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Colonoscopy

COLONOSCOPY – THE PROCEDURE

On the day of the colonoscopy you will be brought to the assessment area where a nurse will insert an intravenous that will allow the anesthetist to give you medication for the colonoscopy. You will then be transferred to the colonoscopy suite where you will have both monitors and oxygen placed on you. Once in the room you will be introduced to the physicians who will be giving you the medication and performing the colonoscopy. Sometimes the medication can cause stinging at the injection site. Possibilities of other side effects/complications from the medication include an allergic reaction, blood pressure fluctuations, and rare heart or lung complications. These serious complications are extremely rare. The anesthetist will be available to discuss any further questions.

You will be asked to lie comfortably on your left side or on you back. Afterwards the anesthetist will give you medication known as sedatives to make you relax. The sedation will tend to make you sleepy and forgetful. The procedures will then start and should last approximately 20 minutes. Most people say that the preparation for the colonoscopy is the hardest part of having the colonoscopy. Majority of patients sleep through the procedure while others remain awake and watch the procedure on the TV.

Once the procedure is done you will be taken to the recovery room by a nurse who will continue to monitor you until the medications have worn off and you are awake and alert. Once you are ready to go home you will be given clear instruction on how to care for yourself after the colonoscopy along with note stating the appropriate follow up for your procedure. You MUST ALWAYS have another adult with you to take you home after the procedure.

You cannot drive a motor vehicle or operate machinery or engage in other tasks that require attention or concentration for 24 hours after having sedation.

POST COLONOSCOPY INSTRUCTIONS AFTER A BIOPSY AND/OR POLYP (GROWTH) REMOVAL

If you were informed that you had a biopsy of removal of polyp as part of the colonoscopy and you are on blood thinners such as Aspirin, Plavix, and or Coumadin it is important that you start your blood thinners again as per the instructions of your physician. If you are unsure what you should do please ask the staff at the Beverly Hills Endoscopy prior to leaving the clinic.

You may experience bloating and cramps after your procedure. This feeling is caused by the air in your stomach that was inserted during the colonoscopy. Walking, warm fluids and warm bath will help relieve this feeling. Similarly, avoiding certain foods such as legumes, milk products and certain green vegetables such as broccoli for the first 24 hours may be helpful.

It is not uncommon to have small amount to bleeding with your bowel movements. This may appear in the stool, toilet bowel or on toilet paper. This bleeding should resolve within 24 hours. If the bleeding does not stop or the bleeding is more significant in that you are seeing large volumes of blood or clots, you should go to the Emergency room right away.

IF A BIOPSY AND OR A POLYP WAS REMOVED IT IS VERY IMPORTANT THAT YOU KEEP THE FOLLOW UP APPOINTMENT WHICH WAS MADE BY THE BEVERLY HILLS ENDOSCOPY CLINIC. The results of your biopsy should be available within 2 weeks. If you have any questions regarding your follow up, please do not hesitate to contact the Beverly Hills Endoscopy at 647-352-3233

WHEN TO CALL A DOCTOR

It is very rare for serious complications to occur from a colonoscopy. If you are having:

  1. Severe pain in your stomach and / or discomfort that does not go away or gets worse.
  2. Fever and or chills with a temperature that is greater than 38.5 degrees Celsius or 101.3 degrees F.
  3. Nausea and vomiting
  4. Heavy bleeding with large volumes of blood or clots.

If any of these occur, get a friend and or family member to take you to the nearest emergency room. If you are unable to get someone to drive you, call an ambulance. Remember to bring your colonoscopy report with you

PRE – COLONOSCOPY CONSULTATION

Prior to having a colonoscopy, you may need to have a SEPARATE appointment at which you meet with a specialist who will go over your medical history and the indication for a colonoscopy. If your medical history is simple and you are deemed to be at low risk, you may be referred to us by your Family Physician to go directly to your procedure. Based on your health and the information we receive from your Family Physician, you may not need to attend a consultation on SEPARATE day.

If you are given a SEPARATE appointment for a consultation, you will meet with a specialist who will go over your medical history and the indication for a colonoscopy. A physical exam will be carried out followed by a discussion regarding the colonoscopy. It is IMPORTANT to have the consultation to ensure that the right procedure is being done to address your concerns and that it is safe for you to undergo the procedure. Once the procedure and its potential complications have been discussed and you agreed to have the procedure you will be asked to sign a CONSENT agreeing to have the colonoscopy done. Following you will be given a prescription and a clear set of instructions regarding the preparation of your bowel that is required for you to take before the colonoscopy can be performed. Prior to leaving the clinic you will be given a date and time for your procedure along with contact information for the Beverly Hills Endoscopy clinic such that if any questions arise you can call the clinic to have your questions addressed.

IF you are not able to attend the colonoscopy, it is YOUR RESPONSIBILITY TO CALL BEVERLY HILLS ENDOSCOPY at 647-352-3233. Beverly Hills Endoscopy expects a 3 working day notice for any cancellation and/or change of date. This will allow the Beverly Hills Endoscopy sufficient time to schedule another patient in your slot. If you do not show up to your appointment and you have not informed the clinic you will charged $150

WHAT IS A COLONOSCOPY?

A colonoscopy is a procedure that uses a flexible telescope (colonoscope) or a tube to look inside your large intestine or the colon in order to diagnose diseases like polyps (growths) and cancer of the large intestine. The colonoscope is also crucial for trying to determine why you may have a change in bowel habits, bleeding or abdominal pain. The colonoscope, which has a camera at the end of it, will be inserted into your rectum and moved along the entire length of the colon. Through a small valve on the colonoscope, air will be injected into the intestine allowing the doctor to see on a television in front of them the inside of the colon.

