Skip to main content

Colonic and Rectal Endoscopy

  • Living reference work entry
  • First Online:
Coloproctology

Abstract

Colonoscopy represents the main procedure for diagnosis and treatment of many colorectal disorders. Thanks also to the development of other endoscopic devices, using modern “high-definition” endoscopes in association with a correct technique, we can today offer patients a “high-quality” diagnostic and operative colonoscopy. In this chapter, we describe the basic components of modern endoscopes, actual indications and contraindications of colonoscopy, management of antithrombotic drugs, the different types of bowel preparation, principles of sedation, quality indicators and technique of colonoscopy, colonoscopy findings, and, finally, principles of operative colonoscopy. We also include indications for procedures alternative to colonoscopy, such as capsule colonoscopy and CT colonography.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  • Amato A, Radaelli F, Paggi S et al (2013) Carbon dioxide insufflation or warm water infusion versus standard air insufflation for unsedated colonoscopy: a randomized controlled trial. Dis Colon Rectum 56(4):511–518

    Article  PubMed  Google Scholar 

  • Appleyard M, Fireman Z, Glukhovsky A et al (2000) A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions. Gastroenterology 119:1431–1438

    Article  CAS  PubMed  Google Scholar 

  • Appleyard M, Glukhovsky A, Swain P (2001) Wireless-capsule diagnostic endoscopy for recurrent small-bowel bleeding. N Engl J Med 344(3):232–233

    Article  CAS  PubMed  Google Scholar 

  • ASGE Standards of Practice Committee (2009) Management of antithrombotic agents for endoscopic procedures. Gastrointest Endosc 70:1060–1070

    Article  Google Scholar 

  • ASGE Standards of Practice Committee (2012) Appropriate use of GI endoscopy. Gastrointest Endosc 75(6):1127–1131

    Article  Google Scholar 

  • Benjamin SB (1996) Complications of conscious sedation. Gastrointest Endosc Clin N Am 6(2):277–286

    CAS  PubMed  Google Scholar 

  • Boustière C, Veitch A, Vanbiervliet G et al (2011) Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 43(5):445–461

    Article  PubMed  Google Scholar 

  • Bretthauer M (2010) Turning science into clinical practice – the case of carbon dioxide insufflation. Endoscopy 42(12):1104–1105

    Article  CAS  PubMed  Google Scholar 

  • Calderwood AH, Jacobson BC (2010) Comprehensive validation of the Boston bowel preparation scale. Gastrointest Endosc 72:686–692

    Article  PubMed  PubMed Central  Google Scholar 

  • Caos A, Benner KG, Manier J et al (1986) Colonoscopy after Golytely preparation in acute rectal bleeding. J Clin Gastroenterol 8(1):46–49

    Article  CAS  PubMed  Google Scholar 

  • Dixon MF (2002) Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 51:130–131

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eliakim R, Fireman Z, Gralnek IM et al (2006) Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study. Endoscopy 38(10):963–970

    Article  CAS  PubMed  Google Scholar 

  • Ell C, Fischbach W, Bronisch H-J et al (2008) Randomized trial of low-volume PEG solution versus standard PEG + electrolytes for bowel cleansing before colonoscopy. Am J Gastroenterol 103:883–893

    Article  PubMed  Google Scholar 

  • Endoscopic Classification Review Group (2005) Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 37(6):570–578

    Article  Google Scholar 

  • Eun CS, Han DS, Hyun YS et al (2011) The timing of bowel preparation is more important than the timing of colonoscopy in determining the quality of bowel cleansing. Dig Dis Sci 56:539–544

    Article  PubMed  Google Scholar 

  • Freeman ML (1994) Sedation and monitoring for gastrointestinal endoscopy. Gastrointest Endosc 4(3):475–499

    CAS  Google Scholar 

  • Froehlich F, Wietlisbach V, Gonvers J-J et al (2005) Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc 61:378–384

