Coordination care with quick biopsy and surgical collaboration

Gastrointestinal endoscopy is in proceeded under the hands of 4 gastroenterologists in permanent presence, after diagnosing, the gastroenterologist in charge will provide personal interviews and link the patient to an early diagnosis and surgical treatment.


Endoscope Center

Gastroscopy / Colonoscopy

By using therapeutic endoscopy, early detection and treatment of a gastrointestinal diseases is available. In order to solve the discomfort feeling felt during the examination, we proceed conscious sedation endoscopy too.

Recently endoscopic submucosal dissection is getting attention because it can treat early gastric and colorectal cancer only by using endoscopy. Besides that, we also proceed various endoscopic treatments such as polypectomy, and hemostasis when upper gastrointestinal tract bleeding, etc.

About the examination

Gastroscopy is performed after 8 hours of fasting, as for colonoscopy since it needs about 3 days before the examination for dietary control and medication, it is registered by a reservation. Reservations can be made by phone, after the prompt, accurate examination and examination proceeded by doctor in charge, an interview is available on the same day of the examination.

About endoscopic cleaning

When the inspection is done, we follow the principles of disinfecting the device with an automatic washer after washing our hands. With the latest endoscope sterilizer, we manage the devices under the procedures of [cleanse-disinfection-rinse-dehydrate]infection control standards that has been certified by the Korean Society of Gastrointestinal Endoscopy and the Korean Society of Gastrointestinal Endoscopy Nursing.

About Colonoscopy(conscious sedation)

- Introductions 1 week before examination

Since the medication that you’re taking may include thrombolytic drugs such as aspirin and warfarin, patients undergoing treatments with high blood pressure, diabetes, hyperlipidemia, after consulting with the medical attendant, may have to stop taking thrombolytic drugs for about 7 days before the examination.

※ Make sure to consult with your physician before stopping medication

- Introductions on the day of examination

If you are a patient that has been diagnosed and receiving medical treatment with other heart disease, asthma, liver disease, prostatic disease, glaucoma, you must inform us in advance.

※ As for blood pressure medications, take it with a small quantity of water(half a cup) 3~4 hours before the examination.

- I want to know about the procedures!

  • When the endoscopy starts, we inject a sleep inducer by intravenous injection(if it’s conscious sedation endoscopy) while the patient lies in left lateral decubitus.
  • The usual inspection lead time is about 30 minutes, if removal of the polyp is necessary additional inspection time is required.
  • On the day of conscious sedation endoscopy, please avoid dangerous jobs such as driving and machine manipulation.
  • Do not wear accessories(ring, wristwatch, bracelet, hairpin) when visiting the hospital for endoscopy.

※ If a polyp is discovered during the endoscopy, polypectomy is proceeded. Additional cost for polypectomy will be separately billed, and hospitalization will also be decided then.

Endoscopy Room : 031-8041-3571,3671

  • Contact to Emergency Room at night time : 031-8041-3019


01 Outlines


Gastroscopy is a diagnosis method that inserts a thin long electronic endoscope starting from the gullet, stomach, duodenum, and directly observe the inner conditions that appears on the screen.

An endoscopy is the most basic test that could diagnose the various diseases in the gullet, stomach, or duodenum.(example: stomach cancer, stomach ulcer, duodenal ulcer, esophagitis)

Unlike the upper gastrointestinal angiography that takes X-rays and observe the gullet, stomach, small intestine after drinking or injecting a substance called a contrast agent, endoscopy is a great help in therapeutic decision and accurate diagnosis since it is capable of direct biopsy as an abnormality is detected.
Since the occurrence of stomach cancer is especially high in South Korea, an endoscopy is crucial for the sake of early diagnosis in stomach cancer.

  • Gastric endoscopy equipment component list: endoscope end piece, forceps for biopsy, endoscope operation unit, endoscope unit
  • Gastroscopy and upper gastrointestinal angiography: Diagnosis by looking directly into the digestive canal - may perform biopsy on the regions that are suspected of abnormality - take radiographs after barium and effervescent agent intake - check for abnormalities after monitoring the visual data barium and air creates inside the stomach(biopsy is unavailable) (Barium: a substance that does not pass radiation, Effervescent agents: medication that produce gas)
  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
02 Indication and contraindication of Gastroscopy


Regardless of age(infant to elderly), sex, if you have symptoms related to upper digestive tract diseases, all are available for inspection except for the existence of special contraindications. Since South Korea has high occurrence rate of stomach cancer, even though your not showing particular symptoms for early detection of stomach cancer, we recommended the examination for all adult patients over 40.

