Via Nouva 3 ● CH-7503 Samedan
Tel. +41 81 851 81 11 ● Fax +41 851 85 17
www.spital-oberengadin.ch
KLINIK
Innere Medizin
Dr. med. D. Marugg, Chefarzt
Dr. med. P. Egger, Leit. Arzt
Dr.med. M. Kubli, Leit. Arzt
Information sheet recommended by the Swiss Society of Gastroenterologists FMH
Large intestine endoscopy (colonoscopy), with possible polyp removal
Information sheet about the patient briefing (in duplicate)
Name:………………….. First name:…………………….. Date of birth:…………….
Why a colonoscopy?
In this way diseases of the large intestine can be reliably detected and partially treated.
Why should I read this information sheet?
We wish to inform you beforehand about the investigation procedure, possibility of intervention
and risks. You can prepare any questions you may have in advance. Please bring this
information sheet with you to the investigation.
What happens during the investigation?
A flexible instrument, called the endoscope, will be introduced into the cleansed intestine
through the anus and pushed forward until the entrance of the small intestine. In doing so, the
mucous membrane will be closely examined. In this way, abnormal changes are reliably
detected. Special attachments make it possible to remove small tissue samples for a closer
examination.
Is the investigation painful?
Without medication, the investigation can be painful. Therefore, as a rule, we administer a
sedative. We also carry out the investigation without medication if specially requested.
What additional surgical interventions are possible during the colonoscopy?
It is possible that during the endoscopy one or more polyps (mostly benign growths of the
mucous membrane) are discovered. As such polyps may carry the risk of developing into a
malignant tumour at some time, they are mostly removed during the same investigation with
an electric loop (polypectomy) without causing any pain to the patient.
Other:
What preparations are necessary?
A large intestine endoscopy requires the intestine to be cleaned thoroughly. Please follow the
instructions for cleaning the intestine exactly. If you take blood-thinning agents or
preparations containing aspirin, or if you are diabetic, please discuss the exact preparations in
advance with your general practitioner or with us. If a polyp removal is planned you should
cease taking blood-thinning agents, including preparations containing aspirin, 7 days before
the investigation.
Seite 2
Via Nouva 3 ● CH-7503 Samedan
Tel. +41 81 851 81 11 ● Fax +41 851 85 17
www.spital-oberengadin.ch
What are the risks associated with this intervention?
The purely diagnostic investigation and taking of tissue samples have a very low risk of
complication (0.2%). During polyp removal complications can occasionally arise, despite taking
great care, such as injuries to the wall of the intestine or even perforation (1-2%) or a
haemorrhage (5%). Very rarely an operation is necessary due to a complication (1-2%).
How can I minimize the risk of complications?
By following the instructions about preparations exactly and answering the questions below in
full:
Do you take coagulant inhibitors for blood-thinning (e.g. Sintrom,
Marcoumar) or have you taken aspirin, alcacyl, tiatral or similar anti-flu
medication, respectively analgesics, within the past 7 days?
 Yes
 No
Do you have a marked tendency to hematoma (with small trauma as
well, e.g. tooth extraction)?
 Yes
 No
Do you have an allergy to certain medication? If yes, which ones
 Yes
 No
 Yes
 No
………………………………………………………………………….
Do you suffer from a heart valvular defect, have you had a heart
operation or do you have an artificial joint?
What happens after the investigation?
After the investigation/treatment and receiving an injection of painkiller
you are not allowed to drive that day or operate machinery and you should not sign any legally
binding documents. After a few hours you may have a feeling of pressure in your stomach (=
more air in the intestine). If this increases, or new severe stomach pains occur, or you observe
bleeding from your anus, inform us, or your general practitioner or nearest hospital without
delay.
Any questions about the patient briefing?
In the patient briefing session you should ask all questions that seem important to you, e.g.
- How necessary and urgent is the investigation/treatment?
- Are there alternative investigation or treatment methods?
- Are there personal risks for me which are not mentioned in the briefing leaflet?
I, the undersigned, have taken note of this information sheet and have been informed in an
understandable way by the doctor during a consultation about the diagnosis, type, course and
risks of the investigation, respectively the interventions. My questions have been satisfactorily
answered. I agree to the procedure.
___________
Date
__________________
Patient’s signature
________________
Doctor’s signature