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A variety of techniques are available to investigate the left side of the colon and the rectum but the “gold-standard” remains direct visualisation with flexible endoscopy. It is the most accurate means by which pathological processes may be identified and offers advantages in that specimens may be removed to allow careful assessment and conditions (such as polyps and early cancers) effectively treated. It is the most appropriate and most commonly performed investigation for rectal bleeding
An enema inserted into the anal canal and rectum to assist with a full evacuation of the bowel usually after admission to hospital as a day case. A consent form is signed by surgeon and patient. The scope is inserted through the anal canal and guided around the left colon and rectum whilst the patient is lying on the left side.
The procedure takes about 5 to 10 minutes to complete and the results can usually be given and clearly understood immediately upon completion. Any biopsies taken will be sent for pathological assessment and results may not be available for several days. Normal diet and activity may be resumed over the next 24 hours although a small amount of abdominal discomfort may remain over this period which usually improves with passing wind.
Complications of the procedure include colonic bleeding (less than 1 in 100 cases) and perforation (less than 1 in 1000 cases). Both complications may require hospital admission, observation and/ or emergency surgery.