Unlike the upper gastrointestinal angiography that takes X-rays and observe the gullet, stomach, small intestine after drinking or injecting a substance called a contrast agent, endoscopy is a great help in therapeutic decision and accurate diagnosis since it is capable of direct biopsy as an abnormality is detected.
Since the occurrence of stomach cancer is especially high in South Korea, an endoscopy is crucial for the sake of early diagnosis in stomach cancer.

  • Epigastrium pain(upper belly)
  • Gastroesophageal reflux symptoms : cause heartburn and pain because of stomach acid, bile esophageal reflux
  • Dysdipsia and odynophagia : hardly digestible or pain is occurred when food is swallowed
  • Stomach cancer screening inspection : a screening that distinguishes whether the health conditions are healthy or not. If you get positive reactions on this screening, you may receive a test to confirm the suspected diseases. Therefore, this is not a confirmed test for diagnosis.
  • Upper gastrointestinal tract bleeding
  • Familial adenomatous polyposis : a genetic disorder that occurs numerous polyps in the intestines, gradually progresses as colon cancer.
  • confirmations on the occurred lesion using the radiographic inspection
  • Collect tissues or intestinal juices
  • Determine the degree of acute damage after cautery substance intake
  • Endoscopic observation of lesions in need of a follow-up
  • Other organic disease that may accompany lesion in the upper gastrointestinal tract
  • When suspicious of other upper gastrointestinal tract diseases


- Absolute contraindication

  • If the patient doesn’t agree to the examination proceed
  • Difficulties in passing the endoscope because of otorhinolaryngology disease or strangulation on the throat and upper gullet.

- Relative contraindication

Although the endoscopy and endoscopic treatment may entail a risk or worsen the symptom, if the doctor judges that the benefits from proceeding the endoscopy and endoscopic treatment exceeds the risk of the examination, we must proceed the examination after making patient in a stabilized condition as possible. In these cases stated below, other methods of examination or medical treatment should be considered besides endoscopy.

  • Unstable vitals signals(blood pressure, pulse, breathing, temperature)
    If possible, proceed examination after stabilization of the vitals sign.
  • Possible existence of gastrointestinal perforation
    But in this case, the location of perforation is needed. So in some cases, the examination is proceed with great caution and less air insertion as possible.
  • Gastrointestinal obstruction or right after gastrointestinal surgery
    The following cases stated below requires attention since it may worsen the symptoms or complications when the gastroscopy is proceeded with force.
  • Right after occurrence of acute myocardial infarction(AMI) or patients with serious cardiovascular diseases such as cardiac arrhythmia, cardiac insufficiency, aneurysm of the aorta.
  • Patients with serious respiratory disease accompanied by respiratory difficulty, poor full body condition, cervical spine disorder.
  • A patient with clouded consciousness or unable to communicate.
    In the following cases, must proceed examination after stabilizing the patient fully using a tranquilizer.
  • Patient with acute corrosion-induced esophagitis(in case of intaking strong acid, strong alkali, chemical substances)
    As for these cases, esophageal perfroation is easily occurred when endoscopy is proceeded. But since the endoscopy is a mandatory examination for detecting the degree and extent of the damage, the examination should be proceeded as soon as the patient is stabilized.
  • Besides the cases stated above, elderly patients, mental patients, patient that is not feeling well on the inspection day should also be proceeded after carefully considering about the necessity of inspection and possible occurrence of complications.
  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
03 Preparation item before examination

Preparation item before examination

- Fasting

  • It is difficult to make an accurate diagnosis when there are food left in the stomach. So fasting is mandatory before the examination. The last meal before the examination should be finished until 9pm, one day before the examination. Fasting must be kept till the examination is over. As for the dosing of heart, blood pressure, asthma medications, etc, consult with your doctor about taking medications.
  • If this is your check-up after the gastric cancer surgery and you have medical history with indigestion, we recommended you to fast for a whole day before the examination or eat rice gruel or white porridge lightly for lunch.

