COLONOSCOPY INFORMATION

What is a Colonoscopy?

Wolfson endoscopy procedure room

Colonoscopy is a test which allows the doctor to look directly at the lining of the large intestine (the colon). Diagnostic colonoscopy is recommended for alterations in bowel habits, occult or frank blood in the stool, unexplained anaemia and as a screening test for colon cancer. In order to do the test a colonoscope is carefully passed through the anus into the large intestine. The colonoscope is a long flexible tube, about the thickness of your index finger, with a bright light at its tip. The video camera on the colonoscope transmits images of the inside of the colon to a monitor allowing the physician to examine the lining of the colon checking for any disease or abnormalities.

The physician may take a biopsy - a sample of the lining of the bowel for closer examination under the microscope. A small piece of tissue is removed painlessly through the colonoscope, using tiny biopsy forceps.

It is also possible to remove adenomas (polyps) during colonoscopy. Polyps are abnormal projections of tissue, rather like a wart, which the doctor will want to remove and examine in more detail.

Preparation

To allow a clear view, the colon must be completely empty of waste material. If it is not, certain areas may be obscured and the test may have to be repeated. The links below provide information on patient preparation for a colonoscopy procedure.

• Bowel preparation instructions for colonoscopy am & pm appointments
   
• Bowel preparation instructions for colonoscopy when carried out with an upper endoscopy (OGD) - morning appointments
   
• Bowel preparation instructions for colonoscopy when carried out with an upper endoscopy (OGD) - afternoon appointments
   
• Diabetic colonoscopy patient advice (insulin or tablet controlled)
   
• Diabetic colonoscopy patient (insulin or tablet controlled) example light diet

It is important to take all of the laxative prescribed and also considerably increase your intake of clear fluids on the day before the examination, which will help clean the bowel.

When you come to the department, a member of staff will explain the test to you and will usually ask you to sign a consent form. This is to ensure that you understand the test and its implications. Please tell the doctor of nurse if you have had any allergies or bad reactions to drugs of other tests. They will also want to know about any previous endoscopy you have had, or of any other medical conditions which you may suffer from and any medication which you may be taking. If you have any worries or questions at this stage don't be afraid to ask. The staff will want you to be relaxed as possible for the test and will not mind answering your queries.

What will happen?

You will be placed in a comfortable position on your left side, and may be given medication by injection through a vein to make you sleepy and relaxed. The doctor will then pass the colonoscope through the anus into the rectum, and advance it through the colon. You may experience some abdominal cramping and pressure from the air which is introduced into your colon. This is normal, and will pass quickly. You may also be asked to change position during the examination, and will be assisted by a nurse. The examination takes 15-60 minutes.

Afterwards

You will be left to rest in the recovery area for up to 1 hour, until the main effects of any medication wear off. A responsible adult must be available to escort you home as the sedation impairs your reflexes and judgment. For the remainder of the day you should not drive a vehicle, operate machinery or make important decisions. We suggest that you rest quietly.

When will I know the results?

In many cases the doctor will be able to tell you the results of the test as soon as you are awake. However if a biopsy sample or polyp was removed for closer examination, these results may take up to ten days to process.

Many patients find that sedation tends to make them forget any explanations that may have been given them. Details of any results or further investigations may be obtained from your GP or specialist (whoever referred you for the test).

What to expect after Colonoscopy
 

Endoscopy patient recovery

After your colonoscopy a responsible adult must collect you, as you will be drowsy from the medication you have been given. You must not drive a vehicle, drink alcohol or make any important decisions until the day following your discharge. This is because it takes some time for the medication to work its way through your system. You may resume your normal daily activities the day after the examination.

Food and drink
Alcohol in combination with any sedation you may have received is likely to make you much more sleepy than usual. Normal food can be taken after the examination, though you may prefer light meals on that day of examination. The doctor or nurse will have told you before being discharged if you had biopsies taken or polyps removed. If this was the case you may notice traces of blood coming from your back passage. If bleeding persists, becomes more severe or the abdominal pain becomes worse, you should contact the Endoscopy Unit or your GP or come to the Accident & Emergency Department.

Medications
You may resume normal medications immediately after your colonoscopy but if a polyp was removed we advise against taking aspirin or anti-inflammatory drugs in any form for the next week. Please ask if you are not sure that a medication will be safe. You may take stool softeners and bran but do not take strong laxatives.

Bowel actions
Your colon has been completely emptied and you should not expect necessarily to start to have normal bowel function for two to three days. Bowel actions after that should rapidly return to normal.

Things to report to your doctor

• Severe pain or vomiting
• Passage or vomiting of blood
• Temperature greater than 38 degrees
• Redness, tenderness and swelling at the site of the intravenous injection that persists

If you have any worries please do not hesitate to contact the Endoscopy Department, your own GP or go to the Accident & Emergency Department of your local hospital.