What is a Colonoscopy?

A colonoscopy is an examination of the inside of your colon (large bowel) using a slim, flexible tube (colonoscope) passed through your anus (bottom).

The tube contains a digital camera, allowing the endoscopist to look for problems which may be causing your symptoms. The procedure takes approximately 30 – 40 minutes.

For an afternoon appointment

The day before your colonoscopy – Take your bowel preparation as instructed in the enclosed leaflet and also follow the diet instructions this includes, going to clear fluids after lunch and take half your normal insulin dose. Check your blood sugars regularly taking extra sweet drinks if the level is low.

The day of your colonoscopy – Take half your morning dose of insulin, and bring your insulin to the clinic. Check blood sugars regularly and take sweet drinks if it is low.

After the test – take half the morning dose of insulin when you start to eat and drink. In the evening take half the evening dose of insulin. Continue to check your blood sugars.

If you are diabetic on tablets follow the instruction below:

For a morning or afternoon appointment

The day before your colonoscopy – Follow the diet instructions and take the bowel preparation as instructed on the enclosed leaflet. Move onto the liquid diet following your last meal. Take your normal tablet dose and check blood sugars regularly- taking extra sweet drinks if the level is low.

Day of your colonoscopy – Do not take your tablets; continue taking fluids until 2 hours before the test. Continue to check your blood sugar, taking sweet drinks if the level is low.

After the test – Return to your normal tablet dose and eat as normal in the evening but continue to check your blood sugar.

Aftercare

After your procedure, you will receive your results, and be free to go home within 30 minutes if you only have Entonox. If you have sedation or pain relief, you will need to stay a short while in the unit until the effects have worn off. You will also require someone to drive you home and have a reliable adult to stay with you for the first 12 hours after your procedure.

The endoscopy report and results of any samples will be sent directly to your own doctor. You may eat and drink as normal after the examination.

Advice for diabetic patients

If you are diabetic on insulin follow the instructions below:

For a morning appointment

The day before your colonoscopy – Take your bowel preparation as instructed in the enclosed leaflet and also follow the diet instructions this includes, going to clear fluids after breakfast and take half your normal insulin dose. Check your blood sugars regularly; taking extra sweet drinks if the level is low.

The day of your colonoscopy – Do not take your insulin; continue taking clear fluids until 2 hours before the test. Bring your insulin with you to the clinic. Continue to check your blood sugar and take sweet drinks if the level is low.

After the test – Take half your normal dose of insulin and a sandwich. Return to normal insulin dose in the evening, but continue to check your blood sugar.

What are the risks of colonoscopy?

The majority of colonoscopies are very safe and uncomplicated, particularly in community based units like ours. Sometimes people who have the procedure will experience mild abdominal discomfort, such as cramp, soreness in the back passage and loose motions for a few days after the test or slight bleeding from the lower part of the bowel.

Rarely, patients may have a reaction to sedative drugs, bleeding or perforation (tear in the lining). This would require admission to hospital for further treatment. At the unit we only remove small polyps to reduce this risk, and refer any large polyps found to our colleagues within the hospital. Very rarely an abnormality may not be identified due to poor bowel preparation. This may occur in less than 5% of cases, or where a polyp is smaller than 1 centimetre.

Please speak to your endoscopist if you are concerned, or would like more information.

Do I need to bring anything with me?

Make sure you bring a list of any medications you are taking. It is important to bring asthma inhalers, angina sprays and diabetic medication. Bring your consent form. You may sign this at home if you feel you have enough information.

What preparation is required before a colonoscopy?

For this examination to be successful, your bowel must be empty. It is important that you take the bowel preparation sent to you and follow the detailed instructions on how to take it and what you can eat and drink.

Please try to avoid eating seeded foods for one week prior to your procedure.

Anticoagulant advice: If you are taking Clopidogrel, or other antiplatelet tablets, you may be asked to stop it 5 days before the procedure if it is considered safe for you to do so. If this applies to you details will be included in your appointment letter. You do not need to stop taking aspirin.

If you take warfarin or other blood thinning tablets, please contact us as you may have to stop them prior to the procedure. If you have to stop warfarin it is usually for 5 days before your appointment and you need to have an INR done at your practice the day before and bring the result along with you on the day of the procedure.

If you are taking Apixaban, Rivaroxaban, Dabigatran or Edoxaban, please omit on the day of the procedure.

If you are taking iron tablets please stop 1 week prior to your procedure date.

About the colonoscopy procedure

A nurse will check your details, blood pressure pulse and allergies and explain the procedure. If you haven’t signed your consent form, the nurse or endoscopist will explain and sign it with you. We will ask you to change into a gown for comfort.

In the procedure room you will be made comfortable on a trolley, lying on your left hand side. A device will be attached to you to measure your heart rate and oxygen levels. We will give you some oxygen through a nasal cannula (slim tube just inside your nostril) If you are having sedation, or using Entonox (gas and air) this will be administered before the endoscopist starts the procedure. To help with the endoscope moving easily round the bowel, you may be asked to turn to your back or other side.

A biopsy (small sample of tissue) may be taken during the examination to be sent to the laboratory for more tests. You cannot feel this being done. The examination takes between 30-40 minutes.

A nurse will be with you to monitor and reassure you throughout the examination.

Do I need an anaesthetic for a colonoscopy?

A general anesthetic is not required for this procedure. We do however, offer a number of options to make you feel more comfortable during the procedure; pain relief (Fentanyl) and sedation (Midazolam) administered by injection. Entonox, which is inhaled via a mouthpiece. If you only have this, you can resume your normal activities including driving 30 minutes following your procedure.If you have either Fentanyl or Midazolam, certain restrictions apply following your procedure.

For 24 hours following your procedure you must not:

• Drive a motor vehicle
• Operate machinery including a cooker
• Drink alcohol
• Sign any legal documents

You will require an escort home.