- Nonsmoking

Since smoking enhances the secretion of gastric juice and stomach peristalsis, smoking is banned for the day of the inspection.

- Medicate antifoaming agent

In order to remove air bubbles inside the stomach and mucus attached to the gastric mucous membrane, we proceed oral administration in small dose of antifoaming agent like gasocol 10-20 minutes prior to the examination.
When the mucus attaches, this helps the detection of superficial and exiguity lesions that shows limited occurrence on the surface which is hard to observe.

- Sympatholytic intramuscular injection

To suppress the secretion of saliva, gastric juice and gastrointestinal peristalsis, we administer parasympathetics like Buscopan by intramuscular injection before 10-15 minutes or intravenous injection before 5-10 minutes prior to the examination. There may be side effects such as : dry mouth, mydriasis, urination disorder, hot flush, heart acceleration. So patients with high blood pressure, heart disease, prostatism, glaucoma, etc should avoid the injection.

- Throat topical anesthesia

In order to allow the endoscope to comfortably pass through we suppress gag reflex, swallowing reflex and reduce pain in the throat, by anesthetizing the throat area before the examination using the local anesthetic like liquid lidocaine. At some very rare cases, if the patient shows hypersensitivity to local anesthetics, it may lead to serious complications such as airway obstruction due to airway edema. When the patient tells that they’ve experienced these kind of occasions, the usage of local anesthetics is not recommended.

- Remove false teeth

Since the endoscopy is inserted by the patient’s mouth, expect on special occasions, false teeth must be removed before the inspection.

- Pose for examination

Lie as in left lateral decubitus, that is, place your left body down on the laboratory table and put on the mouthpiece.

  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
04 Inspection method and precautions

Inspection method

  • The endoscope is first inserted into the mouthpiece hole in the mouth, and passes through the gullet, stomach, duodenum. Then the examiner could observe the patient’s mucous membrane on the gullet, stomach, duodenum by one’s own eyes. At first the patient may feel pressure, nausea, or mild pain when the endoscope passes through the throat. But when the endoscope passes the throat, there are almost no pain in the latter.
  • Relax your tongue and throat and breathe slowly, deeply through your nose and stomach. If you follow the directions and refrain yourself from coughing, endoscope insertion will be done relatively easy. After this, while slowly doing abdominal breathing, suppress the feeling of nausea and vomiting and do not swallow the saliva collected in your mouth just drool it naturally. These tips will help you receive a smooth examination.
  • Sometimes when abnormalities at the gullet, stomach, duodenum are detected while examination, a biopsy may be performed for diagnosis.For accurate diagnosis, even there is a slight inflammation detected we may proceed a biopsy. However, we do not always perform biopsy because we suspect a cancer.
  • Test takes about 10-15 minutes, but in some cases it may take a bit longer.

- Inspection procedure of Gastroscopy

  • 01Observe the gulley while inserting the endoscopy into the patient’s mouth.
  • 02Enter the stomach passing the gullet.
  • 03Observe the vestibular region and pyloric in the stomach.
  • 04After passing the pyloric, observation on the duodenum is proceeded.
  • 05Observe the lesser curvature and body of a stomach by curving the endoscope into a J shape.
  • 06Observe the body and fungus of the stomach.

- Gastroscopy biopsy

  • 01Detect an abnormal region
  • 02Collect some tissues using the biopsy forceps
  • 03Request a biopsy at the pathology department
  • 04Stain the tissue
  • 05Diagnose with microscopy

Precautions after examination

  • Due to throat anesthesia, your ability to swallow food may be poorly functioned. So no food intake is recommended until 30 minutes after the examination. If there were biopsy performed during the examination, you are allowed to eat about 2 hours after the examination. When food is eaten while anesthetic hasn't worn off, it may be the cause of aspiration pneumonia or caught in the throat because the food might block the airways.
  • Some of the patients complain of persistent pain on the neck after the neck anesthesia is worn off, it is usually a temporary condition. So no need to worry! In this case, drinking lukewarm water or rinsing your throat may help the relieve of pain.
  • There may be a bit of blood smeared in the saliva, but most patients show natural disappearance of this symptom.