    Article  PubMed  Google Scholar 

  • Garborg K, Kaminski MF, Lindenburger W et al (2015) Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: a multicenter randomized controlled trial. Endoscopy 47(3):192–199

    PubMed  Google Scholar 

  • Ginsberg GG, Gostout CJ, Kochman ML (2012) Clinical gastrointestinal endoscopy. How endoscope works, 2nd edn. Elsevier (Saunders), Philadelphia, USA, pp 25–45

    Google Scholar 

  • Harewood GC, Sharma VK, de Garmo P (2003) Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc 58:76–79

    Article  PubMed  Google Scholar 

  • Harris GJ, Senagore AJ, Lavery IC et al (2001) The management of neoplastic colorectal obstruction with colonic endolumenal stenting devices. Am J Surg 181:499–506

    Article  CAS  PubMed  Google Scholar 

  • Hassan C, Bretthauer M, Kaminski MF et al (2013) Bowel preparation for colonoscopy: ESGE guideline. Endoscopy 45:142–150

    Article  CAS  PubMed  Google Scholar 

  • Hsieh YH, Koo M, Leung FW (2014) A patient-blinded randomized, controlled trial comparing air insufflation, water immersion, and water exchange during minimally sedated colonoscopy. Am J Gastroenterol 109(9):1390–1400

    Article  PubMed  Google Scholar 

  • Iddan G, Meron G, Glukhovsky A et al (2000) Wireless capsule endoscopy. Nature 405(6785):417

    Article  CAS  PubMed  Google Scholar 

  • Jacobs DO (2007) Clinical practice. Diverticulitis. N Engl J Med 357(20):2057–2066

    Article  CAS  PubMed  Google Scholar 

  • Jansen SV, Goedhard JG, Winkens B et al (2011) Preparation before colonoscopy: a randomized controlled trial comparing different regimes. Eur J Gastroenterol Hepatol 23:897–902

    Article  PubMed  Google Scholar 

  • Khanna A, Ognibene SJ, Koniaris LG (2005) Embolization as first-line therapy for diverticulosis-related massive lower gastrointestinal bleeding: evidence from a meta-analysis. J Gastrointest Surg 9(3):343–352

    Article  PubMed  Google Scholar 

  • Kobayashi N, Saito Y, Sano Y et al (2007) Determining the treatment strategy for colorectal neoplastic lesions: endoscopic assessment or the non-lifting sign for diagnosing invasion depth? Endoscopy 39(8):701–705

    Article  CAS  PubMed  Google Scholar 

  • Ladas SD, Triantafyllou K, Spada C et al (2010) ESGE recommendations on VCE in investigation of small-bowel, esophageal, and colonic diseases. Endoscopy 42(3):220–227

    Article  CAS  PubMed  Google Scholar 

  • Longcroft-Wheaton G, Bhandari P (2012) Same-day bowel cleansing regimen is superior to a split-dose regimen over 2 days for afternoon colonoscopy: results from a large prospective series. J Clin Gastroenterol 46:57–61

    Article  PubMed  Google Scholar 

  • Longstreth GF (1997) Epidemiology and outcome of patients hospitalized with acute lower GI hemorrhage: a population-based study. Am J Gastroenterol 92(3):419–424

    CAS  PubMed  Google Scholar 

  • Marmo R, Rotondano G, Riccio G et al (2010) Effective bowel cleansing before colonoscopy: a randomized study of split-dosage versus non-split dosage regimens of high-volume versus low volume polyethylene glycol solutions. Gastrointest Endosc 72:313–320

    Article  PubMed  Google Scholar 

  • Matro R, Shnitser A, Spodik M et al (2010) Efficacy of morning-only compared with split-dose polyethylene glycol electrolyte solution for afternoon colonoscopy: a randomized controlled single-blind study. Am J Gastroenterol 105:1954–1961

    Article  CAS  PubMed  Google Scholar 

  • Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A et al (2006) The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study. World J Gastroenterol 12:6161–6166

