go home after? โ€” Yes, but you must not drive for 24 hours post sedation.
  • Will I be able to eat? โ€” Resume normal diet after recovery unless told otherwise.

โœ… Benefits

  • Direct visualisation of colon
  • Ability to biopsy suspicious areas or remove polyps immediately
  • Prevention or early detection of colorectal cancer

๐Ÿ”„ Alternatives

  • CT colonography (less sensitive for small polyps)
  • Flexible sigmoidoscopy (views only part of colon)
  • No investigation โ€“ not recommended in most cases due to risk of missed serious pathology

๐Ÿง  Special Considerations

  • Ensure anticoagulation status reviewed โ€“ may need to pause warfarin or DOACs
  • Check renal function if bowel prep or contrast is used
  • Assess capacity and language needs (interpreter if required)
  • Ensure patient understands not to drive, operate machinery, or make major decisions for 24 hours post sedation
  • Advise who to contact in case of bleeding, severe pain, or fever after the procedure

๐Ÿ—ฃ๏ธ Example Consent Script

  • We are recommending a colonoscopy to investigate your symptoms. This involves inserting a flexible camera into your bowel to look for causes such as bleeding, inflammation, or growths.
  • The benefits include diagnosing conditions, removing polyps, or taking biopsies during the same procedure if needed.
  • Risks include bloating, minor bleeding, or โ€” rarely โ€” perforation of the bowel or a reaction to the sedation. You will be monitored closely throughout.
  • You will receive sedation to help you relax. After the procedure, you should not drive or make important decisions for 24 hours.
  • You have the right to ask questions, refuse the procedure, or withdraw consent at any time. Do you have any questions or concerns?

๐Ÿ”— External Resources