How to Prepare for a Colonoscopy

For many, a colonoscopy requires both mental and physical preparation.  A colonoscopy is a visual examination of the inside of the rectum and the large intestine or colon through a fiber-optic scope.  A camera fitted to the end of the scope senda video feed to a monitor in the procedure or treatment room.

Colonoscopies are a primary diagnostic tool with the capability of identifying abnormal growths or tissues for biopsy in a laboratory, as well as to remove polyps.  If left untreated, polyps do have the potential to develop into cancerous growths and are considered precursors of colon or rectal cancer.

Individuals over the age of 50 (or younger in specific situations) are encouraged to undergo routine colonoscopy examination to look for and diagnose diseases of the colon, and to assess and/or remove precancerous polyps and benign or cancerous tumors.

Colonoscopies can be conducted by proctologists, colon and rectal surgeons, gastroenterologists, general surgeons, or some general practitioners trained and experienced in the procedure.  Colonoscopies are generally performed in outpatient surgical facilities, hospitals, or if properly equipped, a physician’s office.

Preparing for a Colonoscopy

Prior to a colonoscopy procedure, the colon must be cleansed through the use of laxatives, or other liquid preparations that trigger bowel movements that flush waste from the colon.  This process enables a better view of the lining of the colon during the procedure.

Your physician will provide bowel preparation instructions and determine the type of colon cleansing process best for you to undertake prior to the colonoscopy.  Your doctor will also advise you regarding medications prior to the procedure. The same applies to the type of bowel preparation solution. A number of options are available which are combined with generally 24 hours of clear liquid diet (with limitations including fluids,jello products, popsicles, or juices that contain artificial red, blue, or purple colored dyes or extracts).  Options may include:

  •         Sodium phosphate solutions (some brands have been discontinued)
  •         Polyethylene glycol-based solutions

For most, the bowel cleansing aspect of preparation causes the most concern for patients.  Accessibility to a bathroom is recommended during this stage of preparation, as you may feel the need to evacuate your bowels frequently as the solution works to clear your colon. Frequent urination due to the large amount of liquid intake is also common.

The urge to evacuate the bowels occurs within just over 90 minutes after the first dose, and continues for anywhere between one to 14 hours after.  With the second dose, onset of urge to evacuate occurs more rapidly and lasts a shorter duration. The physician will advise regarding the timing of the doses depending on appointment time and distance required to travel from home to the treatment center.

Polyethylene glycol solutions also comes with specialized instructions, and may also include the addition of bisacodyl tablets.  Consumption of approximately 64 ounces of a clear liquid may be recommended in conjunction with this type of solution and/or use of the bisacodyl tablets.

It’s very important for patients to follow instructions provided by their physician for diet recommendations and use of bowel-cleansing solutions prior to the colonoscopy procedure.

The Colonoscopy Procedure

Before conducting a colonoscopy, medical staff will ensure that arrangements have been made to drive you home following the procedure.  This is because intravenous anesthetic agents are used to keep you comfortable during the procedure and they may have lingering effects.  It is not recommended that you attempt to drive yourself home or to use public transportation alone.

During the actual colonoscopy procedure, a lubricated colonoscope is inserted into the rectum and slowly passed into the colon.  This tube is long, capable of traversing the length of the large intestine. While the colonoscope is guided through the large intestine, the physician is able to view its journey via a video monitor. This enables the ability to not only locate, but examine and even treat polyps or tumors.  During the procedure, the doctor may use additional fluids or air to aid the passage of the colonoscope throughout the colon.

The actual procedure takes an average of 30 to 40 minutes.

Following the procedure, you’ll be taken to a recovery room.  You may feel bloated and gassy. Don’t be embarrassed! Your nurses are familiar with the process and will encourage you to pass gas to reduce potential for mild stomach cramps.

The nurse will remove your IV and encourage you to drink.  Don’t be alarmed if you feel a bit “dopey” as the anesthesia wears off.  When the nurses determine you’re stable enough to go home, you’ll be provided with discharge instructions and released.