Screening

You may be offered a colonoscopy as bowel cancer screening program. Bowel cancer screening is offered to everyone over the age of 60, every two years.

Other reasons for a colonoscopy

There are several other reasons why your doctor may recommend you have a colonoscopy:

• Investigating symptoms that could indicate bowel cancer, such as bleeding from your bottom or a change in your bowel habits
• You have a strong family history of bowel cancer .
• Investigating symptoms of inflammatory bowel disease (for example, ulcerative colitis or Crohn’s disease).
• Monitoring your bowel if you’ve previously had a polyp or cancer removed, or if you have a family history of a genetic polyp syndrome.

Your doctor can also perform a biopsy (remove a sample of tissue) or remove polyps during a colonoscopy if necessary.

You’ll usually have a colonoscopy in the endoscopy unit at a hospital and be able to go home the same day. You’ll need to arrange for someone to drive you home, as you’ll usually have a sedative. This can make you feel drowsy for a while afterwards, so you won’t be able to drive yourself until the day after.

VIGOS hospital will give you detailed instructions about what else you need to do to prepare for your colonoscopy.

Medicines to stop

There are certain medicines that you’ll need to stop before having a colonoscopy. These include:

• iron tablets – you’ll need to stop taking these one week before your colonoscopy.
• anti-diarrhea medicines, or any medicines that may cause constipation
• medicines that affect the way your blood clots (eg warfarin, aspirin or clopidogrel)

If you take any of these medicines (or any others), let your hospital know before you have the colonoscopy.

Clearing your bowel

Your bowel will need to be completely empty for the procedure so that your endoscopist can see everything clearly. Your hospital will give you a strong laxative that you’ll need to take before your colonoscopy. It usually comes as a powder that you mix with water. You may not be able to take the laxative if you’re pregnant or breastfeeding, so be sure to tell the hospital if this applies to you.
The laxative can quickly give you diarrhea, so make sure you stay close to a toilet after you take it. You might feel some discomfort or bloating in your tummy (abdomen), and it can taste unpleasant. Try putting the mixture in the fridge before you drink it, as it can make it taste better. Remember that although taking a laxative can be unpleasant, it’s really important to be able to do the colonoscopy effectively.

It’s important to keep drinking plenty of clear fluids though like water, squash or black tea or coffee, to make sure you don’t get dehydrated.
If you have diabetes, or if you’re having another procedure, such as a gastroscopy, on the same day, the preparation might be different for you. Follow the instructions given to you by your hospital, and if you’re unsure, ask.

At the hospital

When you arrive at the hospital you’ll be seen by a nurse or doctor and will be able to ask any final questions you may have. You’ll be given a hospital gown to change into, and sometimes a pair of paper shorts to wear.

A colonoscopy usually takes around 30 to 45 minutes, although the appointment itself will last longer than this.
You might need an anesthetic for a colonoscopy, or you’ll be offered a painkiller and sedation. A sedative will make you feel more relaxed and a bit drowsy, but you’ll remain awake during the procedure. It’s given as an injection into a vein in your hand at the start of the procedure. At some hospitals, you might be offered gas and air (Entonox) for pain relief instead of a sedative.

We (doctor or nurse) will ask you to lie on your left-hand side and bend your knees. First, they’ll gently examine your back passage using their finger. They’ll then carefully insert the colonoscope, using lubricating gel to make it as comfortable as possible.

We will pump air into your bowel through the colonoscope to inflate it slightly and give a better view of your bowel. This can make you feel a little bloated. Your endoscopist will gently guide the colonoscope through your bowel.

The images from the camera at the end of the colonoscope will appear on a monitor. Your endoscopist might ask you to change your position during the procedure, to help them to look at different areas of your bowel. They may ask an assistant to press on your tummy to help move the colonoscope in the right direction.

We may take a small sample of cells (a biopsy) if needed, and remove any growths (polyps) they find. This is done by passing instruments through the colonoscope. For more information, see our FAQ: What are polyps and should they be removed?

If you find the procedure particularly uncomfortable at any stage, tell your endoscopist and they will stop or change what they’re doing.

Recovering from a colonoscopy

You may feel bloated and have some cramping pain after a colonoscopy. This is caused by the gas used during the procedure and usually settles down within a few hours. If you need pain relief, you can take over-the-counter medicines, such as paracetamol or ibuprofen. You may also bleed a little from your back passage if you’ve had a biopsy or a polyp removed. This should stop on its own within a couple of days.

Having sedation can really take it out of you. You might find that you’re not as coordinated as usual or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or make any important decisions

A colonoscopy is usually the best investigation to see inside your bowel, as it can examine the whole of your large bowel, and pick up on very small changes. But it isn’t appropriate for everyone so your doctor might suggest other tests.

Other options include the following:

• Virtual colonoscopy. This involves having a CT scan .
• Flexible sigmoidoscopy. This is similar to a colonoscopy but uses a shorter instrument to look inside colon.
• Barium enema. This involves taking X-ray images of your large bowel, using a contrast or dye .

Complications of a colonoscopy

Complications are when problems occur during or after the procedure. The main complications of a colonoscopy are listed below.

Breathing problems. You may have a reaction to the sedation, which can affect your breathing or your heart rate.

A tear in your bowel (bowel perforation), caused by the colonoscope. This is rare, but if this does happen, it’s likely you’ll need an operation to repair it.

Bleeding. This is most common after having biopsies or polyps removed, and usually stops on its own. In rare cases though it can become more serious and you may need a blood transfusion.

Contact the hospital department where you had your procedure if you continue to bleed from your back passage or have severe pain in your tummy that doesn’t get better within a couple of days.