Possible complications caused after performing Gastroscopy

Gastroscopy performed for diagnosis is a common examination proceeded in medical institutions. Although it is known as a very safe test, it often occurs complications.

  • Because of the usage of various drugs that are used for endoscopy, some patient may occur these kind of complications: urticaria, hypersensitivity reaction like asthma, heart system complications like arrhythmias or cardiac infarction.
  • Bleeding, abdominal pain, or perforation may occur during the examination.
  • Although in most cases it is healed by oneself, but you may experience temporarily fever or septicemia, swelling of the parotid area under the ears, oppressive pain within a few hours after the examination.
  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
05 Diseases detectable by Gastroscopy

Gullet disease

Includes esophagitis, esophageal cancer, esophageal varix, esophageal submucosal tumor, esophagitis.

Double esophageal submucosal tumor is not only the tumor formed on the surfaces, but it is also formed at tissues under the mucous membrane such as muscles or stroma. So it is a tumor that appears to be pressing the mucous membrane, and tends to have a clean bulging appearance.

Stomach disease

Includes gastritis, stomach ulcer, stomach cancer, gastric submucosal tumor, etc.

  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
06 Gastroscopy(with conscious sedation)


Endoscopy is the most commonly used examination to check for abnormalities in the upper digestive system. However, due to the pain and discomfort during the examination, some patients avoid or fear receiving endoscopy.

Conscious sedation endoscope is a gastroscopy that is proceeded after sleep induction using tranquilizers. Thanks to the anti-anxiety effect and anterograde absent-mindedness effect(amnesia effect) of the tranquilizer, the patient is able to receive much comfortable examination than general gastroscopy.

But the degree of anesthesia is not proceeded until the patient has no conscious at all. Instead the examination is performed in sedation, in which the patient’s cooperation is possible. Also, despite the use of appropriate amount of drugs differed by each patients, there are actually some cases of patients that cannot reach the adequate level of sedation or sleep. These cases are rather hard to perform the examination itself because of low cooperation of the patient.

Precautions before examination

  • The sedatives used on gastroscopy, may affect some of the patient’s breathing, blood pressure, etc. If you’re a patient with these cases, please consult with the doctor whether or not to receive gastroscopy before the examination: liver cirrhosis and liver function abnormalities accompanied with chronic diseases, chronic lung disease, angina, myocardial infarction, etc.
  • Sleep inaction may be delayed or not work depending on the individual’s characteristics.
  • The time spent till waking up differs by patients, and you may experience constant hazy conditions. So we recommend you to visit the hospital with a guardian when examination.

Preparation items before examination

  • Other pre-examination preparations are the same as undergoing general gastroscopy.
  • You’ll receive a plain IV through blood vessels in the hand or arm while lying on the examination bed.
  • After injecting the sedative before the examination, sleep is induced. Then the endoscopy is started.

Observations during examination

During the examination, we continuously monitor the patient's conditions by measuring the oxygen saturation and pulse rate by using the pulse oximeter, and blood pressure in a regular interval. If necessary, in order to reduce the risk of hypoxia, we may proceed oxygenation during the examination.

Precautions after examination

  • When the examination is over, you’ll be transferred to the recovery room and get some sleep. After certain amount of sleep in the recovery room bed, you are allowed to return home.
  • We recommend you to refrain driving, machinery operation, or to make important decisions on the day of examination. If possible, it is desirable to take the day off.
  • There may be temporary pain or discomfort in the throat after the examination.
  • Eating is available right after leaving the recovery room. But if you’ve received biopsy during the examination, eating is available after about 2 hours.

Possible complications when Gastroscopy(with conscious sedation)

  • Respirator complications such as respiratory difficulty and hypoxia.
  • Cardiovascular complications such as slow bradycardia heart rate and blood pressure fall
  • Falling accident
  • In very rare occasions, the patient’s life may be on threat because of cardiac and breathing arrest. So emergency treatment may be needed for hypersensitivity reactions. Therefore if the patient has lung function disorder due to respiratory, kidney, heart disease, when performing of conscious sedation endoscope caution is required.
  • After the conscious sedation endoscopy, stability is required for full recovery. Please avoid driving or important appointment and tasks on the day of examination.
  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털


01 Outlines


Unlike the past, diseases on the large intestine tend to remarkably increase in South Korea. (polyps (polypus), cancer, inflammatory bowel disease, etc. A polyps is a state of an abnormal growth of the colonic mucosa, which is protruded inside the intestine. It is sorted into 2 types of polyps, neoplastic polyp which has the possibilities to process into a cancer and non-neoplastic polyp which is less likely process into a cancer) Under the purpose of early diagnosis of these diseases stated above, colonoscopy is essential.

