What to expect from a colonoscopy appointment?

Before the test, a doctor will review the procedure with you, including possible complications, and will ask you to sign a consent form. You will be given fluid and medicines through the IV line. With sedation/analgesia provided by the anaesthetist so you fall sleep for the duration of the procedure while you are being closely monitored.

The colonoscope is a flexible tube with a fibre optic camera, approximately the diameter of the index finger. The scope gently pumps carbon dioxide into the colon to inflate it and allow the doctor to see the entire lining.  You might feel bloating or gas cramps as the carbon dioxide opens the colon. Try not to be embarrassed about passing this gas post procedure and let us know if you are uncomfortable.

During the procedure, we may take a biopsy (small pieces of tissue) or remove polyps. Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most polyps are benign (not cancerous). However, some polyps can become cancerous if allowed to grow for a long time. Having a polyp removed does not hurt.

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How to prepare

If your colonoscopy in the morning

One week prior

  • Stop taking iron tablets.
  • All other medications can be continued unless advised by your doctor.
  • Do not take fibre supplements such as Metamucil or Benefiber.
  • Do not eat any fruits containing seeds, including – Tomatoes, Strawberries, Passionfruit and / or Nuts.

Two days prior

  • Maintain a low fibre diet and avoid brown /wholegrain breads, cereals, seeds and nuts, vegetables, fruits.
  • The following are NOT allowed beef, lamb, pork, dairy.
  • The following are allowed: eggs, steamed fish, boiled chicken.
  • Take two Dulcolax tablets at 8.00PM
  • Take two Dulcolax tablets at 8.00PM

One day prior

  • Drink clear fluids ONLY.
  • Mix the GLYCOPREP-C in 1 litre of water and refrigerate for drinking later.
  • Avoid all red and purple liquids.
  • Clear fluids include: Water, cordial, gatorade. strained fruit juices – no pulp, ice popsicles, clear broth or bouillon, coffee, tea no milk or cream.
  • Take a further two Dulcolax tablets at 1.00PM.
  • 1st Dose – PICOPREP at 5.00PM
  • Dissolve the contents of ONE sachet of PICOPREP in 250ml of cold water and drink slowly until completed.
  • 2nd Dose – GLYCOPREP-C at 7.00PM
  • Remove the 1 litre of GLYCOPREP-C from the refrigerator and drink a glass (250ml) of the preparation every 15 minutes over the period of one hour until completed.

On the day

  • 3rd Dose – PICOPREP AT 4.00AM
  • Dissolve the contents of ONE sachet of PICOPREP in 250ml of cold water and drink slowly until completed.
  • THEN NIL BY MOUTH AFTER THE LAST DOSE OF PICOPREP UNLESS INSTRUCTED OTHERWISE UNTIL YOUR PROCEDURE.

If your colonoscopy is in the afternoon

One week prior

  • Stop taking iron tablets.
  • All other medications can be continued unless advised by your doctor.
  • Do not take fibre supplements such as Metamucil or Benefiber.
  • Do not eat any fruits containing seeds, including – Tomatoes, Strawberries, Passionfruit and / or Nuts.

Two days prior

  • Maintain a low fibre diet and avoid brown /wholegrain breads, cereals, seeds and nuts, vegetables, fruits.
  • The following are NOT allowed beef, lamb, pork, dairy.
  • The following are allowed: eggs, steamed fish, boiled chicken.
  • Take two Dulcolax tablets at 8.00PM

One day prior

  • Drink clear fluids ONLY.
  • Mix the GLYCOPREP-C in 1 litre of water and refrigerate for drinking later.
  • Avoid all red and purple liquids.
  • Clear fluids include: Water, cordial, gatorade. strained fruit juices – no pulp, ice popsicles, clear broth or bouillon, coffee, tea no milk or cream.
  • Take a further two Dulcolax tablets at 300PM.
  • 1st Dose – PICOPREP at 6.00PM
  • Dissolve the contents of ONE sachet of PICOPREP in 250ml of cold water and drink slowly until completed.
  • 2nd Dose – GLYCOPREP-C at 8.00PM
  • Remove the 1 litre of GLYCOPREP-C from the refrigerator and drink a glass (250ml) of the preparation every 15 minutes over the period of one hour until completed.

On the day

  • 3rd Dose – PICOPREP AT 10.00AM
  • Dissolve the contents of ONE sachet of PICOPREP in 250ml of cold water and drink slowly until completed.
  • THEN NIL BY MOUTH AFTER THE LAST DOSE OF PICOPREP UNLESS INSTRUCTED OTHERWISE UNTIL YOUR PROCEDURE.

The Laxative bowel preparation usually induces frequent, loose bowel movements within 1 to 3 hours of taking the first dose. It is best to stay at home in the afternoon within easy reach of toilet facilities. To avoid dehydration and to gain an ideal bowel preparation and procedure outcome, please ensure that you consume a large amount of water and fluids in addition to that consumed with the bowel prep.

Make sure that you have plenty of water and approved clear fluids before and after each dose of Ducolax.

Hint: The PICOPREP and GLYOCPREP are best consumed cold and through a straw. You may choose to place a “Werther’s Original” or similar type lozenge in your mouth whilst drinking.

Medicines

You can take most prescription and non-prescription medicines right up to the day of the colonoscopy. Dr Yoganathan should tell you what medicines to stop. You should also tell the doctor if you are allergic to any medicines.

Some medicines increase the risk of heavy bleeding if you have a polyp removed during the colonoscopy. Ask your doctor how and when to stop these medicines, including warfarin / Coumadin, Clopidogrel / Plavix, or any other anticoagulant medicine. Do not stop these medications without first talking with your doctor.

After the colonoscopy appointment

After the colonoscopy, you will be observed in a recovery area until the effects of the sedative medication wear off. The most common complaint after colonoscopy is a feeling of bloating and gas cramps. You may also feel groggy from the sedation medications. You should not return to work or drive that day so be sure to organise transportation home. Most people are able to eat normally after the test. Ask your doctor when it is safe to restart your blood-thinning medications.

Although many people worry about being uncomfortable during a colonoscopy, most people tolerate it very well and feel fine afterward. It is normal to feel tired following the procedure so plan to take it easy and relax the rest of the day. We will describe the results of the colonoscopy as soon as it is over.

Transport home

Most patients are given a sedative (a medicine to help you relax) during the colonoscopy, so you will need someone to take you home after your test. Although you will be awake by the time you go home, the sedative / anaesthetic medicines cause changes in reflexes and judgment that can interfere with your ability to make decisions, similar to the effect of alcohol. You will not be able to drive home or go back to work after the examination if you received sedation for the procedure. You should be able to return to work the next day.

Colonoscopy complications

Colonoscopy is a safe procedure, and complications are rare but can occur:

  • Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled.
  • The colonoscope can cause a tear or hole in the colon (perforation). This is a serious problem, but it does not happen commonly.
  • It is possible to have side effects from the sedative medicines.
  • Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.

You should call your doctor immediately if you have any of the following:

  • Severe abdominal pain (not just gas cramps)
  • A firm, bloated abdomen
  • Vomiting
  • Fever
  • Rectal bleeding (greater than a couple of tablespoons [30 mL])

Where to get more information

Your healthcare provider is the best source of information for questions and concerns related to your medical problem.