About the examination
The colonoscopy is an endoscopic examination of the entire large intestine using a colonoscope – a flexible tube composed of numerous optic fibres which transmit a picture of the inside of the colon to a screen, which enables the doctor to check the mucous membrane of the entire large intestine and rectum. The colonoscopy is performed in the hospital or in any of the outpatient clinics specialised for the treatment of intestinal diseases (gastroenterological clinics) as well as in diagnostic centres. The examination is usually not painful, although it can be slightly unpleasant.
The colonoscopy is the most reliable diagnostic method of detecting precancerous and cancerous changes in the large intestine and rectum. If the colonoscopy result is completely normal, the next colonoscopy usually needs to be performed after several years, or as the doctor who performed the colonoscopy determines. This time is shorter for people who show a higher risk for developing colorectal cancer; a gastroenterologist schedules the next colonoscopy based on the information about the type of risk. Since colorectal cancer does not develop the same in all people, it is important to keep a close eye on the functioning of your intestine and turn to your general practitioner in case of problems. If any abdominal problems appear suddenly and are severe, you need to consult your doctor immediately.
The examination usually takes 20 to 60 minutes. During the colonoscopy, you will lay on your side or on your back. In order for the doctor to better see your bowel mucous membrane and any abnormalities, they will blow air (sometimes CO2) into your bowel during the procedure; as a result, you may feel bloated, full of liquid or you can get cramps. Pain during the procedure is extremely rare. In case you will feel any pain, tell your doctor so they can act on it.
During the colonoscopy, the doctor may perform some other procedures: remove polyps (polypectomy), take a small tissue sample for further examination (biopsy), and stop bleedings from injured blood vessels, etc.
After the colonoscopy, the doctor will tell you how it went, if any abnormalities were found, if any polyps were removed, if a biopsy was performed, etc. The doctor will immediately tell you the good news if no special changes in your large intestine were found. If tissue samples were taken for a more detailed examination, you will have to wait for the results. A biopsy doesn’t mean that the doctor has found cancer; it merely means the doctor wants to make sure what kind of tissue it is.
After the colonoscopy, you will stay in the medical institution for short observation. Exceptionally, you can be kept in for observation until the following day.
We recommend that you have somebody escort you to the examination. If you are given a sedative or a painkiller during the examination, you will not be able to drive any motor vehicle for 24 hours. Thus, you will need someone to drive or escort you home. You may be kept in hospital for observation until the following day, so you may need someone to run some errands for you.
Complications are extremely rare. Bleeding may occur during the removal of any polyps but it usually stops without additional procedures. Exceptionally, a colon perforation can occur, which requires surgery. If you experience a strong pain in your stomach or significant bleeding from your colon (light bleedings will soon pass), if your body temperature increases or you get a fever, you must immediately consult your general practitioner. Bleeding can exceptionally occur a few days after polyps have been removed, so you need to pay close attention to your stools for a few more days. It is very important to have a completely clean colon for the colonoscopy to ensure that the procedure is really safe.
In order for the doctor to better see your bowel mucous membrane and any abnormalities, they will blow air (sometimes CO2) into your bowel during the procedure; as a result, you may feel bloated, full of liquid or you can get cramps. Pain during the procedure is extremely rare. In case you will feel any pain, tell your doctor so they can act on it.
We recommend that you have somebody escort you to the examination. If you are given a sedative or a painkiller during the examination, you will not be able to drive any motor vehicle for 24 hours. Thus, you will need someone to drive or escort you home.
If you have received a positive test results for occult blood in your stool within the Svit Programme, we will organize your colonoscopy examination. Therefore, call us immediately after your doctor’s appointment, or you can ask the nurse to call the Svit Programme Call Centre on 01/62 04 521 from Monday to Friday between 9:00 AM and 2:00 PM and inform us on whether your health condition is suitable (or not suitable) to undergo a colonoscopy. We will arrange the time and place for the colonoscopy that fits in with your schedule. You can also e-mail us at info@program-svit.si or send us a fax to 01/62-04-529.
