Colonoscopy FAQs

Plan to be at the hospital for 2-4 hours in total. The actual procedure takes 15-45 minutes depending on the type, but you’ll need time for preparation, recovery, and discharge. If you have sedation, you’ll need longer to recover before going home.

You’ll need to follow a special low-residue diet for 2-3 days before, then clear fluids only on the day before. You’ll be given bowel preparation medication (usually Moviprep, Klean-Prep, or Picolax) to drink which will cause diarrhea to clear your bowel.

Follow the timing instructions exactly as given.

Continue most medications as normal, but some need stopping or adjusting. Particularly important: stop iron tablets 1 week before, diabetes medications may need adjustment, blood thinners like warfarin need careful management.

Always check your pre-procedure letter or call us if unsure.

It’s essential to complete the preparation for a safe, effective procedure. If you’re struggling, try drinking it chilled, through a straw, or with clear fruit cordial. Take breaks between glasses but complete it within the timeframe.

If you’re unable to keep it down due to vomiting, contact the unit immediately.

This depends on why you take them and your medical history. For diagnostic procedures, aspirin usually continues. Warfarin, DOACs, or clopidogrel may need stopping if biopsies are likely.

Never stop these medications without consulting your doctor or our unit first, as this could be dangerous.

If you are diabetic, please contact your diabetes team or GP for specific advice about adjusting insulin or diabetes medications. Generally, if on insulin, you may need to reduce your dose. If on tablets like metformin, these usually continue.

Monitor blood sugar more frequently and bring glucose tablets to the appointment.

If you have sedation or pain relief medication during your procedure, you cannot drive for 24 hours afterwards and must have someone accompany you home. If you have the procedure without sedation, you can drive home yourself.

This is for your safety and is a strict requirement.

Most patients find the procedure uncomfortable rather than painful. For gastroscopy, you may feel gagging initially. For colonoscopy or flexi sigmoidoscopy, you might feel bloating or cramping.

We can offer sedation to make you more comfortable, or Entonox (gas and air) to help with any discomfort during the procedure.

Sedation is medication given through a small cannula in your hand to make you drowsy and relaxed during the procedure. It’s not a general anaesthetic – you’ll be conscious but comfortable.

Many patients choose sedation, especially for colonoscopy. If you have sedation, you will not be able to drive for 24 hours and you’ll need someone to collect you.

Yes, many patients successfully have endoscopy without sedation. This means you can drive yourself home and get back to normal activities sooner.

We can still offer throat spray for gastroscopy or gas and air during colonoscopy if needed. You can always ask for sedation during the procedure if you change your mind.

We’ll insert the colonoscope gently through your bottom. You may feel pressure, bloating, or cramping as air is used to expand the bowel for better views.

Most discomfort comes from air being introduced. The endoscopist will try to minimise discomfort and you can ask for pain relief if needed.

Yes, if you’re having the procedure without sedation, you can watch the monitor and the endoscopist can explain what they’re seeing. Many patients find this interesting and reassuring.

If you have sedation, you’ll be too drowsy to follow what’s happening but can ask for photos afterward.

If we see anything abnormal, we can often take a small tissue sample (biopsy) for testing, or remove small polyps during the same procedure.

This doesn’t usually cause pain. We’ll explain any findings and what they mean. Biopsy results typically take 1-2 weeks and will be sent to you and your GP.

You’ll spend 30-60 minutes in recovery until the sedation wears off enough for you to go home safely. You may feel drowsy for the rest of the day.

Don’t drive, operate machinery, make important decisions, or drink alcohol for 24 hours after sedation.

If you had no sedation, you can eat and drink as soon as you feel ready. If you had throat spray for gastroscopy, wait until the numbness wears off (about 1 hour) to avoid choking.

If you had sedation, start with sips of water when you feel alert, then light foods once you’re home.

You may feel bloated and have wind pains from the air used during the procedure. Walking around helps pass the trapped air. You might see small amounts of blood if biopsies were taken – this is normal.

Bowel movements may be irregular for a day or two as your bowel returns to normal.

Contact the hospital immediately if you experience: severe abdominal pain, persistent vomiting, fever above 38°C, heavy bleeding from your bottom, difficulty swallowing after gastroscopy, or signs of severe bleeding (dizziness, fainting, black stools). These are rare but need urgent attention.

Biopsy results typically take 10-14 working days. Urgent samples may be processed faster. Results are sent to your GP and you’ll receive a copy by post.

If results show anything requiring urgent attention, we’ll contact you sooner. No news within 2-3 weeks means you should contact your GP.

Polyps are growths on the bowel wall that are usually benign (non-cancerous). Small polyps are often removed during the procedure and sent for testing.

Most are harmless, but some types can develop into cancer over many years if left untreated. Removal prevents this risk.

This depends on the type, size, and number of polyps found. Low-risk polyps may just need routine screening in 5-10 years. Higher-risk polyps might require surveillance colonoscopy in 1-3 years. Your results letter will explain the recommended follow-up schedule based on your individual findings.

Colonoscopy is generally safe, but risks include:

• bowel perforation (1 in 1,000-2,000)
• Significant bleeding (1 in 150 if polyps removed)
• Very rarely, missed cancers.

Sedation carries small risks of breathing or heart problems. These risks are small compared to the benefits of early detection and treatment.

Colonoscopy is generally avoided during pregnancy unless absolutely essential. If urgent investigation is needed, it’s safest in the second trimester.

We’d discuss alternatives like flexible sigmoidoscopy or delaying until after delivery if possible. Any decision would involve your obstetrician.

Most pacemakers and medical devices are not affected by endoscopy. However, we need to know about all implanted devices beforehand. Some procedures using electrical current (like polypectomy) may require cardiology input.

Always inform us of any implanted devices when booking your appointment.

Endoscopy rooms are open spaces, not enclosed like MRI scanners. The procedure itself doesn’t confine you. If you’re anxious, sedation can help you relax.

We can also arrange for you to visit beforehand to see the room and equipment. Most claustrophobic patients manage the procedure well with support.

You can bring someone for support, and it’s required if you’re having sedation. They can usually stay with you until you go into the procedure room and will be called when you’re ready to go home. They cannot typically stay during the procedure itself for safety and space reasons.

Please give us as much notice as possible if you need to rearrange.

Cancellations with less than 48 hours notice may result in a delayed new appointment due to high demand. Call the endoscopy unit directly using the number on your appointment letter.

Bring:

• Your appointment letter
• A current medication list
• Comfortable loose clothing
• Something to read while waiting
• Any relevant medical information

If you are having sedation, please bring someone to drive you home

It is important to remove any jewellery, dentures, and contact lenses before the procedure.

If you have vomiting or diarrhea before starting prep, contact the endoscopy unit for advice. If you develop these symptoms after starting prep, try to continue if possible, but please contact us if you are unable to keep the solution down.

We may need to reschedule if you’re too unwell.

You can have:

• Water
• Clear fruit cordials (not red/purple)
• Tea and coffee without milk
• Clear soups/broths
• Glucose drinks
• Jelly (not red/purple).

Please Avoid: milk, cream, anything red or purple coloured, and alcohol.

The preparation will cause frequent, watery diarrhea starting 1-3 hours after your first dose. You may feel mild cramping, nausea, or bloating. Stay near a toilet and use soft toilet paper or wet wipes. Barrier cream can help prevent soreness. This is normal and necessary for a successful procedure.

You can usually work in the morning before starting bowel preparation, but plan to be at home once you begin the prep as you’ll need frequent toilet access. Many people take the day off to rest before their procedure.

Avoid strenuous physical activity during the preparation.

If you’re not having clear, watery diarrhea, contact the endoscopy unit. You may need additional preparation or the procedure might need postponing.

Poor preparation can make the procedure unsafe or mean abnormalities are missed, so adequate preparation is essential.

Usually yes, continue your blood pressure medication as normal with small sips of water, even during the fasting period. However, always check your specific pre-procedure instructions or contact the unit if you’re unsure.

Stopping blood pressure medication can be dangerous.

Contact the endoscopy unit immediately to discuss whether to proceed or reschedule. Even small amounts of food can be dangerous during sedation or affect the quality of gastroscopy. The decision depends on what you ate, how much, and when.

No, avoid gum, sweets, or anything in your mouth during the fasting period. These can stimulate digestive juices and saliva production, which we want to minimize. They also pose a choking risk. Stick to the fasting guidelines exactly as given.

Before your procedure, a healthcare professional will explain what will happen, discuss the benefits and risks, answer your questions, and ask you to sign a consent form. This confirms you understand the procedure and agree to proceed. You can ask questions at any time and change your mind if you wish.

You’ll change into a hospital gown for the procedure. You can usually keep underwear on for gastroscopy, but will need to remove it for a colonoscopy or flexi sigmoidoscopy (you’ll be given disposable underwear with an opening). We’ll ensure your dignity and privacy throughout.

If you’re having the procedure without sedation, you may be able to use headphones for music to help you relax.

However, you need to be able to hear and respond to the endoscopist’s instructions. Check with the team beforehand as policies may vary between units.

Tell the endoscopist immediately if you’re feeling anxious or uncomfortable. We can pause the procedure, offer reassurance, provide additional pain relief or sedation if appropriate.

Your comfort and safety are our priorities, and we can usually help you complete the procedure successfully.

All CHEC endoscopists are fully trained doctors or specialist nurses who have completed extensive training in endoscopy. They perform these procedures regularly and are supervised appropriately based on their experience level.

Your safety and the quality of your procedure are our top priorities.

We may ask if medical students or trainee endoscopists can observe for educational purposes.

This is entirely your choice and you can say no without affecting your care. Having observers present doesn’t change the quality or safety of your procedure.

Don’t panic – ‘abnormal’ doesn’t always mean serious. Many abnormal findings are treatable conditions like inflammation or benign polyps.

If urgent action is needed, we’ll contact you quickly. Otherwise, results will be sent to your GP who will discuss them with you and arrange any necessary follow-up.

Inform us of all allergies when booking and remind staff on arrival. We need to know about reactions to latex, medications, or contrast agents. We can usually accommodate most allergies by using alternative medications or equipment.

Your safety is paramount and we’ll adjust our approach accordingly.

If you have any infection symptoms (fever, cough, runny nose, sore throat), contact the endoscopy unit before your appointment. We may need to postpone your procedure to protect other patients and staff, and to ensure your safety under sedation when your breathing might be compromised.

The endoscopist will give you an immediate summary after the procedure. If biopsies were taken, you’ll need to wait for lab results.

You’ll also receive a written report to take home.

Certain bowel preparations can affect kidney function. Inform the endoscopy team if you have kidney disease. An alternative preparation may be prescribed to reduce risk.

Yes, you must have a responsible adult stay with you for 24 hours after sedation to ensure your safety. You should not be left alone overnight.

Inform the endoscopy unit on the number provided on your appointment letter. Sometimes an additional laxative or earlier preparation is needed to ensure your bowel is cleared properly.

Do not take extra medication without advice.

Most patients do not feel the biopsy at all. Occasionally you might feel a brief tug or pinch, but it is not painful. Biopsies are very safe and routine.

If your symptoms worsen significantly, don’t wait for your next appointment. Contact your GP for urgent issues, call 111 for non-emergency concerns, or go to A&E if you have severe symptoms like intense pain, heavy bleeding, or breathing difficulties.

Two days before your procedure you may eat normally, but please avoid high fibre foods such as fruit vegetables, wholemeal bread (see table below)

Have a good breakfast choosing foods from the list below until 9am. After 9am – DO NOT eat any solid food until after your examination but drink plenty of acceptable clear fluids / clear jelly (not red coloured). Boiled sweets or mints are allowed if you are hungry

Have a good breakfast and a light lunch choosing foods from the list below until 3pm

After 3pm – DO NOT eat any solid food until after your examination but drink plenty of acceptable clear fluids Clear jelly (not red coloured) and boiled sweets or mints are allowed if you are hungry

One day before your procedure – Starting bowel preparation

At 2:00pm the day before your Colonoscopy, commence the bowel preparation as follows:

• Empty the contents of DOSE 1 into a jug containing 500mls of cold water and stir until dissolved
• Start to drink the 500mls of solution – try to drink one glass every 15 -20 minutes until the jug is empty. You may add ice cubes if you wish
• Once completed drink at least 500mls of clear fluid (please note this is mandatory )

At 6:00pm

• Empty the contents of DOSE 2 (both A& B sachets) into a jug containing 500mls of cold water and stir until dissolved
• Pour half into another glass / jug and place in the fridge covered with cling film.
• Start to drink the 250mls of solution – have a few sips every 10-15 minutes until the jug is empty
• Once completed, drink at least 500mls of water or clear fluids. (please note this is mandatory )

On the day of your Colonoscopy

At 6 am

• Drink the remaining 250ml of solution that was placed in the fridge
• During the morning drink at least 500ml of water / clear fluids (please note this is mandatory )
• Stop drinking 2 hours before your procedure time
• Avoid taking any tablets within one hour before or after drinking your bowel preparation.

On the day of your procedure – Starting bowel preparation

At 6am the day of your Colonoscopy, commence the bowel preparation as follows:

• Empty the contents of DOSE 1 into a jug containing 500mls of cold water and stir until dissolved
• Start to drink the 500mls of solution – try to drink one glass every 15 -20 minutes until the jug is empty. You may add ice cubes if you wish
• Once completed drink at least 500mls of clear fluid (please note this is mandatory)

At 8:30am

• Empty the contents of DOSE 2 (both A& B sachets) into a jug containing 500mls of cold water and stir until dissolved
• Pour half into another glass / jug and place in the fridge covered with cling film.
• Start to drink the 250mls of solution – have a few sips every 10-15 minutes until the jug is empty
• Once completed, drink at least 500mls of water or clear fluids. (please note this is mandatory)
• Stop drinking water 2 hours before your procedure
• Please ensure you take your medication / tablets as instructed by your pre-assessment nurse and bring it with you on the day of procedure
• Avoid taking any tablets within one hour of your bowel preparation medicine

When you arrive you will be admitted by a nurse who will ask you a few questions. The nurse will record your heart rate, blood pressure and vital signs. If you are a diabetic your blood glucose will also be recorded.

The nurse will also make sure you understand the examination and discuss the risk and benefits for the procedure. They will sign your consent form with you.

Please bring this information booklet in with you which contains your copy of the consent form.

You be escorted into a waiting area, if you have opted for sedation for the procedure the nurse will put a cannula (tube)into your arm or the back of your hand.