Colonoscopy or Lower GI Endoscopy

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A colonoscopy is a procedure that examines the inside of your large intestine. It uses a colonoscope, a flexible tube with a light and camera, to view the inner lining of your bowel.

The camera projects images of the inside of your bowel to a television screen for the endoscopist to review.

During your colonoscopy:

Biopsies: The endoscopist may take small tissue samples (biopsies) from the lining of your large bowel for examination. This procedure is typically painless.

Photographs: Photographs may be taken during the procedure for your medical records.

Purpose of the Colonoscopy:

You have been recommended a colonoscopy to:

Determine the cause of your symptoms.

Guide treatment options.

Plan further investigations if necessary.

Common reasons for having a colonoscopy include:

  • Changes in bowel habits: Such as constipation or diarrhoea.
  • Bleeding from the rectum.
  • Investigating the cause of anaemia.
  • Abdominal pain.
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If none of these reasons apply to you, your referring doctor will discuss the specific reasons for recommending this test.

A colonoscopy typically takes 30 to 45 minutes to complete. However, you can expect to spend approximately 2 hours at the hospital in total, from arrival to departure.

Your comfort is crucial during the procedure to ensure its successful completion.

To enhance your comfort, you have a few options:

  • Sedation: You can choose to receive a sedative medication. This will make you feel drowsy and relaxed throughout the procedure.
  • Gas: Alternatively, you may receive gas during the procedure. This can help to alleviate any discomfort and promote a sense of calm.

Important Note: Even with gas, you will remain awake but may feel drowsy and have reduced awareness of your surroundings.

We understand that the prospect of a colonoscopy can be anxiety-provoking for some. However, it’s important to remember that this test is crucial if your doctor has recommended it.

Preparing for your Colonoscopy

Before Your Procedure:

Maintain a Healthy Lifestyle:

  • Diet: Focus on a healthy diet, avoiding foods that worsen your bowel symptoms.
  • Alcohol: Reduce alcohol consumption.
  • Smoking: Consider stopping smoking.
  • Constipation: If constipation is a concern, use laxatives regularly as directed by your doctor.
  • Hydration: If you are being investigated for diarrhoea, ensure you are well-hydrated by drinking plenty of fluids.

Bowel Preparation:

Importance of Empty Bowel: A completely empty bowel is crucial for a successful colonoscopy. This allows for a thorough examination of your colon lining.

Pre-Procedure Diet (2 days before):

Plain foods only:

  • Plain chicken or white fish
  • White rice, pasta, or bread
  • Clear soup

Laxative Preparation (Day before):

  • You will receive laxative sachets to prepare your bowel.
  • Drink the sachets as instructed, typically at varying intervals throughout the day.
  • Expect Diarrhoea: Diarrhoea is common after starting laxatives. Stay close to a toilet.

Questions: If you have any questions about the bowel preparation instructions, please contact us promptly.

Recovery from a Colonoscopy

Following your procedure, you will be given time to recover from the procedure in a comfortable setting.

If you received sedation:

  • The initial effects of sedation typically wear off within 30 minutes. However, some individuals may feel fully alert immediately after the procedure.
  • During your recovery, our nurses will offer you a drink and something to eat, and closely monitor your oxygen levels, blood pressure, and heart rate.
  • Sedation can remain in your system for up to 24 hours, and you may experience drowsiness and some memory lapses.

If you had gas: You will be offered a drink and something to eat while your recover from your procedure.

Important Note:

Driving Restrictions: You will not be able to drive after receiving sedation. Please arrange for someone to escort you home and supervise you for 24 hours.

Frequently Asked Questions

What is a Colonoscopy and why might I need one?

A colonoscopy is an examination of the large bowel (colon) using a thin, flexible camera that is passed gently through the back passage. This test allows the clinician to look for inflammation, polyps, bleeding, or other abnormalities that may be causing symptoms such as changes in bowel habit, abdominal pain, or unexplained bleeding. During the procedure, small samples (biopsies) may be taken or polyps removed if required. You may be offered sedation and pain relief to help keep you comfortable, and most patients are able to go home the same day once they have recovered and are safe to be discharged.

