Colonoscopy

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

The Centre for Gastrointestinal Health are experts in performing colonoscopies and aftercare, ensuring that your procedure goes smoothly with no complications.

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What is a Colonoscopy?

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.

Colonoscopies assess the health of the gastrointestinal tract and although it is generally a one-off examination, a repeat colonoscopy may be required if issues are discovered that require further examination and treatment.

Reasons For Colonoscopy

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

  • As a screening exam for polyps, including removing polyps or examining previous polyps (a polyp is an abnormal growth of cells in the lining of the bowel)
  • Bowel cancer screening
  • Rectum issues (e.g. rectal bleeding)
  • History of colorectal cancer
  • Change in bowel habits or stool type (e.g. persistent diarrhoea)
  • Hypoactive or hyperactive bowel sounds
  • Anaemia (i.e. Iron deficiency which is a decrease in blood count due to loss of iron)
  • Chronic, unexplained abdominal/rectal pain
  • Abnormal x-ray exams, like a barium enema or CT scan
  • Family history of similar issues

 

Getting a Faecal Occult Blood Test

If you have been referred, you may have already taken a faecal occult blood test (FOBT). While this cannot diagnose bowel or colorectal cancer, it can detect microscopic traces of blood in the stool. 

If your faecal occult blood test results are positive, a colonoscopy should be performed as soon as possible. It is 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 get you a more definitive result.

Colonoscopy Preparation

Prior to the day of your procedure, 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 procedure. 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.

 

What to Eat Before a Colonoscopy

A few days before your procedure, you should adopt a low-fibre diet. Avoid whole grains, nuts, seeds, dried fruits, and raw fruits and vegetables. On the day before your procedure, you must not eat solid foods. It is recommended you consume clear liquids only, such as broth, tea, apple juice, clear soft drinks, or sports drinks. On the day of your procedure, you can have clear liquids only. You must not eat or drink anything two hours prior to your procedure.

 

Bowel Preparation

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. On the afternoon or evening before your procedure, you will be required to take a strong laxative to empty your bowels. Your doctor will advise you with more information with examples of what laxatives to take. This preparation will be diarrhoea-inducing, therefore patients are recommended to take time off work and be at home in a comfortable environment with easy access to a toilet. Moist wipes and adult nappies may be required to ease discomforts.

 

When Should I Fast From?

Patients are advised to fast 24 hours before their procedure, only consuming clear liquids up until two hours before the colonoscopy.

 

What Medications Should I Stop Before the Colonoscopy?

Consult your doctor and colonoscopist if you are taking medications including but not limited to blood thinners, iron tablets, aspirin or anti-arthritis medications. It is also recommended to cease vitamin consumption prior to the procedure.

What To Expect Right Before Your Procedure

On the day of your procedure, 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 procedure is performed to minimise risk.

The Colonoscopy Procedure

Patients will be sedated/under general anaesthetic during the process. This puts most patients to sleep for the duration of the test. However, in some cases, sedation may only make the patient feel relaxed and comfortable. In this case, the specialist will request an anaesthesiologist to 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 samples of pieces of tissue) of the colon or bowel, or remove polyps.

 

How Long Does a Colonoscopy Take?

It will often take between 20 minutes and up to an hour.

 

What are Polyps and Why Are They Removed?

Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most are benign (not cancerous). However, some can become cancerous if left to grow over time, therefore they are removed during the process if the surgeon finds any. Having a polyp removed does not hurt.

 

When Will I Get My Results?

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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Recovery from Colonoscopy

After the Procedure

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

Arrange transport to and from the hospital or private hospital. It is recommended not to catch public transport after your procedure because there is a small risk you will be unwell. If you are taking medication, consult your doctor on when it is safe to commence dosages again, especially blood thinners.

 

How Soon Can I Be Discharged After A Colonoscopy?

Approximately two hours post-procedure you will be discharged so long as there are no major complications, which are very unlikely.

 

Do I Need to Book a Follow-up Appointment?

Yes, you will have a follow-up appointment 1-3 weeks after for a check-in.

 

What to Eat After a Colonoscopy?

You must wait at least half an hour until you drink again. It is recommended you start with small sips and if this is easy then you can proceed to eat small amounts of solid foods. Although prior to the procedure, a liquid diet is required, most patients are able to eat normally after the procedure.

 

How Long Does It Take to Recover From a Colonoscopy?

Recovery is a normal part of the process and does take some time. Do not do anything the day of, or the day after your procedure. Allow your body to rest. It is normal to feel tired for several hours afterwards, so relax at home for the rest of the day. Patients often worry about bowel discomfort during the procedure but people usually feel fine after it is done.

They do commonly experience bloating and gas though, so to alleviate symptoms, you can use heat packs, have gentle movements like walking and yoga, and lie on your left side. It is recommended not to sign any legal documents or undertake a written report afterwards because you will likely be feeling groggy and dysfunctional.

Colonoscopy Complications

Although colonoscopies have minimal risks, complications can occur:

  • Bleeding from biopsies or the removal of polyps (usually minimal and controllable).
  • 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]).

FAQs

Is Colonoscopy Covered by Medicare Australia?

Medicare covers colonoscopies every 120 months, or 48 months post-flexible sigmoidoscopy. If you are at high risk for colorectal cancer you can be covered for colonoscopies once every 24 months. Medicare does not have a minimum age requirement for these coverages either.

How Much Does a Private Colonoscopy Cost?

Roughly $1,300-$2,100. The Department of Health reports that 80% of private patients with health insurance were not out of pocket for their colonoscopy. The average out of pocket expenses for private patients is $150.

How Often Should You Have a Colonoscopy?

If you do not have any histories then it is recommended to have your first colonoscopy by age 50. If you have a family history of bowel cancer or undiagnosed conditions, you should have a colonoscopy earlier rather than later. If you have diverticulosis, it is recommended to have one every 5 to 8 years. If you have ulcerative colitis, it is recommended to have one every 2 to 5 years.

How Do I Book a Colonoscopy in Sydney?

Contact the team at the Centre for Gastrointestinal Health for your initial consult. Phone 1300 580 239 or email practicemanager@www.centreforgastrointestinalhealth.com.au We have three convenient locations in Castle Hill, Gregory Hills and Bowral (coming soon).

What are the Average Waiting Times for a Colonoscopy in Sydney?

A colonoscopy should be performed within 30 days of patients experiencing bowel cancer symptoms. Unfortunately, wait times can be up to six months or longer, with Bowel Cancer Australia petitioning the Australian government to increase funding and decrease wait times.

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