We will send you a notice by post with the exact date and time of the colonoscopy and the address of the clinic where you will undergo the examination together with the instructions for colon cleansing.
The colonoscopy is performed in the hospital or in any of the outpatient clinics specialised for the treatment of intestinal diseases (gastroenterological clinics). The list of centres, which perform colonoscopy within the Svit Programme, is available here. You will be able to express your wish on where you want to undergo the colonoscopy to the adviser from Call Centre when you will be arranging the time and date of the procedure.
You will not have any expenses with the colonoscopy. The Health Insurance Institute of Slovenia covers the costs of the colonoscopy within the Svit Programme. The only condition is that you have your mandatory health insurance.
Menstrual bleeding does not impede the colonoscopy. We advise the use of a tampon but tell the colonoscopy staff about it.
Anticoagulants are not an obstacle for the colonoscopy. Your general practitioner or specialist doctor, who prescribed them to you, will give you precise instructions on how to use them.
During the preparation for the colonoscopy, your general practitioner or your diabetologist will give you instructions for adaptation of your dosages. Follow their instructions precisely.
You will drink the laxative, which you will obtain from the pharmacy, at home after you will dissolve the laxative in the water and drink the solution in accordance with instructions you have received from the Svit Programme.
If your colonoscopy is scheduled in the morning, start the cleansing procedure the evening before; if you are scheduled for the afternoon, start the cleansing very early in the morning of the same day. Please follow the instructions thoroughly.
After consulting your general practitioner, you can chose any other laxative, but you will have to pay for it yourself.
About the disease
If the cells in the large intestine or rectum start dividing uncontrollably, a tumour develops. Tumours can be malign or benign. Malign tumours in the large intestine and rectum are called colorectal cancer. Cancer cells divide fast and spread into the surrounding tissues, even into other body parts, where they metastasize.
Colorectal cancer is a disease with high morbidity and mortality levels. The prevalence of cancer increases and around 1,600 people are diagnosed every year in Slovenia. It represents the second most common cause of death due to cancer. Colorectal cancer can be treated if it’s discovered and treated in early developmental stage.
A polyp is a tissue formation (growth), which grows from the mucous membrane and protrudes from the lining of the colon or rectum into the colon. This growth can just be on the surface of the intestinal mucous membrane. Small polyps often don’t cause any problems. If they do, the most common one is bleeding from the colon, which is usually not visible. Polyps grow and can in time turn into a cancerous formation, thus they count as precancerous changes. They need to be removed as soon as possible.
If the faecal occult blood test was positive this doesn’t necessarily mean you have cancer. In order to clarify the cause of bleeding, you will need an examination of the large intestine – a colonoscopy.
Age – 90 % of all patients are older than 50 years when they are diagnosed. Thus, professionals advise diagnostic and screening tests in this age period.
Genetic burden – people, whose relatives were diagnosed with colorectal cancer, have a twice greater risk.
Nutrition – the risk of developing colorectal cancer increases with the consumption of meat products and fatty foods. Experts advise diverse food with a lot of fruit and vegetables, which are rich in fibres.
Unhealthy lifestyle – smoking, alcohol consumption, not enough exercise, obesity (BMI ≥ 30). Healthy lifestyle protects you not only from cancer but also from many other diseases.
Chronic inflammatory bowel diseases increase the risk of developing cancer. Ulcerous colitis and Crohn’s disease are the most common chronic inflammatory bowel diseases.
Symptoms and signs of colorectal cancer are not characteristic; most of them are connected with other diseases:
- Abdominal pains, flatulence, gasses;
- Different bowel movements (softer or harder stool, change in the frequency of defecation, constipation or constipation followed by diarrhoea);
- Visible blood in the stool – fresh bleeding or black stool;
- Thin stool;
- Nausea and vomiting;
- Anaemia and related symptoms – fatigue, vertigo and tinnitus, general malaise;
- Unintentional weight loss.
