Colonoscopy: What to Expect Before, During & After the Procedure

Going for your first colonoscopy procedure can be unnerving. Find out what to expect during the procedure, how you can prepare beforehand and if you should get additional support after the procedure.

by Calvyn Ee

What is a Colonoscopy?

For certain diagnoses of specific digestive tract conditions, a colonoscopy may be ordered. This procedure involves the use of a colonoscope: a long, thin and flexible tube about the width of your finger. It is equipped with a light and camera on one end. The colonoscope will be inserted via the rectum and is then used to examine the length of your colon (hence the name of the device). The camera transmits its image to a screen that doctors can view to look for abnormalities in the colon. The colonoscopy is usually long enough to run the entire length of your colon.

Your colon forms a part of the large intestine. Its primary function is to receive the digested food from the small intestine, called chyme, and then digest it to eventually form a stool. The colon will absorb water and nutrients and passes the waste to the rectum to be excreted from the body.

During a colonoscopy, a sample biopsy may be performed to obtain tissue samples from the colon. The colonoscope has space to allow special tools to be inserted through the colonoscope to obtain tissue samples. The medical team can use these samples to diagnose your condition and find out what you might be afflicted with, and what treatment plan will work best.

Is a Colonoscopy Really Needed?

A specialist in the digestive tract, called a gastroenterologist, will recommend a colonoscopy is needed. They may recommend a colonoscopy for a variety of reasons, but screening can be helpful if you or your loved one might be facing gastrointestinal-related complications. You may be able to determine if the complication is something mild or if it requires further treatment; early detection of chronic gastrointestinal issues such as appendicitis, diverticulitis, and many others.

Apart from that, a colonoscopy is your first line of defence in detecting – and subsequently treating – colorectal (or another type of) cancer. For those above the age of 45, or who may have other risk factors pertaining to colorectal cancer, you are advised to undergo frequent colonoscopies to look for signs of cancer. Meanwhile, those who undergo a different cancer diagnosis test which comes back negative may also need to have a colonoscopy performed as a precaution. Apart from signs of cancer, the doctors will also look for, and remove, polyps found along the colon wall.

Worried About the Colonoscopy?

It’s perfectly fine to feel a little apprehensive about the whole procedure. In fact, quite a number of people do feel reluctant to go through it or are embarrassed at the thought of it. However, the medical team will prioritise your privacy and comfort from start to finish. You can speak to them at any time to ask questions that can help allay your anxieties.

During the procedure, you’ll also be given intravenous medications that will help you feel relaxed and a little drowsy. It will help reduce any discomfort you may feel while the colonoscopy is being performed. Your comfort is equally important while the procedure is performed, so do let the medical team know of any discomforts you might experience.

There are also potential risks that can occur before, during and after the colonoscopy.

Some of these include:

  • Rectal bleeding
  • Perforation
  • Allergic reaction(s) to the anaesthesia
  • Inflammation when treating/removing a polyp
  • Infection

Your doctor will bring these up as you discuss the colonoscopy with them. They will do their best to minimize risks during the procedure, while you need to provide them accurate information about your overall health in order for them to help reduce these risks from occurring. If ever in doubt, be sure to speak at length with the medical team. Take some time beforehand to prepare some questions to ask them.

Preparing for a Colonoscopy

You or your loved one will have to undergo a few important steps before the colonoscopy. Granted, the term isn’t the most flattering, but it underscores the importance of preparing yourself (and informing the medical team about certain aspects of your life and health) for the procedure ahead of time, as well as when the procedure is being performed and when it’s completed.

Before the Procedure

The most important step is to notify the doctor if you or your loved one might have specific health problems and if you’ve been prescribed medications to address these conditions. Your doctor will advise you on which medications and supplements to avoid for the time being; you may also have to reschedule your medication timings until the procedure is done. This is especially important if you or your loved one has diabetes, heart complications, or are taking blood thinners.

If you happen to have any allergies, especially to sedatives that might be used during the procedure, make sure you notify the doctor immediately so they can arrange for a suitable replacement. In rarer cases, you might have to undergo a virtual colonoscopy instead (which we will cover later in this article).