How do I prepare for the procedure?

You’ll need to follow a special low-residue diet for 2-3 days before, then clear fluids only on the day before. You’ll be given bowel preparation medication (usually Moviprep, Klean-Prep, or Picolax) to drink which will cause diarrhea to clear your bowel.

Follow the timing instructions exactly as given.

When can I eat and drink?

If you come for a colonoscopy or flexible sigmoidoscopy the nurse will assess to see if you see if you pain free and will then offer you something to can eat We will get you a cup of tea or coffee and some biscuits to have before you leave, feel free to bring your own food if you would prefer, and we advise if you’re a diabetic or special diet to bring your own snack in.

However, if you have a procedure when local anaesthetic (Throat spray) is used you cannot eat or drink for a minimum of one hour after the procedure. You will be discharged home after Throat Spray and the Nurse will advise you when you are able to eat and drink.

Can I stop the procedure?

You can stop the procedure at any time. Simply inform the team or, if having a gastroscopy where speaking is difficult, raise your hand. Please do not grab the equipment, as this is unsafe. A nurse will be by your side throughout to monitor your comfort and safety.

Understanding Sedation

  • Conscious Sedation: You will remain awake but relaxed; it does not “put you to sleep.”

  • Memory: The sedative may affect your memory of the procedure or post-operative discussions.

  • Recovery: You may feel drowsy or lightheaded afterwards.

Post-Procedure Requirements

For 24 hours following sedation, you must:

  • Have a responsible adult stay with you.

  • Avoid driving or operating machinery.

  • Refrain from signing legal documents or drinking alcohol.

  • Rest for the remainder of the day.

Your pre-assessment nurse or the department staff can answer any further questions upon your arrival. Written guidance will also be provided in your post-procedure paperwork and via post.

Who will be with me during the procedure?

During the procedure you will have a nurse accompanying you who oversees your care. They will support you throughout the procedure and help you with any questions or concerns you have. Additionally, they will be monitoring you throughout the procedure and making sure you are as comfortable as possible. Family or friends are not allowed in the endoscopy department.

What if the bowel prep isn't working?

If you’re not having clear, watery diarrhea, contact the endoscopy unit. You may need additional preparation or the procedure might need postponing.

Poor preparation can make the procedure unsafe or mean abnormalities are missed, so adequate preparation is essential.

How long will I be in hospital?

How long you stay in the endoscopy department will depend on what procedure you have, if you have sedation for the procedure, and how you feel after the procedure. Different procedures take different lengths of time; additionally, the recovery period may vary depending on what procedure you have had. After any procedure we ensure that you are safe to be discharged from the department, if you have had sedation for your procedure this may impact the time, we wish to monitor you prior to being discharged. Whilst we strive to keep waiting time to a minimum, occasionally lists run late, or procedure take longer than anticipated. If this does happen during your visit the nursing team will keep you informed throughout your stay

Can I work before my procedure?

You can usually work in the morning before starting bowel preparation, but plan to be at home once you begin the prep as you’ll need frequent toilet access. Many people take the day off to rest before their procedure.

Avoid strenuous physical activity during the preparation.

How will bowel prep affect me?

The preparation will cause frequent, watery diarrhea starting 1-3 hours after your first dose. You may feel mild cramping, nausea, or bloating. Stay near a toilet and use soft toilet paper or wet wipes. Barrier cream can help prevent soreness. This is normal and necessary for a successful procedure.

What clear fluids can I drink during bowel preparation?

You can have:

  • Water
  • Clear fruit cordials (not red/purple)
  • Tea and coffee without milk
  • Clear soups/broths
  • Glucose drinks
  • Jelly (not red/purple).

Please Avoid: milk, cream, anything red or purple coloured, and alcohol.

Can I have te procedure if i'm pregnant?

Colonoscopy is generally avoided during pregnancy unless absolutely essential. If urgent investigation is needed, it’s safest in the second trimester.

We’d discuss alternatives like flexible sigmoidoscopy or delaying until after delivery if possible. Any decision would involve your obstetrician.

Are there risks to having the procedure?