Colonoscopy is an examination that observes the insides of the anus, rectum and large intestine(colon) by endoscopy. If an abnormality is detected, an examination called biopsy is proceeded by inserting a test forceps through a tube inside the endoscope and collects a piece of a tissue. Then it is examined with a microscope. When a patient have polyps (polypus), it is usually removed and excised by using a trap during the colonoscopy. And if a complication such as bleeding occurs, hemostasis can also be performed. Apart from colonoscopy, you may receive colonography in order to diagnose diseases in the colon by using radiography.

A colonography is an examination that checks the overview of the colonic mucosa by inserting a substance called a contrast agent which makes shaded appearances on radiography, into the intestine. Since only the overviews are checked, for accurate diagnosis of the detected abnormality, an additional colonoscopy is required. Compared to colonography, colonoscopy has higher accuracy on various sizes of polyps, and has the advantage of being able to perform a biopsy or removal surgery when abnormality is detected.

Purpose of examination

You’ll get to receive colonoscopy in every case of suspected colon diseases. Many patients receive colonoscopy for these following reasons.

  • 01In order to detect symptoms that are occurred and caused from the the large intestine. Various symptoms are caused by colon diseases. Symptoms like diarrhea or bleeding are caused by various reasons: constipation, unexplained abdominal pain, weight loss, etc.
  • 02The purpose of screening inspection for an early detection or monitoring for the detection of colon tumor in patients with high risk diseases such as colon cancer. If you have no particular symptoms and no family medical history of colon cancer, you are recommended to receive a colonoscopy after the age of 50. Because starting from the age of 50, the occurrence of the polyps which is the causative lesion that can make prodromal change diseases related to colon cancer, shows rapid increase. As the number of colon polyps increase, after a certain period so as the risk of colon cancer increases too.
  • 03To check on the abnormalities detected while colonography. Colonography is an examination that finds the lesion by first inserting the contrast agent into the intestine, then compare the overview of the normal person’s intestine and the lesion. Since the colonography can only show the overview of it, when abnormalities are detected, a colonoscopy is performed for the detailed examination of definite diagnosis and biopsy. According to a foreign study that has reported that when we remove the colon polyps by endoscope, it lowers the risk of colon cancer occurrence. Under this study’s results, we recommend that all citizens over age of 50 including patients with high-risk groups for colon cancer, should undergo colonoscopy even if the participant has no risk factors.
  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
02 Inspection procedure and meal-related precautions before examination

Inspection procedure

In order to receive colonoscopy, you must first make an appointment. Then proceed controlled dietary and intake cleansing solution at the day before or on the day of the examination for the purpose of washing the intestines. When you visit the hospital on the day of the examination, after doing a simple paper-written medical examination you’ll be changing into an examination uniform and lie onto a bed. Now you’re all set up for the examination.

Since we inject pain killers before the examination, most of the patients do not feel much pain. During the examination, you should lie by your left side and pose. Place the slightly bent both knees on the stomach with your buttocks slightly pulled out to the backward.

In some cases, we require the patient to change posture for an easier insertion. The time spent on the test differs by cases, but takes about 20 - 40 minutes average. But if you’re applied in these cases, it may take a bit longer: complex and many lesions, difficulties in insertion. When biopsy is performed for an accurate diagnosis, the test may take longer time.

After the examination, patients get to rest for a while. If the medical staff judges that the previously administered sedative has lost its efficacy though physical examination, you may change back into your normal clothes and get additional measures, the examination is completed.

Meal-related precautions before examination

For accurate colonoscopy, washing the insides of the intestines is needed. The food you’ve eaten before you took the cleansing solution, also has a lot of influence too.

You should avoid drinking red or grape-colored beverages throughout the day before the examination. Also these foods should be avoided too: fruits with seeds such as melons, watermelons, grapes, vegetables like kimchi, foods containing sesame seeds and marine plants(seaweed, laver). If possible, your main diet should contain soft foods such as porridge until 6 pm, the day before the examination. Even if you’re going to be cleansing off the intestine, eating too much food before the examination will not be completely removed from the intestines and may cause interference during the examination.

  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
03 Preparation item before examination

Preparation item before examination

For a successful colonoscopy, it is important to wash off the contents existing in the intestines. The most commonly used cleansing agents are laxative that causes diarrhea which contains polyethylene glycol and sodium phosphate.

Pugative with polyethylene glycol

The most used cleansing agent containing polyethylene glycol, known as ‘Colyte Powder’ and ‘Colonlyte Powder’. As a non-absorbable electrolyte solution, it washes off the feces using the difference in osmotic pressure occurred inside the intestine when dosed. Make a potion by adding and shaking barley tea or bottled water inside the container that has powdered medicine in it. Pour it up to the 4 liter marked part before 1 hour taking the cleansing solution the day before the examination. If you’re not going to drink it right away after making it into a potion, please store it in the refrigerator. These days, there are small containers that could hold 0.5 liters for the comfort of dosing.

Administration method differs by the time spent on examination. When you are receiving the examination in the afternoon, starting from 6 am(6 hours before examination), drink the first 2 cups of pre-chilled cleaning solution of an amount of a regular cup(capacity about 240cc). Then constantly drink 1 cup every 15 minutes. Diarrhea starts while you drink the solutions, and gradually instead of diarrhea, only water comes out at the end. When only clear water comes out, you may stop drinking the solution. But if possible, we recommend you to drink all of it. The intestine should be washed out clean for an accurate examination.

If your examination are proceeded in the morning, you may drink the solutions when awake at dawn like the above case. But many tend to take 2 liters the night before the examination and taking the remaining 2 liters in the morning of the examination day. However when the interval period of dosing of cleansing solution and examination is prolonged, the cleansing work does not function well and makes it impossible to proceed the examination. So please be careful.

Take Fleet Phosphosoda

Phosphosoda also washes off the feces using the difference in osmotic pressure occurred inside the intestine like the Colyte Powder stated above. Take 45 mL at time, each once the day before the test and on the day of the test. When dosing, drink a mixture of 45mL with water in a regular cup (capacity 250mL). After this, you need to take additional 0.5 liters of water. The feeling of wanting to go to the bathroom occurs within 1-2 hours after dosing it for the first time. As the effect disappears after 5 hours, trip to the bathroom will be over by then.

Because this drug makes strong differences in the osmotic pressure inside the intestine, there may be symptoms like vomiting or dehydration. So please take it with plenty of water. Compared to Colyte Powder that has relatively large amounts of dosage, this medication is much convenient since even if the dosage is small and has similar cleansing effects. But because it has strong action, it may lead to electrolyte imbalance in the body. And patients with these characteristics may occur acute renal failure, so it must be avoided: Elderly or children, renal (kidney) dysfunction, taking high blood pressure drugs such as angiotensin receptor inhibitors, etc. It is also a contraindication in patients with : heart failure, liver cirrhosis, intestinal obstruction, and children under 5 years of age.

  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
04 Inspection opinion

Inspection opinion

The examination opinions of the intestinal endoscopy are very diverse. Not all symptoms related in the gastrointestinal tract appears by colonoscopy. So it is crucial to leave endoscopic opinions about judgments related to gastrointestinal symptoms on the hands of a profession.

Normal opinion

The normal colonic mucosa are very thin and transparent (bottom left picture). Blood vessels in the mucous membrane are very visible. But in some cases, the intestinal mucosa turns dark brown because of physiological changes. When you take laxatives or aloe for the purpose of treating constipation, colonic mucosa may show strained colors such as the picture right below.

Colon polyp

Colon polyps is a protruded lesion on the mucosal surface inside the colon. Most of it are benign and shaped like a small lump as if the wart on the skin. he reason we pay attention to a polyp is because most of the colon cancer are precancerous lesion that transforms starting from a polyp. Not every polyps progress to cancer, but if the size are large or shaped strangely, shows dysplasia on biopsy it is very likely to progress into cancer. So it is desirable to remove them when discovered while colonoscopy.

Most of the colon polyps show no symptoms, but may occur blood in the stool or bloody excrement when the sizes are big. And are rarely lead to intestinal obstruction.