You or your loved one will also need to abide by a specific food plan. You may have to restrict the consumption of solid foods or stick to a low-fibre diet, as well as stick to clear liquids only. The latter means you can still have tea and coffee, but without any sugar, milk or cream added. On that note, avoid any coloured drinks like fruit juices, especially those with a red or purple colour, like apple or grape juice, as it can be mistaken for blood.

On top of all these, you will also need to keep an empty bowel a few hours to a day before the procedure. This is the part that most people tend to associate with the colonoscopy procedure as being very unpleasant (short of the procedure itself), as keeping the bowel empty will require you to take prescribed laxatives, whether in liquid form or given as pills.

The medication’s primary function is to cause diarrhoea so that your colon is emptied of any waste material. You may either have to finish it the night before the procedure or have one portion the night before and the remainder in the morning just a few hours before the procedure.

If you find it difficult to drink the laxative solution you were given, you can add lemon drops or chew ginger candy to deal with the unpleasant taste of the laxatives. Once you have finished it, be sure to stay close to the washroom while the laxatives take effect. Because of how frequently you will be passing frequent liquid stools, you should ideally apply Vaseline ointment, or something similar, on the area around the anus before you consume the laxatives. Doing this can be helpful to combat skin irritation caused by frequent stool passage.

At this point, you might be thinking why it’s so important to clean out your bowel before the procedure. The reason is simple: any obstructions in the colon can affect what the doctors see in the colonoscope’s camera. The camera provides a clear image but does not have excellent resolution capture like most modern smartphones. As a preventive measure to ensure doctors do not misdiagnose something they see on the camera, it is best to remove all waste in the colon as a safety measure for the sake of your long-term well-being.

Be sure to consult your doctor for any additional steps that are required prior to the procedure.

During the Procedure

Before you go for the procedure, you can take a shower but do avoid using any lotions, perfumes or deodorants. Also, refrain from bringing along any jewellery or other valuables as they might get in the way of the colonoscopy.

You will wear a surgical gown for the procedure. An IV line is inserted into your arm and hand. The line will be injected with a sedative or a combination of a sedative and pain medication so that you will not feel any pain or discomfort during the procedure. If need be, you may be put to sleep with general anaesthesia.

Before the sedative/combination is injected, you will be asked to lie on your side with your legs pulled up towards your chest. Once you are sedated, the doctor will carefully insert the colonoscope into your anus and moved it into the rectum and colon. If the sedation keeps you mildly awake and aware, you might feel some pain, cramping or discomfort as the tube goes in. You may be asked to breathe in slowly and deeply while the tube is being inserted to minimize the pain or discomfort.

Besides being able to see what’s inside the colon, the colonoscope may also be used to inject air into the colon, inflating it and making it easier to see its contents. The colonoscopy may also be used to stream a water jet to clean the lining of the colon. If there might be liquid stools that were not excreted, suction is used to remove them from the colon. All these are possible as the colonoscope has space to allow various tools to be inserted through it and used for various purposes.

Again, if you feel any cramping or pain while any of these tools are in use or when the colonoscope is moved around, continue breathing in slowly and deeply. If you are under general anaesthesia, you won’t feel anything at all. Throughout the procedure, the doctors will closely monitor your readings, such as your oxygen intake, heart rate, and more.

The colonoscope’s camera will help doctors look out for any abnormalities along the length of the colon. If a polyp or something else is found, a tissue biopsy may be performed. In some cases, tools to remove these abnormalities may be used. Otherwise, a future procedure (such as bowel surgery) might be needed to remove them.

All in all, a colonoscopy will take anywhere between 30 to 60 minutes, depending on what the doctors need to examine and whether they need to remove any abnormalities or retrieve tissue samples.

After the Procedure

Once the procedure is completed, you will be taken to a recovery room for observation. If all your readings are normal, and you are awake and fully alert, you will be taken back to the ward to rest. Alternatively, if everything seems fine, you may be discharged and allowed to go home. Make sure you have someone accompanying you, as the effects of the sedative may take some time to fully go away; have your escort take you home, and allow yourself the rest of the day to rest and recuperate.

Once home, you do not have to restrict your diet and can resume taking your medications and supplements, unless indicated otherwise by the doctor. Also, be sure to avoid ingesting alcohol or refrain from smoking (or both) for at least a 24-hour period. Drink more fluids to make up for all the water you lost during bowel preparation.

