Dr. Hall graduated from Indiana University School of Medicine in 1984 and completed her Family medicine Residency in 1987. During her residency she spent time at Kendrick Hospital (now St.Francis of Mooresville), learning how to do colonoscopies. She was one of the founding members of Kendrick Colon and Rectal Associates p.c. From there she left to help form American Health Network, a large group of primary care and specialty physicians practicing in Indiana and Ohio. In addition to her clinical practice, she has served on numerous local, state, and national medical organizations. Currently she is the President of the Indianapolis Medical Society Foundation.
Colonoscopies are usually done with IV sedation. This means that the doctor will instruct the nurse to give you medicine in your IV to keep you sleepy but arousable. It is important for your doctor to wait for the medicine to make you sleepy before they start. The doctor will then give more medicine during the procedure if you begin to awaken.
Red coloring can imitate blood in the colon. So in an effort to not confuse or worry your doctor it is best to avoid the color red the day before your colonoscopy.
We all have bacteria in our digestive system and part of the role of these bacteria is to help digest sugar. Unfortunately, during this digestion process the bacteria can produce Methane gas. Methane is a combustible gas. If hot cautery is required to remove polyps in the presence of Methane there would be a risk of combustion.
The small intestine gets angry when we begin to clean the colon. It reacts by producing mucous. The mucous in the small intestine will then slide down into the right side of the colon and it could potentially cover small or flat polyps. The second dose of the colon prep continues to clean the colon and acts like a rinse to remove the mucous.
Most colonoscopies are done with IV sedation which is medicine which is controlled by the doctor doing the colonoscopy. Propofol is a medicine that requires, because it is a general anesthetic, an anesthesiologist or a nurse anesthetist. Propofol is also given in the IV. The patient goes completely asleep but without a tube being placed in the airway. This medicine is used when the patient has increased health risks or known bowel adhesions.
Some people request to have a colonoscopy without any medicine. This is something that has to be discussed with the doctor BEFORE arriving for the colonoscopy. If the patient and the doctor agree, then yes, you can have a colonoscopy with out any anesthesia.
Your doctor’s office should check to make sure that your exam is a covered procedure. But, since you are the one who will be stuck with the bill, if they do not, my advice is, for you to also check. Insurance companies can be tricky and agree to pay for “screening” colonoscopies but change up and not pay at the same level if polyps are found. Everybody should know their own policy.
During a colonoscopy air is put in your colon so the doctor can open the colon and see where it goes. As the scope is being withdrawn the doctor should try to remove air. If you have a lot of polyps to be removed or if you have a lot of bowel adhesions then there will be more air. The best thing to do is to release the gas from your rectum as soon as you start feeling it. Also, sitting on the toilet one last time before you leave the surgery center is a good way to get rid of any extra gas.
Regardless of the colon clean-out that you choose, the end goal is a clean colon. The day of the procedure a lot of patients will pass yellow liquid and be concerned that they area not cleaned out. If the yellow liquid is clear then they are cleaned out and they are just passing digestive juices. The stomach and small intestine think any minute that you are going to come to your senses and feed them. So they are making juices in overtime mode hoping to get lucky. Since your digestive tract is clean the juices fall down into your colon and pass out your rectum as clear yellow liquid. If you are passing cloudy or brown liquid then you probably are not well cleaned out and you should tell your nurse as you are being admitted. Tell them the first thing so that they can inform the doctor to see if any further clean out is required. Remember the quality of your exam depends on 2 things: #1 How good your doctor is. #2 How clean your colon is. You could have the best doctor in the country but if your colon is not well cleaned out you will have a substandard exam.
There are several different colon preparations. Your doctor should have discussed the options with you to decide which would work the best for your situation. The colon prep that is dreaded the most is a gallon of liquid that is taken in divided doses. This is a prescription prep and unfortunately for some people it is the only option. The gallon prep has been FDA approved and is the safest prep for the kidneys. Patients that have even mild kidney problems should use this prep. There have been instances of patients using the other prep options and harming their kidneys. No prep is risk-free; so, the decision as to which colon prep is appropriate for you should be made after consulting with the doctor.
Lots of decisions are made prior to you undergoing a colonoscopy. Dr Hall likes to review your medicines, your allergies and your health history. This information helps her decide what type of anesthesia (IV sedation or Propofol) will be best for your procedure. Also, some medicines need to be adjusted or held and this visit allows that decision to be made. Frequently, labs need to be checked in order to decide which prep would be optimal. Finally, she will examine you. In this examination she evaluates your heart, your circulation, your thyroid, your lungs, and your abdomen. Specifically, she wants to know that you do not have a heart arrhythmia or murmur that would require special care. Also she needs to know how well your lungs function before she gives you IV sedation. She also examines your abdomen to make sure your spleen and liver are not enlarged. The colonoscope will pass by the liver and spleen and if one of these organs are enlarged it is important for Dr Hall to know that a head of time. Lastly, she listens to your abdomen to make sure she does not hear an enlargement in your abdominal aorta. Obviously, an aortic aneurysm diagnosis would require further cardiac work up. This visit, also, gives you the opportunity to have all of your questions answered.