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ColonoscopyPublished by Bupa's health information team, December 2006. This factsheet is for people who are having or thinking of having a colonoscopy. Your care may differ from what is described here because it is adapted to meet your individual needs, so it's important to follow your doctor's advice. A colonoscopy is a test that allows your doctor to look inside your large bowel using a narrow, flexible, tube-like telescope called a colonoscope. This is carefully passed through your back passage and rectum. The large bowelThe large bowel, also called the colon, is the lower part of your intestines. It absorbs water and nutrients from digested food that pass through it. The rectum, at the end of your colon, is where faeces collect before they go out through the back passage. Why have a colonoscopy?A colonoscopy can help find out what is causing symptoms such as changes in bowel habit or pain in your abdomen. It is also used to check for certain bowel conditions such as inflammation, early signs of bowel cancer, and polyps. Sometimes, a colonoscopy is used to confirm the results of other tests - a barium enema, for example. During the procedure, your doctor may take one or more biopsies (samples of tissue) for examination in a laboratory. It is also possible to remove polyps that may be found on the bowel wall. Polyps are formed by an overgrowth of cells from the bowel wall, known as adenoma. They are harmless but can sometimes turn into cancer. Most bowel cancers are thought to develop from a pre-existing polyp. For more information on polyps and bowel cancer, please see the separate BUPA health factsheet, Bowel cancer. What are the alternatives?Depending on your symptoms and circumstances, it may be possible to diagnose your bowel condition using a different test.
Preparing for the procedureColonoscopy is routinely done as an out-patient or day case. Colonoscopy is usually performed under sedation to help ensure that you are relaxed and comfortable during the procedure. Afterwards, most people have very little memory of the test. For more information about sedation, please see the separate BUPA health factsheet, Local anaesthesia or sedation. If you normally take medication (eg tablets for blood pressure), continue to take this as usual, unless your doctor specifically tells you not to. If you are unsure about taking your medication, please contact the hospital. For your doctor to see the bowel wall clearly, the bowel needs to be completely empty. To help clear it out you will be asked to:
Depending on the type of laxative you are given, the effect can be quite powerful. When you take the laxative, you must stay close to a toilet. Follow your doctor's instructions carefully. If your bowel isn't completely empty, your doctor won't be able to see the inside of your bowel and the test may have to be repeated. Some people are also given a bowel washout (an enema) immediately before the test. A tube is inserted into your rectum and water is used to flush out the remaining contents of your bowel. About the procedureYou will be asked to put on a hospital gown that opens at the back and rest on your side. If you are having sedation, a small plastic tube (cannula) will be placed in the back of your hand. The sedative will be injected through the cannula, and you should start to feel relaxed and drowsy almost immediately. Sedatives can sometimes affect your breathing. While you are sedated, the amount of oxygen in your blood will be monitored constantly through a clasp on your finger and you may be given extra oxygen through a mask. With you resting on your side, your doctor will gently examine your back passage with a gloved finger before carefully inserting the colonoscope. Lubricating jelly will be used to make this as easy as possible. Air is then usually pumped through the tube into the colon to make it expand and the bowel wall easier to see. This may briefly cause pains similar to having wind and you may get an urge to go to the toilet, but as the colon is empty, this won't be possible. Most people pass some wind. There is no need to feel embarrassed about this as your doctor will expect this to happen. A camera lens at the end of the colonoscope sends pictures from the inside of your colon to a video screen. Your doctor will look at these images to examine your bowel. During the procedure, you may be asked to change your position - for example turning from your side onto your back. This helps your doctor to examine different areas of the colon more easily. If necessary, your doctor will take a biopsy and/or remove polyps. This is done using special instruments passed inside the colonoscope, and is quick and painless. When the examination is finished, the colonoscope is taken out quickly and easily. The procedure usually takes 20 to 30 minutes to complete. The test won't hurt but may be uncomfortable.
What to expect afterwardsMost people are able to go home after resting for about half an hour, although you may need to stay in longer if polyps are removed. ResultsIf you have a biopsy or polyps removed, the results will be ready several days later and will usually be sent in a report to the doctor who recommended your test. Other findings may be discussed before you leave the hospital. If you have sedation, it's a good idea to have someone with you if the results are being discussed immediately after the procedure, as you may not remember the details clearly. Going homeThe effects of any sedative may last longer than you expect. Do not drive, drink alcohol, operate machinery or sign legal documents until your doctor tells you that it's safe to do so. This will be at least 24 hours after your procedure. This means that you will have to arrange for someone to drive you home. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor's advice. Once home, you should take it easy and have someone to stay with you for the first 24 hours. Most people have no problems after the test. Please contact your doctor if you develop any of these symptoms:
Deciding on having a colonoscopyColonoscopy is a commonly performed and generally safe procedure. For most people, the benefits in terms of having a clear diagnosis are much greater than any disadvantages. However, as with all medical procedures, a colonoscopy carries an element of risk. In order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications. Side-effects are the unwanted but mostly temporary effects of a successful procedure. After the test you may:
Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. Complications of colonoscopy are uncommon but it's possible to damage or, in very rare cases, perforate the colon during the procedure - this can lead to bleeding and infection, which may require further surgery or treatment with medicines. Your doctor will be experienced at performing colonoscopies, but even so a few are not successfully completed and may need to be repeated. Ask your doctor to explain how these risks apply to you. The exact risks will differ for every person. This is one of the reasons why we have not included statistics here. Further information
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