Colonoscopy is a procedure that allows your doctor to see the inside of your large bowel. This test is very common and is recommended by doctors to screen for colon cancer.
Your bowel will need to be empty before this test so you will take a laxative and drink clear fluids.
The day before the procedure, you will begin a bowel prep, which involves drinking a combination of liquids that cleans out the colon. This is necessary so that your doctor can get a clear view during the colonoscopy. During the prep, you may have to make frequent trips to the bathroom. If you are concerned about nausea, try to drink a lot of fluids and low-fiber foods such as ice chips or broth. You can also take anti-nausea medications as needed. You should avoid eating solid foods, but you can eat as much of the prep liquid as you want.
On the morning of your procedure, you will need to have someone drive you to and from the hospital or medical office. You should not drive after a colonoscopy due to the sedatives you will receive. You should also have someone stay with you at home for 24 hours to monitor your condition. If you decide to have no sedation, it is still important that you bring someone along to help you because you will remain awake but may be groggy after the examination.
During the procedure, you will lie on an exam table and your doctor will insert a long, flexible tube with a camera at its tip (the colonoscope) into your anus, rectum and colon. The camera sends real-time video to a monitor so the doctor can see everything in your colon. The doctor can identify, remove and, in some cases, biopsy any abnormalities such as polyps. The doctor may also inject fluid to inflate the colon and obtain a better view of the lining.
After the procedure, you will probably feel bloated and have stomach cramps from the air insufflated into your colon. This discomfort usually goes away with passing gas. You may also have some blood in the stool because of tissue that was removed or biopsied during the test.
Before the procedure, you will need to discuss your health history with the doctor and provide a list of all medications you are taking—both prescription and over-the-counter, including vitamins, supplements and herbal remedies. Be sure to talk about any allergies to drugs or a previous negative reaction to sedation or anesthesia.
Procedure
Colonoscopy is an outpatient procedure. You lie down while a doctor slowly advances a long, flexible tube (colonoscope) through the large intestine to examine its lining. The procedure can take less than 30 minutes if there are no polyps to remove or other complications. However, removing polyps or taking tissue samples for laboratory tests may add up to 60 minutes to the test time.
Your doctor will give you specific instructions about preparing for your colonoscopy. You will probably need to follow a liquid diet one or two days before the exam and to complete a laxative regimen. This regimen can include pills, a powder that you dissolve in liquid or an enema. The laxative will cause diarrhea, so you should be prepared to stay close to a toilet.
On the day of your test, you should drink only clear fluids until two hours before the examination. You will then be given a prescription for a bowel preparation kit that includes a special laxative. The liquids from the kit will cleanse your bowel of stool and other residue so that your colon will be completely empty for the exam.
During the procedure, you will be given sedation. You will be awake enough to answer questions and respond to requests, but you will be relaxed and drowsy. You may not remember anything about the test afterwards.
If the doctor finds polyps, he or she may use the colonoscope to remove them. Polyps are small growths that often look like normal cells, but they can be cancerous. Your doctor will also use the colonoscope to remove tiny amounts of tissue for laboratory testing if the results suggest that you might have cancer or precancerous conditions.
After your exam, you will be monitored in the recovery room until the effects of the sedation wear off. You should have someone take you home after the test, as the sedation may impair your ability to drive or sign legal documents. You may experience some cramping and bloating after the procedure, but this should pass quickly as the air insufflated during the colonoscopy passes through your body.
Recovery
A colonoscopy can be an uncomfortable test to undergo. You need to be prepared to not eat solid food the day before and drink only clear fluids. You may also be given a laxative to cause diarrhoea and you need to make sure you are in an environment where you can access toilets easily. You will have to be in hospital for a number of hours after the procedure, as you will have sedation during the test, and you will need someone to drive you home.
After the procedure, you will be in a recovery room and monitored by nurses until you are awake enough to leave. This is to ensure that you do not have any immediate complications. You may feel gas, bloating or cramping after the colonoscopy, which is due to air being blown into your colon. This should pass quickly but can take a few hours to settle down. It is normal to see some blood in your first stool after the procedure, but this will stop quickly. If you see large amounts of bleeding, call your doctor.
It is important to stay hydrated after the procedure so drink water or herbal tea. The fluids will help to flush out the contrast dye used during the colonoscopy and can aid in the recovery process. It is also important to follow any instructions your doctor gives you for dietary changes and to attend any follow-up appointments as scheduled.
It is essential to tell your doctor about all medications and supplements you are taking, even if they are natural or over-the-counter. Some drugs, including glucagon like peptide (GLP)-1 agonists for diabetes and sodium-glucose cotransporter (SGLT)-2 inhibitors such as empagliflozin, must be stopped before the test. Other medicines such as blood pressure pills, indigestion remedies and painkillers can be taken as usual.
Results
There are so many myths and horror stories out there about colonoscopies that people are afraid to schedule them. But the truth is that they’re relatively safe and not as painful as you might think.
The reason a doctor performs a colonoscopy is to look at a person’s large intestine, which includes their anus, rectum and colon. They’ll do this by inserting a tube with a lighted camera called a colonoscope into the anus and then through the rectum and into the colon. This allows them to see the lining of the colon and rectum and take tissue samples (biopsies) as needed.
If they find polyps during the procedure, doctors can remove them. The tissue is then sent to a lab to determine whether it is cancerous or precancerous. The doctor can also use the colonoscope to check for other abnormalities such as inflammation (colitis) or chronic tissue damage from infection, ischemia or autoimmune disease.
After the test, the doctor will give you the results right away. They’ll also tell you if they removed any tissue for biopsy and when you can expect those results. Depending on the tests, it could be a few days or weeks before you know for sure what’s up.
The good news is that the vast majority of colonoscopies return a positive result. It’s important to have regular colonoscopies, especially if you’re at increased risk of colon cancer, such as if you have a family history of colorectal cancer or inflammatory bowel disease. The frequency of colonoscopies will depend on your age and the size and number of polyps found.
Most people will need a friend or family member to drive them home from the hospital after their colonoscopy, because they’ll still be under sedation. They should also plan on taking it easy for the rest of the day, since they may experience cramps or gas pains and bloating. The good news is that these symptoms should subside as the sedative wears off. If these symptoms persist, it’s a good idea to talk with your doctor about them.