Almost one fourth of colorectal cancer patients have this disease in the family. We are not completely aware of the reasons for this, but it seems that the family is probably more prone to the disease and also the risk factors (smoking, harmful substances in the food, fatty food, not enough fruit, vegetables and fibres in food, not enough exercise and similar).
If a family member (father, mother, son, daughter, brother, sister, half-brother, half-sister) was diagnosed with colorectal cancer before the age of 60 years, it is advised that their closest relatives (father, mother, son, daughter, brother, sister, half-brother, half-sister) undergo a colonoscopy examination 10 years before the age when that family member was diagnosed or at 40 years of age. This colonoscopy has to be repeated every five years if the result was negative. If a family member was diagnosed with cancer when they were older than 60 years, their closest relatives (father, mother, son, daughter, brother, sister, half-brother, half-sister) are advised to have a first colonoscopy examination at the age of 40 and if the results are normal, the procedure must be repeated every ten years.
About the programme
The Svit Programme is the national screening and early detection programme for colorectal cancer. The Health Insurance Institute of Slovenia covers all costs of the programme.
It is aimed at men and women aged 50 to 74 years, who have mandatory health insurance.
“Screening” means examining seemingly healthy people with a simple test. It is a special procedure where we invite seemingly healthy people in order to detect the ones who are at great risk of having a pre-stage or early form of cancer in question.
The general objective of the Svit Programme is to detect people at higher risk for developing or those who already have colorectal cancer with the help of faecal occult blood testing. The aim of the programme is mainly in detecting the so-called precancerous changes – polyps (adenomas), which may lead to developing cancer.
The Svit Programme uses immunochemical test for faecal occult blood. The test can be either negative or positive.
The repetition of the test is not recommenced according to the professional doctrine; therefore, we are not repeating it within the Svit Programme. Possible pathological changes in large intestine and rectum can bleed in intervals, therefore the results could be false negative the second time.
Usually you should turn to you general practitioner for the check-up colonoscopy and they will issue a referral which you will use to make arrangements for the inclusion into the regular programme. In case, the Svit Programme will arrange the date of your check-up colonoscopy, this will be written in the final test results.
Joining the program
The Svit Programme is the national screening and early detection programme for colorectal cancer. It is aimed at men and women aged 50 to 74 years. You cannot enter the Svit Programme self-initiatively. You will receive invitation from the Svit Programme central unit. The only condition is mandatory health insurance. If you have problems with defecation (fresh blood in your stool, black stool, thin stool, constipation or diarrhoea, abdominal pains, unintentional weight loss) immediately consult your general practitioner and do not wait for our invitation.
The Svit Programme is the screening and early detection programme for colorectal cancer, which is aimed at men and women aged 50 to 74 years. If you are not in this age group, you are not able to participate in the Programme. You will be invited, when you will be 50 years old. If you have problems with defecation (fresh blood in your stool, black stool, thin stool, constipation followed by diarrhoea, abdominal pains, and unintentional weight loss) immediately consult your general practitioner and do not wait for our invitation. Consult your general practitioner if any of your close relatives was diagnosed with colorectal cancer.
Joining the Svit Programme cannot replace the colonoscopy. If you have been advised the colonoscopy from medical reasons, it is important that you undergo the procedure. The Svit Programme includes a screening test for occult blood in your stool. This screening test among the asymptomatic population (people without problems or diseases symptoms) enables us to detect people at risk for colorectal cancer.
You will be invited to the Svit Programme, when you will be 50 years old, because the programme is aimed at people aged 50 to 74 years.
According to the fact that you are diagnosed with chronic inflammatory bowel disease, you are probably supervised by a gastroenterologist. We advise you to take regular check-ups and tests prescribed by your gastroenterologist.