Colonoscopy: step by step
In this article, Mr Paul Sutton, a consultant colorectal surgeon, explains the colonoscopy process.
A colonoscopy is a routine test used to look inside your bowel to help us try and understand what is causing your bowel and/or abdominal symptoms. We also use colonoscopy to investigate the bowel if screening tests (for example a ‘FIT’ test) are raised.
A colonoscope is a long, thin, and flexible tube with a small camera inside that is passed into your bowel through your bottom, and is moved slowly through the large bowel.
To ensure I can get a clear look inside your bowel, you will be given laxatives to take the day before your procedure to ensure your bowels are empty.
You are normally awake during your colonoscopy, but you will be offered a medicine to make you feel more relaxed and help the test to be completed more easily.
Common reasons for colonoscopy
- Persistent diarrhoea
- A strong family history of bowel cancer
- Pain in your tummy
- Changes to your bowel habit
- Bleeding from your bottom
- You may have been placed on the bowel cancer screening pathway
- Existing conditions that need check-ups such as colitis
- Any other reason at the recommendation of your surgeon
Often the test will not find anything unusual, but sometimes there may be things that need a closer look or extra tests. This may require biopsies to be taken from the bowel, or small polyps (benign growths in the bowel) to be removed for testing.
Getting ready
On the two days before your colonoscopy, you should eat plain foods like:
- Clear soups
- Plain chicken or fish without sauces
- Pastas, breads and rice
- Bovril
You should avoid foods with skin, pith, nuts, and seeds. The day before your colonoscopy you will need to take your laxatives. The timing of this will be explained to you in a letter and by my pre-procedure team. It is likely that you will experience diarrhoea within a few hours of your first sachet – this is normal. It is advisable to stay at home near a toilet once you have started taking your laxatives.
If you do not have your laxatives as it says in the letter you may not be able to have your procedure
On the day
You will be told in your letter when to stop eating and drinking. This includes tea, coffee, and also chewing gum. You should bring with you any medication you are on.
To make the procedure easier you may be offered a sedative, painkillers, and gas and air. If you have sedation, you will be unable to drive or operate heavy machinery for 24 hours – you will need someone to collect you after your procedure.
The procedure should take around 40 minutes and I will discuss this with you before the procedure starts. I will make sure you understand what is going to happen, as well as the risks of having the procedure. Serious complications from colonoscopy are rare. The biggest risk is of making an injury to the bowel, which is around 1:1000. Once you are clear and happy to proceed, your consent will be taken and you will be asked to sign a form to say you are happy.
What you might feel
You might feel:
- The sensation of the camera going into your bottom, but this should not be painful
- Stomach cramps
- Bloating/feeling full
These feelings may continue for a few hours after your colonoscopy, and you may have some blood in your poo or bleeding from your bottom for a couple of days – this is quite common.
After your colonoscopy
You will spend some time in our recovery area where you will be given something to eat and drink, before moving back to our private ward. I will go through the results of the investigation with you, and give you a copy of your report. If a follow-up appointment is required, we will arrange that with you either before you leave or shortly afterwards.
If you need a colonoscopy or have concerns regarding your colorectal health, consult with Mr Sutton via his Top Doctors profile.