Colonoscopy is generally safe, but risks include:

  • bowel perforation (1 in 1,000-2,000)
  • Significant bleeding (1 in 150 if polyps removed)
  • Very rarely, missed cancers.

Sedation carries small risks of breathing or heart problems. These risks are small compared to the benefits of early detection and treatment.

Will I need another colonoscopy if polyps are found?

This depends on the type, size, and number of polyps found. Low-risk polyps may just need routine screening in 5-10 years. Higher-risk polyps might require surveillance colonoscopy in 1-3 years.

our results letter will explain the recommended follow-up schedule based on your individual findings.

What does it mean if they find polyps during my colonoscopy?

Polyps are growths on the bowel wall that are usually benign (non-cancerous). Small polyps are often removed during the procedure and sent for testing.

Most are harmless, but some types can develop into cancer over many years if left untreated. Removal prevents this risk.

What will i feel during the procedure?

We’ll insert the colonoscope gently through your bottom. You may feel pressure, bloating, or cramping as air is used to expand the bowel for better views.

Most discomfort comes from air being introduced. The endoscopist will try to minimise discomfort and you can ask for pain relief if needed.

What is sedation and do I need it?

Sedation is medication given through a small cannula in your hand to make you drowsy and relaxed during the procedure. It’s not a general anaesthetic – you’ll be conscious but comfortable.

Many patients choose sedation, especially for colonoscopy. If you have sedation, you will not be able to drive for 24 hours and you’ll need someone to collect you.

Will the procedure be painful?

We try to ensure that you are as comfortable as possible throughout your stay in endoscopy. We have a variety of different medications that can be used at your request, such as, sedation(midazolam), analgesia (fentanyl), local anaesthetic, and Entonox. Whilst we use these medications to keep you as comfortable as possible, some discomfort is quite common. In procedures such as colonoscopy and flexible sigmoidoscopy patients often feel they are experiencing trapped wind, furthermore in investigations that go into the stomach you can feel bloated. These feelings occur due to the use of air or carbon dioxide passing through the equipment into your body.

What if I am diabetic and need to fast?

If you are diabetic, please contact your diabetes team or GP for specific advice about adjusting insulin or diabetes medications. Generally, if on insulin, you may need to reduce your dose. If on tablets like metformin, these usually continue.

Monitor blood sugar more frequently and bring glucose tablets to the appointment.

Can I take my regular medication before my procedure?

Continue most medications as normal, but some need stopping or adjusting. Your pre-assessment nurse will advise on: stop iron tablets 1 week before, diabetes medications may need adjustment, blood thinners like warfarin need careful management.

Always check your pre-procedure letter or call us if unsure.

When will I receive my results?

Once your procedure has finished, and you are more alert (if you have had sedation), we will inform you of the results of the procedure where possible. However, if during the procedure any biopsies or sampling has been taken, then these results can take a few weeks to be processed. We will let you know how to attain the results of these results.

Can I bring someone to my appointment?

You can bring someone for support, and it’s required if you’re having sedation. They can usually stay with you until you go into the procedure room and will be called when you’re ready to go home. They cannot typically stay during the procedure itself for safety and space reasons.

What if I have a pacemaker or other medical device?

Unfortunately, Clarity are unable to offer this procedure to patients that have a pacemaker.

How long will it take to recover from sedation?

You’ll spend 30-60 minutes in recovery until the sedation wears off enough for you to go home safely. You may feel drowsy for the rest of the day.

Don’t drive, operate machinery, make important decisions, or drink alcohol for 24 hours after sedation.

Can I drive after my procedure?

If you have sedation or pain relief medication during your procedure, you cannot drive for 24 hours afterwards and must have someone accompany you home. If you have the procedure without sedation, you can drive home yourself.

This is for your safety and is a strict requirement.

What if I can't drink all of the bowel prep?

It’s essential to complete the preparation for a safe, effective procedure. If you’re struggling, try drinking it chilled, through a straw, or with clear fruit cordial. Take breaks between glasses but complete it within the timeframe.

If you’re unable to keep it down due to vomiting, contact the unit immediately.

Got another question? Speak to our team to find out more. Contact Us