By performing the colonoscopy, the doctor will be able to see if there are any abnormalities inside the colon including any abnormal growths such as polyps and or cancers. If abnormal growths are detected the doctor will try to remove the growths or alternatively take a sample of the growth (biopsy). All the tissue samples taken at the time of the colonoscopy will be sent to a laboratory that will carefully assess the specimen to determine if the specimen is benign or cancerous.

POTENTIAL COMPLICATIONS OF A COLONOSCOPY

The complication from the colonoscopy are infrequent. The bowel preparation can lead to rare abnormalities in your electrolytes. It is therefore important that you tell you physician during your initial consultation if you suffer from any diseases that affect your kidneys or electrolytes. Similarly, if you suffer from any heart disease and or any respiratory symptoms it is important that you relay that to your physician at the time of your consultation.

The colonoscopy itself carries a small risk of both bleeding and or perforation (making a hole in the bowel). The risk of bowel perforation is about 1 in 3,000 for a diagnostic procedure, but if polyps need to be removed, the risk increases to 1 in 1,000. If a perforation occurs, surgery is usually needed. The risk of bleeding is also rare and occurs in approximately 1/2000 colonoscopies where polyps are removed. If bleeding occurs, it is often treated at the time of

After the colonoscopy is complete and you have recovered fully you will be sent home with a summary of your colonoscopy findings and follow up plans. You will need to arrange for a family or a friend to drive you home after the procedure. As you have received sedation for your colonoscopy you should NOT:

  1. Drive after the procedure and for the remainder of the day
  2. Operate machinery
  3. Make major legal decisions

Following your procedure, you it is recommended that you remain with company for the remainder of the day.

Once you are done with your colonoscopy you will be permitted to return to your regular diet. However, it is recommended that you stay away from heavy, fatty or spicy foods for the first 24 hours. You should not drink alcohol until the following day.

It is not unusual to have a sense of bloating and occasional cramps from the air that was used to inflate your colon during the colonoscopy. This feeling should resolve by passing gas. If you are difficulty passing gas you can try drinking warm fluids such as tea or coffee, walking and even a taking a warm bath.

It is normal to have stools that are either soft or liquid stools for the first 24 hours after the procedure with small amounts of blood. If these symptoms do not go away in 24 hours contact either the Beverly Hills clinic or your family physician.

PREPARATION

Click for part 1 Colonoscopy Preparation instructions

Click for part 2 Colonoscopy Preparation instructions

Dr. Ashwin Maharaj obtained his undergraduate degree in Biology/Physiology from the University of Western Ontario (BSc). e became certified through is a Diplomate of the American Board of Surgery and was certified as fellow of the American College of Surgeons (FACS) and recently recertified. He is a member of the Canadian Association of General Surgeons. His current clinical interests are devoted to outpatient acute and chronic gastrointestinal medicine/surgery as well as abdominal wall hernia surgery and practices in certified facilities in Toronto. He has research experience in gastrointestinal disease as well as surgical education teaching resident surgeons and medical students.

Dr. Diana Magee completed her undergraduate education at Cornell University followed by a Master of Public Health degree at Boston University. She received her medical degree from Queen’s University and completed her urology residency at the University of Toronto. While in residency she enrolled in the Surgeon Scientist program and completed her Master of Science in Health Services Research. She completed her fellowship in urologic oncology at Fox Chase Cancer Center in Philadelphia. Dr. Magee’s area of expertise is in the management of urologic cancers as well as performing minimally invasive surgery.

Dr. Pianezza completed his medical degree (MD) at the University of Ottawa in 2002. He became a member of the Royal College of Physicians of Canada (FRCSC). He then completed a one-year fellowship in minimally invasive surgery and endourology at the University of Alberta in Edmonton in 2008.

Dr. M. Pianezza has been a staff urologist in Sudbury at the Health Sciences North since January 2010. He was Head of Urology from February 2013 to September 2016. He is an Assistant Professor of Surgery at the Northern Ontario School of Medicine.

Dr. Heimrath completed his medical school at the University of Ottawa, his surgical residency at McGill University, and his Endourology, Minimally Invasive, and Robotics Fellowship at the University of Toronto. Dr. Heimrath’s areas of expertise include the management of complex kidney stones and urologic cancers as well as performing minimally invasive surgery. Since 2016, Dr. Heimrath has worked overseas in Malawi and Rwanda to explore opportunities to build urologic and surgical capacity in the developing world. He is a partner in the Urology Global Surgery initiative at the University of Toronto and holds a lecturer appointment with the University of Toronto.

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Dr. Luke Fazio is the current Chief of Urology at Humber River Hospital. Dr. Fazio received his medical degree from McGill University in 1999. Following this, he finished his Endourology and Minimally Invasive fellowship at the University of Toronto. As the Urology Medical Director, he has brought many minimally invasive programs to TCBH and is working on future projects. He currently sits on numerous committees and is an advocate for innovation in healthcare. He is the physician lead for the Da Vinci Robotic Surgery Program. He also is the Chair of the Innovation Committee.

Dr. Bhargava has a primary focus of providing care for her patients in the form of minimally invasive procedures and cutting edge technology. She is the Medical Director of TCBH Surgical Centre (The Clinic at Beverly Hills Healthcare) and has been instrumental in bringing Laser Hemorrhoid Treatment to her Centre.

Achievements:
Dr. Bhargava completed both her medical school and surgical residency at the University of Western Ontario. In addition to her Bariatric fellowship, she has also completed Minimally Invasive fellowship at the University of Cincinnati in Ohio.
Dr. Bhargava has published multiple research papers and lead articles.

Memberships:
Canadian Medical Association, Canadian Association of General Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Royal College of Physicians and Surgeons of Canada, College of Physicians and Surgeons of Ontario, and American Society of Bariatric Surgery