- Colonic polypectomy

As colon polyps are a benign tumors that develops inside the large intestine, it itself is not harmful but if left untreated, it may progress to cancer. So if possible, it is desirable to remove the polyp by using an endoscope. Since there are no nerves that feel pain in the colonic mucosa, the performance of polypectomy is proceeded painless. But compared to colonoscopy performed for diagnosis, have higher risk of complications such as bleeding and perforation(1-3 patient per 100 of them).

You should maintain fasting right after the polypectomy. When undergone examination, you may start by drinking honey tea or clear water the hour after the examination. If there are no symptoms such as bleeding or abdominal pain at the next morning, start by eating with porridge. It requires you to rest for at least a week.

  • Colon polyp’s metastasis process to colon cancer: normal state > mucosal dysplasia > neoplastic polyp > intraepithelial carcinoma > progressive cancer > metastatic cancer

Colon Cancer

Colon cancer is a cancer with one of the fastest growing occurrence rates in South Korea. As the westernized eating habits developed, the excessive intake of animal fat and lack of fiber intake is also thought to be one of the main causes.

Although in the early stages of colon cancer show no particular symptoms, if it is on progress, you may experience stomach pain and changes in bowel habits such as diarrhea, constipation, and thinner stool. Bleeding may occur on the anus, and the color of the stool may appear red like blood or black. Also you may detect an unusual chunk(lump or massa) felt on the stomach, and anaemic may occur too.

Diverticular of colon

Diverticular of colon is a protrude at the outside of the intestine walls, shaped in a coiling like bulge. This can occur anywhere in the digestive tracts.

There are no certain reasons of diverticular of colon, but when you eat meals that are low in fiber, it causes the volume of the stool to decrease making the person to put more pressure when bowel movement.

So the intestinal mucosa is more likely to get protruded. Most of the diverticulum doesn't cause any problems even left untreated. But in these cases, a visit to the hospital is recommended : if you feel severe pain on the stomach side where the diverticulum is located, stomachache accompanied with fever, bloody or black colored stools.

Colitis ulcerativa

Colitis ulcerativa is a disease that makes chronic inflammatory on the large intestine with no particular causes. The inflammation starts from the rectum and continues to move to the upper large intestine area. In almost every patients with colitis ulcerativa suffers from inflammation on the rectum and has various attack sites. Since it attacks the inner surface of the large intestine(mucosa, submucosa), patients complains of diarrhea, bloody stools, abdominal pain, etc. Symptoms may start slowly, but sometimes appears very suddenly. As the symptoms repeats the cycle of worsen and improvement, sometimes quite a long period without any symptom exists.

Crohn disease

Unlike the colitis ulcerativa, crohn disease tend to show non-continuous distribution of the lesions because of the entire intestinal tract inflammation. About one-third of patients experience inflammation only on the small intestine, the other one-third of patients has inflammation only on the large intestine. And the remaining one-third of patients experience inflammation on the both side of large and small intestine, usually on the area where the small and large intestine meet. As for symptoms, diarrhea, abdominal pain, and loss of appetite are common. The type and severity of symptoms vary widely from patient to patient, and sometimes show slow or sudden occurrence too. But compared to colitis ulcerativa, many of the patients feel more pain and show poor response in treatment and long-term progress. So many patients undergo surgery.

Ischemic colitis

Ischemic colitis is a condition that has no abnormality in the blood vessels that supply nutrients to the intestines, but cause damage to intestinal tissues because of relatively poor blood supply. Causes abdominal pain, swelling of the intestinal mucosa, and in severe cases intestinal bleeding too. It tends to occur more commonly in patients with old age and arrhythmias.

  • * 작성 및 감수 : 대한의학회_대한내과학회
  • * 출처 : 국가건강정보포털
05 FAQ

Q. Does Colonoscopy hurt?

Colonoscopy is a procedure that is performed after the removal of stool inside the intestine. It inserts endoscope while pushing air into the empty colon at the same time. Since many of the examination is performed under much care and administration of pain killers, not much of a pain is felt.

But in these cases you may feel pain: if the amount of air that has entered the colon were excessive when inserting the endoscope, the mesentery(one of the type of peritoneum that maintains the intestine in a hanged condition) that supplies nourishment into the large intestine is stretched or forced because of differences in the anatomical curvature of the intestinal tracts.