    Article  PubMed  PubMed Central  Google Scholar 

  • Partecipants in the Paris Workshop (2003) The Paris Endoscopic classification of superficial neoplastic lesions: esophagus, stomach and colon. Gastrointest Endosc 58(6 Suppl):S3–S43

    Article  Google Scholar 

  • Rex D, Bond JH, Winawer S et al (2002a) Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task force on colorectal Cancer. Am J Gastroenterol 97:1296–1308

    Article  PubMed  Google Scholar 

  • Rex DK, Imperiale TF, Latinovich DR et al (2002b) Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol 97:1696–1700

    Article  PubMed  Google Scholar 

  • Rex DK, Schoenfeld PS, Cohen J et al (2015) Quality indicators for colonoscopy. Gastrointest Endosc 81(1):31–53

    Article  PubMed  Google Scholar 

  • Rokkas T, Papaxoinis K, Triantafyllou K et al (2010) A meta-analysis evaluating the accuracy of colon capsule endoscopy in detecting colon polyps. Gastrointest Endosc 71(4):792–798

    Article  PubMed  Google Scholar 

  • Rostom A, Jolicoeur E (2004) Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc 59:482–486

    Article  PubMed  Google Scholar 

  • Schoofs N, Deviere J, Van Gossum A (2006) PillCam Colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study. Endoscopy 38(10):971–977

    Article  CAS  PubMed  Google Scholar 

  • Shaver WA, Storms P, Peterson WL (1988) Improvement of oral colonic lavage with supplemental simethicone. Dig Dis Sci 33:185–188

    Article  CAS  PubMed  Google Scholar 

  • Shlemper RJ, Riddell RH, Kato Y et al (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255

    Article  Google Scholar 

  • Siddiqui AA, Yang K, Spechler SJ et al (2009) Duration of the interval between the completion of bowel preparation and the start of colonoscopy predicts bowel-preparation quality. Gastrointest Endosc 69:700–706

    Article  PubMed  Google Scholar 

  • Spada C, Stoker J, Alarcon O et al (2014) Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline. Endoscopy 46(10):897–915

    Article  PubMed  Google Scholar 

  • Stimac D (2008) Colonic stents for the palliation of malignant colonic obstruction. Dig Dis 26(4):336–341

    Article  PubMed  Google Scholar 

  • Tan JJ, Tjandra JJ (2006) Which is the optimal bowel preparation for colonoscopy – a meta-analysis. Colorectal Dis 8(4):247–258

    Article  CAS  PubMed  Google Scholar 

  • Tongprasert S, Sobhonslidsuk A, Rattanasiri S (2009) Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation. World J Gastroenterol 15:3032–3037

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tursi A (2011) Segmental colitis associated with diverticulosis: complication of diverticular disease or autonomous entity? Dig Dis Sci 56(1):27–34

    Article  PubMed  Google Scholar 

  • Tursi A, Elisei W, Brandimarte G et al (2010) The endoscopic spectrum of segmental colitis associated with diverticulosis. Colorectal Dis 12:464–470

    Article  CAS  PubMed  Google Scholar 

  • Vallappan CS, Kazemi A, Babich M (2015) The role of empiric embolization in diverticular bleeding. Endoscopy 47(Suppl 1):219–220

    Google Scholar 

  • Varughese S, Kumar AR, George A et al (2010) Morning-only one-gallon polyethylene glycol improves bowel cleansing for afternoon colonoscopies: a randomized endoscopist-blinded prospective study. Am J Gastroenterol 105:2368–2374

    Article  CAS  PubMed  Google Scholar 

  • Wang J, Zhang XH, Ge J et al (2014) Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal tumors: a meta-analysis. World J Gastroenterol 20(25):8282–8287

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lucio Petruzziello .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this entry

Cite this entry

Petruzziello, L., Greco, S. (2015). Colonic and Rectal Endoscopy. In: Ratto, C., Parrello, A., Dionisi, L., Litta, F. (eds) Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-10154-5_18-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-10154-5_18-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-10154-5

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics