Colonoscopy (endoscopic examination of the colon)

Colonoscopy at Kirurgen.dk – at a glance

• Waiting time: approx. 8 weeks for a non-urgent colonoscopy
• Cancer pathway: we see you within 7–10 working days on suspicion of cancer
• Sedation: sedative and pain-relief medication offered as standard
• Specialist: Bahir Hadi, consultant surgeon with many years of endoscopy experience
• Price: free with a GP referral (under the Danish public health insurance)
• Location: Charlottenlund, 5 min from Kystbanen – easy access from the whole Copenhagen area

Endoscopic examination of the bowel (Colonoscopy)

Colonoscopy is an endoscopic examination of the bowel, where a flexible tube, about the thickness of a little finger, is passed through the large intestine, which has a length of approximately 90-120 cm. Complete colonoscopy to the cecum can be performed in about 98%. In the remaining 2%, it is supplemented with a CT scan. The colonoscope is 150 cm long. In addition to a TV camera, it contains channels for air, water, suction, and instruments.

When is colonoscopy used?

It is agreed that colonoscopy is the best bowel examination. Colonoscopy is used for the diagnosis of:

• anal bleeding, low hemoglobin, weight loss, abdominal pain, changes in bowel habits, etc.
• screening for colorectal cancer, both with and without familial occurrence
• ongoing monitoring of patients with colorectal polyps
• follow-up after surgery for colorectal cancer, etc.

The Danish Health Authority recommends that close relatives of people with rectal or colorectal cancer undergo regular colonoscopy every 3 or 5 years.

The colonoscopy bowel examination provides a good view of the inside of the intestine. If signs of illness are found, it is possible to take tissue samples (biopsy) and also perform minor surgical procedures. In 20% of patients, polyps will be found and removed during the bowel examination.

How long does a colonoscopy take?

A colonoscopy bowel examination takes 15 to 45 minutes. In cases where the examination is difficult, the reason is typically that the colon is unusually long (can be up to 280 cm) and tortuous. It can also be unusually positioned, which is seen, for example, after major operations.

Is the colonoscopy examination uncomfortable?

The bowel itself has no pain nerves, which is why, for example, cutting and burning the mucous membrane does not cause discomfort.

However, there are pain nerves in the mesentery, which is the term for the bowel's suspension. Discomfort or pain can be triggered by pulling on the mesentery when straightening the bends of the colon during the insertion of the scope.

The discomfort is typically short-lived and ceases as soon as the bowel loop has passed and straightened out.

We recommend pain relief and sedative medication during the colonoscopy bowel examination.

The choice is entirely yours, but be aware that operating machinery and driving a car are not recommended for the rest of the day. In these cases, it may be practical to have an accompanying person.

Preparation for the colonoscopy examination

A prerequisite for a good result of the colonoscopy bowel examination is that the bowel is thoroughly cleansed. This involves both some dietary restrictions and the use of a cleansing agent.

Diet

• Seeds from food can block the examination equipment. Therefore, for the last 3 days before the colonoscopy bowel examination, you must not eat foods containing seeds, e.g., seeded rye bread, sesame seeds, flax seeds, and similar.
• The day before the colonoscopy bowel examination: Eat until one hour before the cleansing begins. Do not eat a very large meal. Thereafter, only clear liquids, e.g., cordial, soda, apple juice, Faxe Kondi, Cola, tea, coffee, sparkling water, broth, sorbet (ice pop) without berries, beer, wine. Preferably no red wine. No dairy products, no creamed or "thick" soups (such as tomato soup and asparagus soup). Drink plenty. Preferably sugary to get some calories. Please avoid beetroot juice and blueberry juice.
• On the day of the colonoscopy, tea, coffee, cordial, and water may be drunk as needed.
• Regular medication should be taken as usual.

Cleansing

Cleansing starts 4 days before the colonoscopy bowel examination.

Here you start by taking 1 Dulcolax tablet of 5 mg x 2 daily for 3 days before starting the cleansing with Picoprep - remember to bring the requisition provided to the pharmacy.

For cleansing the day before the colonoscopy, Picoprep is used, which is provided free of charge at the pharmacy - remember to bring the requisition provided. The package contains 2 sachets of powder.

• At 2 PM, take the first sachet as follows: Take a glass with 150 ml of cold water. Pour the powder from one sachet into the water. Stir the mixture for 2-3 minutes. When it no longer fizzes, the mixture is ready. Drink it within 15 minutes. Drink a minimum of 1½ liters of clear liquid over the next 4-6 hours.
• At 8 PM, take the second sachet of Picoprep and drink a minimum of 1½ liters of clear liquid within the next 2-4 hours.

Reactions to the cleansing vary, so it can take between 3-8 hours for the cleansing to take effect.

The cleansing before the colonoscopy bowel examination will result in watery diarrhea. It is necessary to be near a toilet and it is not recommended to leave the house while the cleansing is taking place.

• It can also affect your night's sleep.
• Many experience some abdominal cramps or nausea.
• Many become irritated around the anal opening. Apply a good fatty cream to this area several times.

If you are taking daily medication, please read the instructions in the package regarding the use of other medications. You should not follow the instructions in the package regarding the cleansing procedure itself.

After the colonoscopy bowel examination

• allow time (½ hour) for general observation. We offer a cup of coffee and a piece of bread.
• If you have received medication during the examination, you should have someone accompany you home.

Is the colonoscopy bowel examination dangerous?

Colonoscopy is a fairly safe bowel examination. Especially when the examiner is experienced. In fact, there are fewer complications with colonoscopy than with a traditional X-ray examination. The few complications are especially seen in connection with polyp removal. There may be bleeding or a perforation through the bowel wall. However, both happen extremely rarely. The risk is so small that it is completely outweighed by the benefits of finding, for example, cancer or precancerous conditions in time.

Kirurgen.dk would like to be contacted if, within the next few days after the colonoscopy bowel examination, you observe:

• Significant bleeding from the bowel
• Abdominal pain lasting more than 3 hours
• Chills and fever above 38.2

Price and referral

With a referral from your GP, the entire pathway is free. The clinic is part of the Danish public health insurance, and you pay nothing for the consultation, the colonoscopy, removal of any polyps or the biopsy result. The current waiting time for a non-urgent colonoscopy is around 8 weeks. If cancer is suspected, you are seen within 7–10 working days through the national cancer fast-track pathway.

Without a referral you can book directly as a self-payer. Contact the clinic for a quote so we can plan the right scope for you. The price depends on whether you need sedation and whether biopsies are taken.

How to find the clinic

The clinic is at Hans Edvard Teglers Vej 9, 1st floor, 2920 Charlottenlund, about a 5-minute walk from Charlottenlund Station on the Coastal Line. This makes colonoscopy in Charlottenlund convenient for patients from Hellerup, Gentofte, Klampenborg, Lyngby and most of the Copenhagen area. From Østerbro or central Copenhagen the train takes around 15 minutes.

If you drive, there is usually free time-limited parking on Hans Edvard Teglers Vej and the surrounding residential streets. Bring a companion if you choose sedation for the colonoscopy. You cannot drive a car or ride a bike for the rest of the day.

Colonoscopy in Copenhagen, Charlottenlund and as a self-payer

• Colonoscopy in Copenhagen: we are 15 minutes from Østerbro and central Copenhagen by the Coastal Line. Most patients from Copenhagen choose us for the short waiting time and the same specialist throughout the whole pathway.
• Colonoscopy in Charlottenlund and North Zealand: the clinic serves Hellerup, Gentofte, Klampenborg, Lyngby, Holte and the rest of North Zealand.
• Private colonoscopy (self-payer): without a referral you can book directly. Contact the clinic for a concrete quote – the price depends on whether polyp removal and sedation are needed.
• Colonoscopy with sedation: we offer sedative and pain-relief medication to everyone. General anaesthesia is not necessary and is not normally used for a colonoscopy.

Frequently Asked Questions about Colonoscopy (FAQ)

Does a colonoscopy hurt?

Most people only experience mild discomfort or a feeling of pressure in the abdomen during the examination. We always offer relaxing and pain-relieving medication, so you feel as little as possible. The examination itself typically takes 20-30 minutes.

References:

• Ristikankare, M., et al. (2000). Sedation and analgesia in colonoscopy. Gastrointestinal Endoscopy. - The study shows that correctly applied sedation and analgesics significantly reduce patient discomfort and increase satisfaction with the procedure.

Why is bowel preparation before the examination so important?

For the doctor to be able to see the entire lining of the bowel and detect even small polyps (precancerous lesions), the bowel must be completely clean. If the bowel preparation is not optimal, the risk of overlooking important changes increases, and the examination may need to be repeated.

References:

• Froehlich, F., et al. (2005). Impact of colonic cleansing on quality and diagnostic yield of colonoscopy. Gastrointestinal Endoscopy. - Documents the direct correlation between the quality of bowel cleansing and the ability to diagnose polyps and cancer.

What happens if you find a polyp?

If we find a polyp during the colonoscopy, we usually remove it immediately. This is painless and prevents the development of bowel cancer, as most cases of cancer start as benign polyps.

References:

• Zauber, A. G., et al. (2012). Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine. - The groundbreaking study proving that prophylactic removal of polyps via colonoscopy reduces colorectal cancer mortality by over 50%.

CONTACT INFORMATION

Hans Edvard Teglers Vej 9, 1.sal. 2920 Charlottenlund

• Phone: +45 39 64 01 25
• Email: mail@kirurgen.dk

APPOINTMENT BOOKING

We are on the phone Monday-Thursday from 9 AM to 12 PM

FOR REFERRING PHYSICIANS

Provider number 215430

Large intestine