Colonoscopy Sydney


A colonoscopy examines the lower part of the gastrointestinal tract, i.e. the colon, large bowel or large intestine. This is different from, but often confused with an endoscopy, which examines the digestive tract.

Colonoscopies are low risk day-surgery procedures that usually help diagnose symptoms such as diarrhoea, blood in the stool and abdominal pain. It may also be used to identify bowel cancer/colorectal cancer or polyps.

A colonoscopy is performed by inserting a device called a colonoscope into the anus and advanced through the entire colon. The time of the procedure is quite short – it generally takes between 20 minutes and one hour. However, preparation is required prior to the procedure.

Reasons For Colonoscopy

You may receive a referral for a colonoscopy to evaluate the following:

  • As a screening exam for polyps (a polyp is an abnormal growth of cells in the lining of the bowel)
  • Bowel cancer screening
  • Rectal bleeding
  • Family history of a disease such as bowel cancer
  • Change in bowel habits (e.g. persistent diarrhoea)
  • Iron deficiency anaemia (a decrease in blood count due to loss of iron)
  • Follow-up test in people with polyps or a disease such as bowel cancer
  • Chronic, unexplained abdominal/rectal pain
  • Abnormal x-ray exam, like a barium enema or CT scan
If you have several symptoms listed above, you may have already taken a faecal occult blood test (FOBT). While this cannot diagnose bowel or colorectal cancer, it can to detect microscopic traces blood in stool. If your faecal occult blood test results are positive, a colonoscopy should be performed as soon as possible. It important for your health that you receive a colonoscopy no later than 120 days after your positive FOBT result. In this case you may be eligible for a direct access colonoscopy but if not, a colonoscopy at our clinic can you get a more definitive result.

Colonoscopy Preparation

Prior to the day of your colonoscopy, correct bowel preparation is important to reduce risk and ensure the procedure is performed properly. Your large bowel must be completely cleaned out so that the specialist can see any abnormalities.

Instructions will be provided to you on how to prepare for your colonoscopy. Read this preparation information immediately so you are aware of changes you will need to make regarding your medications or diet. If you have questions or need additional information, please contact our staff/doctors.

As well as changes to your diet and medications, your preparation will involve avoiding solid food for at least one day before the test. You should also drink plenty of fluids, specifically clear fluids the day before the test. You can drink clear fluids up to several hours before your procedure. You will also be required to take a strong laxative to empty your bowels.

What To Expect Right Before Your Procedure

On the day of your colonoscopy, the specialist will review the procedure with you, including possible complications, and ask you to sign a consent form.

Then, an IV line will be inserted in your hand or arm so fluids and medicines can be administered to you during the procedure. Additionally, you will be set up such that your blood pressure, heart rate, and breathing can be monitored while the colonoscopy is performed to minimise risk.

The Colonoscopy Procedure

Sedation/analgesia will be provided by the anaesthetist. This puts most patients to sleep for the duration of the test. However, in some cases sedation may only make the patient feel relaxed, comfortable. In this case, the specialist will request an anaesthesiologist give you an anaesthetic agent (Propofol) - a stronger sedative - to put you to sleep while you are closely monitored.

At this stage, the colonoscope will be inserted into the anus and advanced through the entire colon.

The colonoscope is a flexible tube with a fibre optic camera, and is quite small (approximately the diameter of the index finger). It gently pumps carbon dioxide into the colon to inflate it and allows the specialist to access and see the entire lining. Bloating or gas cramps may occur due to this. Try not to be embarrassed about passing this gas post procedure and let the doctor know if you are uncomfortable.

During the procedure, the doctor might take a biopsy (small pieces of tissue) of the colon or bowel, 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 left to grow over time. Having a polyp removed does not hurt.

Recovery from Colonoscopy

After the colonoscopy is performed, you will be observed in a recovery area for some time until effects of the sedative medication wear off.

After a colonoscopy, it is common to feel bloated and have gas cramps. You may also feel groggy from the sedation medications but this should wear off within a few hours. However, you should not return to work or drive that day.

Although prior to the procedure, a liquid diet is required, most patients are able to eat normally after the procedure.

Be sure to ask your doctor when it is safe to restart your blood-thinning medications.

Colonoscopy Complications

Although colonoscopies have minimal risks, complications can occur:

  • Bleeding from biopsies or the removal of polyps (usually minimal and controllable).
  • Colonoscope may cause a tear or hole in the colon (perforation). This is a serious problem, but very rare if care is taken.
  • Sedative medicines may have risks.
  • Although colonoscopy is the best way to examine the large bowel, there is a small chance that even the most skilled specialist can overlook an abnormal area/disease/polyp.

You should call your doctor immediately if you have any of the following health issues:
  • Severe abdominal pain (not just gas cramps).
  • A firm, bloated abdomen.
  • Vomiting.
  • Fever.
  • Rectal bleeding (greater than a couple of tablespoons [30 mL]).

After Colonoscopy

Patients often worry about bowl discomfort during a colonoscopy but people usually feel fine after the colonoscopy is done. It is however normal to feel tired for several hours afterward so relax at home for the rest of the day.

The specialist can explain the results as soon as the procedure is done. Hopefully you will get the all clear but if not, the doctor will identify any further surgery or medical procedures you may require. You will also be given an opportunity to ask questions you may have about recovery at home and any next steps you may need to take.

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