Usually if there is a lot of stool left in the intestine, we tend to push a lot of air for a better observation during the colonoscopy. This may be the cause of pain too. Therefore, those who are planning or preparing for the examination, should take great care on washing off the intestines.

Q. Do some patients experience stomachache or bleeding at the anus after colonoscopy?

When performing colonoscopy, in the purpose of a better observation, we widen the colon by putting air inside. So you may experience temporary abdominal inflation and feel pain during or after the procedure. In most cases, these methods will make you feel comfortable: take rest after the procedure, put warmth on your stomach, move and release the gas inside. When biopsy were performed, you may see some blood in the stool after the procedure. But this usually stops soon. If the bleeding continues you should visit the hospital and get treatment.

Q. Can I go back to my workplace right after the examination?

If you’re not receiving ‘conscious sedation endoscopy’, there are no major problems in daily life after the examination. However, as the each person's sensitivity to the drug differs, in case of an emergency, we recommend you to take rest for about 2 hours after the test. So we recommend you to make time adjustments in schedules in advance such as appointments, plans that were planned after the inspection. Also, please avoid self-driving, handling machinery or making important decisions on the day of the examination. When you go through ‘conscious sedation endoscopy’, the drug may still affect you after the examination. It is desirable to take a break for a day or so.

Q. Isn’t Colonoscopy dangerous?

It is capable of an easy check, but in very rare occasions, complications may occur after colonoscopy. Complications occur in less than 1 patient per 1,000 of them. It includes: complications caused by drug administration, bleeding, colon perforation (tear), infection, breathing problems, and sudden changes in the blood pressure. Although complications occur in very rare cases, when occurred, emergency treatment may be required sometimes with surgery too. If you’re experiencing severe pain, bleeding, vomiting, high fever, etc, please visit the hospital without delay and receive proper treatment.

Q. What is conscious sedation endoscopy?

'Conscious sedation endoscopy', commonly called as 'sleep endoscopy’, is a examination that minimizes the anxiety and pain about the examination, and patients are available of some cooperating the request and stimuli instructed by the medical staff while performing the examination. And we also erase the memory related to the examination. During this process, the patient usually falls asleep but not all patients do fall asleep. We use various drugs to get the desired sedative effects. Patients have different drug sensitivity to the drugs used in ‘conscious sedation endoscopy’. So some may maintain sufficient effects only with a small dose, but some does not get wanted sedative effect even though the doses are high. However if excessive dosage are used to the patient, it may lead to paralyze of the respiratory center and cause breathing difficulties. So medical staff should always use it with caution.

Although it has a short duration, the drug may continue to have affects on the patient’s body even after the examination. We recommend you to take plenty of rest after the examination and avoid driving or making important decisions.

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Medical Team

  • 하민수

    Head of Internal Medicine Department/Head of Digestive system Center

    Ha Minsu


    Gastrointestinal tract(stomach/colon) disease, Liver disease, Pancreaticobiliary disease, Therapeutic endoscopy(EMS, ESD etc.), High blood pressure, Diabetes, Hyperlipidemia, and other internal diseases

  • 장우익

    Chief of the Gastroenterology department

    Jang Uik


    Rheumatoid arthritis, Specialized in digestive disease diagnosis, Throat/stomach/colon disease, Liver disease, Pancreaticobiliary disease, Autoimmune disease

  • 문준일

    Chief of the Gastroenterology department

    Moon Junil


    Digestive disease diagnosis(Circulatory and respiratory system diagnosis available), Gastrointestinal tract(stomach/colon) disease, Liver disease, Pancreaticobiliary disease

  • 구지훈

    Head of education and training Cardiology

    Ku Jihun


    Treatment of circulatory (heart) diseases (digestible) Arteriosclerosis, angina, myocardial infarction, arrhythmia, high blood pressure

  • 권지숙

    Chief of the Internal Physical Examination department

    Kwon Jisuk

    Internal Physical Examination

    Specialized diagnosis and treatment of digestive trouble, specialized in gastrointestinal endoscopy, gastrointestinal tract(stomach/colon) disease, pancreaticobiliary disease

  • 김진호