If you still feel some bloating or are passing gas often, that’s normal; your digestive system is still expelling the air injected into your colon. It might take some time for it to clear up. Light walking around the house can also be beneficial in alleviating discomfort.

Because your colon was emptied from bowel preparation, it might take some time before you have any bowel movement.

Also, if you happen to experience any of the following, be sure to notify your doctor as soon as possible:

  • Fever or chills
  • Blood during bowel movement
  • Abdominal/belly pain
  • Frequent swelling/bloating
  • Difficulty passing gas

What Else to Expect

After the procedure, your doctor will inform you of how the procedure went. They may tell you details such as whether they took any tissue samples, removed any polyps, and so forth. They will also indicate if you can resume taking your medications and supplements as usual before you are discharged. You may either have to return for a follow-up check, as well as receive the full report of the colonoscopy, or you may have the report delivered to you; check with your doctor if you are given a choice.

Depending on your colonoscopy results, your doctor will advise you on steps to take to improve or maintain your bowel health. This generally means simple lifestyle modifications, such as reducing your intake of alcohol, red meat or other types of food, or more frequent exercise. In cases where polyps or other abnormalities were detected, your doctor might require future colonoscopy sessions on a regular basis (once every year, for example). This is tied to the severity of the colonoscopy results.

In the case of polyps, not all polyps are cancerous. Even so, prevention is always better than cure, so frequent sessions can help monitor your overall health and reduce the risk of developing serious bowel cancer. A repeat exam or surgery might be ordered with the assistance of a gastroenterologist in the event of polyps or abnormalities that couldn’t be removed.

If something else prevented the colonoscopy from being completed, you may be asked to return for a repeat session. Some aspects of the procedure might change, such as the bowel preparation process, to make sure the procedure can proceed smoothly.

What is a Virtual Colonoscopy?

Virtual colonoscopy, or CT colonography, is another type of colon diagnostic test whose purpose is similar to a regular colonoscopy. It is a minimally invasive procedure that uses computed tomography (CT) scans to create cross-sectional images of your abdominal organs using X-rays. A computer puts all these X-rays together to create these 3D images of your internal organs – in this case, the rectum and colon.

A virtual colonoscopy is a minimally invasive procedure. As such, instead of relying on a colonoscope to examine the rectum and colon, it uses X-rays to build a 3D model of your rectum and colon. You still need to undergo bowel preparation to clean out the colon, but apart from that, it differs in a few ways from a standard colonoscopy.

  • No risk of pain or injury during the procedure
  • No need for sedation, since this procedure uses X-rays
  • Faster screening time
  • Small risk of radiation exposure (since it uses X-rays to create images of your internal organs)
  • Images of areas that a regular colonoscopy can’t reach

A virtual colonoscopy may be recommended for those who refuse to go through a colonoscopy, or in some cases where a colonoscopy may not be recommended due to an allergy to the sedative. However, a virtual colonoscopy is unable to remove any polyps or abnormalities in the lining of the colon, nor does it allow doctors to collect tissue samples. A virtual colonoscopy might also miss very small polyps that a colonoscope might be able to detect. A follow-up colonoscopy might be required to remove these abnormalities.

Your doctor will recommend a virtual colonoscopy depending on your health, whether you are willing to go for a colonoscopy, and various other factors.

Need Professional Help?

Having someone around to keep you company before, during and after the colonoscopy can be helpful in keeping your spirits up and being around to take you to and from the hospital and your home. After the colonoscopy is the most important time to have an escort, due to the sedative’s effects not completely wearing out after the procedure. You should never drive on your own while still recovering from the sedative.

If it might be difficult to get the help you need, consider contacting Homage for professional care and assistance from our well-trained Care Pros. They are able to help you as a medical escort, taking you to the hospital and back after the procedure is complete, and then helping you out at home with activities of daily living (ADLs) and/or chores while you recuperate from home.

Reach out to us by filling in the form below and our Care Advisory team will help you with a personalised plan tailored to your needs!


References
About the Writer
Calvyn Ee
Calvyn is an aspiring author, poet and storyteller. He spends his time reading, gaming and building stories with his action figure photography.
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