Patient Information

Colonoscopy

What to expect before, during, and after your colonoscopy — including bowel preparation, sedation options, and aftercare.

What is a Colonoscopy?

A colonoscopy is a procedure used to examine the lining of the large bowel (colon and rectum). A thin flexible tube with a camera and light on the end (a colonoscope) is passed gently through the back passage to inspect the bowel directly. Colonoscopy is regarded as the best test for examining the bowel because it allows direct visual assessment, biopsies to be taken, and polyps to be removed during the same procedure.

Why Might I Need a Colonoscopy?

·Change in bowel habit

·Rectal bleeding

·Anaemia

·Positive FIT test

·Abdominal pain

·Surveillance for bowel polyps

·Family history of bowel cancer

·Assessment for inflammatory bowel disease

·Investigation of abnormal scans

Clinic Assessment Before the Procedure

You will usually have a consultation beforehand to review your symptoms, medical history, and medications.

Please tell us if you take:

·Blood thinning medication

·Diabetes medication

·Iron tablets

·Weight loss injections (such as semaglutide or tirzepatide)

Bowel Preparation

The bowel must be as clean as possible so that small polyps or areas of inflammation are not missed. Poor bowel preparation can reduce the accuracy of the test and occasionally means the procedure needs to be repeated. We commonly use Plenvu® bowel preparation — a strong laxative solution designed to clear the bowel completely.

Several Days Before

You may be asked to avoid:

·Seeds

·Nuts

·Wholegrains

·High fibre foods

The Day Before

Clear fluids only — no solid food. Acceptable clear fluids include:

·Water

·Tea or coffee without milk

·Clear squash

·Apple juice

·Clear soup

·Isotonic drinks

Avoid: milk, smoothies, red or purple drinks.

Taking Plenvu®

Usually taken in two doses:

·One dose the evening before

·One dose several hours before the procedure

Drink plenty of additional clear fluids to avoid dehydration. Most patients experience frequent loose bowel motions, cramping, and urgency — this means the preparation is working.

Sedation & Pain Relief Options

Intravenous Sedation

Sedation given through a vein in the arm. Most patients remain awake but relaxed and often remember little of the procedure.

Advantages

·Greater comfort and relaxation

·Often improves tolerance of the procedure

Disadvantages

·You cannot drive afterwards

·A responsible adult must accompany you home

·Mild drowsiness can persist for up to 24 hours

Gas and Air (Entonox®)

Inhaled through a mouthpiece during the procedure.

Advantages

·Works quickly

·Wears off rapidly

·Avoids intravenous sedation

·Most patients recover quickly afterwards

Disadvantages

·May provide less relaxation than IV sedation

·Some patients still experience discomfort

No Sedation

Some patients choose to undergo colonoscopy without sedation or gas and air. This avoids recovery time but may be less comfortable. You are free to discuss which option suits you best before the procedure.

What Happens During the Procedure?

You will usually begin lying on your left side. The colonoscope is passed gently through the back passage and advanced carefully around the bowel. Carbon dioxide gas is used to inflate the bowel slightly to improve visibility — this can create temporary bloating or cramping.

During the Procedure

·Photographs may be taken

·Biopsies may be taken painlessly

·Polyps may be removed

·The procedure typically takes 20–45 minutes

·You may be asked to change position to help navigate the bowel

Polyp Removal (Polypectomy)

Polyps are common growths within the bowel lining. Most are benign, but some can slowly develop into cancer over many years. Many polyps can be removed safely during colonoscopy using specialised instruments passed through the scope. Removing polyps helps prevent bowel cancer.

Risks

Colonoscopy is generally a very safe procedure, but complications can occasionally occur. The risks are slightly higher when larger polyps are removed.

Bleeding

Minor bleeding can occur after removal of polyps. Significant bleeding requiring hospital treatment occurs in approximately 1 in 2,500 colonoscopies without polyp removal, up to 1 in 150 procedures involving removal of larger polyps. Further treatment or repeat endoscopy is occasionally required.

Perforation (Hole in the Bowel)

Very rarely, a tear can occur in the bowel wall — approximately 1 in 2,500 colonoscopies overall, higher when larger polyps are removed. Some perforations can be treated endoscopically, but surgery is occasionally required.

Missed Pathology

Although colonoscopy is the best available test for examining the bowel, no investigation is perfect and occasionally small polyps or areas of abnormality may be missed.

Incomplete Examination

Occasionally the entire bowel cannot be examined due to discomfort, technical difficulty, or poor bowel preparation. Further tests may then be required.

After the Procedure

Recovery & Results

You will spend a short period in recovery before discharge. You may experience mild bloating, wind pain, or temporary cramping — this usually settles quickly.

Results:

·Findings are usually discussed with you before discharge

·You will receive a verbal explanation and written report

·Biopsy or polyp results typically take 1–3 weeks

·Results provided at clinic follow-up, by letter, or via your GP

After Intravenous Sedation

If you received intravenous sedation, for 24 hours afterwards:

·Do not drive

·Do not operate machinery

·Do not sign important documents

·Avoid alcohol

·A responsible adult should accompany you home and remain available

When Should I Seek Urgent Medical Advice?

Please seek urgent medical attention if you develop:

—Severe abdominal pain

—Heavy rectal bleeding

—Fever

—Persistent vomiting

—Dizziness or collapse

—Increasing abdominal swelling

Enquire about a colonoscopy

Appointments usually available within days · Spire Norwich & Cambridge

Book a Consultation ☎ 01603 813 732