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How do I have a colonoscopy?

To make sure the endoscopist has a clear view of your bowel during the procedure, your bowel must first be prepared.

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This section outlines the steps of having a flexible sigmoidoscopy:

  • Pre-procedure preparation

  • Arrival to the unit

  • During the procedure

  • After the procedure

During the procedure

Pre-procedure preparation

To ensure that the endoscopist performing your procedure has a clear view of your bowel, it must first be prepared; at Kettering General Hospital MOVIPREP is used.

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It is important that you carry out the following instructions to ensure that the bowel is completely empty of faeces.

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7 Days Before The Procedure

STOP any iron tablets that you may be taking.

CONTACT your Warfarin clinic if you take anticoagulants

CONTINUE with all other usual medications including any other laxatives used.

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2 Days Before The Procedure

DRINK PLENTY

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1 Day Before The Procedure

COMMENCE MOVIPREP preparation (see Preparation of MOVIPREP)

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DRINK PLENTY of clear fluids throughout the treatment with MOVIPREP. Try to drink at least a glass full every hour during the treatment. Water, fizzy drinks, clear soups or meat extracts may be taken at any time. You can also drink tea or coffee without milk. Please click here for top tips for taking bowel preparation.

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MOVIPREP will cause diarrhoea and occaisonally cramps and nausea. It is advised that you stay within easy access of a toilet after taking it. You should also use a barrier cream such as ZInc and Castor Oil on your bottom to prevent any soreness.

DO NOT EAT: 

  • red meat

  • pink fish

  • fruit

  • vegetables

  • cereals

EAT:

  • boiled or steamed white fish

  • boiled chicken

  • egg

  • cheese

  • white bread

  • butter/margarine

  • potatoes (skins removed)

Arrival to the unit

When you arrive to the Endoscopy Unit you will first be booked in by the receptionist. After this you will be reviewed by a member of the specialist nursing team who will ask you a few questions about your medical condition as well as your arrangements for getting home after the procedure.
 
The nurse will also record your heart rate, blood pressure and oxygen levels. If you are a diabetic they will also measure your blood glucose level. This information is used to confirm that you are fit enough to undergo the procedure.

Finally, the nurse will ask you to remove some of your clothing and change into a hospital gown. You may also like to bring your dressing gown and slippers. 

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You may now have to wait some time before your procedure starts. Before you go into the endoscopy room, the endoscopist will come and discuss with you the aspects of the procedure, You will then be asked to sign the consent form which will explain why you are having the procedure as well as the associated risks and benefits. You can withdraw your consent for the procedure at point. Should you have any further questions or need to raise any concerns, the endoscopist will gladly discuss them with you.

During the procedure

Once you are ready for your procedure, you will be taken into the examination room where the team of nurses and the endoscopist will introduce themselves.
 
The team will do checks to confirm your details, your medications and confirm you understand the procedure and signed the consent form. The procedure is usually done with the administration of a light sedative and a painkiller (this is NOT a general anaesthetic). For those who do not want sedation (perhaps they need to drive the next day or care for someone), you can have the procedure unsedated. If you find some of the procedure uncomfortable, you can have Entonox (also known as gas and air or nitric oxide) which is effective and works for a short period of time, meaning that you do not have to have the same restrictions post sedation.

 
The nurse looking after you will ask you to lay on the trolley on your left side with your knees slightly bent. They will also place an oxygen monitor on your finger so that you can be monitored during the procedure.  A scope guide will be placed to lie in front of your abdomen. This is a plate that magnetically detects the shape of the colonoscope, we use this to track the scope position and to aid comfort. A sedative and pain killer will be it will be given via an injection through a cannula in the back of your hand or your arm. Once the sedative is given you may feel a little sleepy but not deeply anaesthetised. The sedative might mean that you have reduced memory of the procedure taking place after a few days.

The nurse looking after you will ask you to lay on the trolley on your left side with your knees slightly bent. They will also place an oxygen monitor on your finger so that you can be monitored during the procedure.  A scope guide will be placed to lie in front of your abdomen. This is a plate that magnetically detects the shape of the colonoscope, we use this to track the scope position and to aid comfort. A sedative and pain killer will be it will be given via an injection through a cannula in the back of your hand or your arm. Once the sedative is given you may feel a little sleepy but not deeply anaesthetised. The sedative might mean that you have reduced memory of the procedure taking place after a few days.

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​The nurse looking after you will be with you at all times, giving you guidance and support throughout the procedure. Most patients find the procedure uncomfortable at times, typically as the colonoscope is pushed through the sigmoid and transverse colon (which are the mobile segments of the colon). The pain is typically waves of cramp in nature. Sharper pains are unusual but can occur if there is scar tissue surrounding the colon; which can occur if you have had previous abdominal surgery. The specialist performing the procedure can give you more painkillers and sedation if necessary.

The endoscopist will start the procedure by examining your back passage with a finger (lubricated with gel) to make sure that it is safe to pass the colonoscope. The colonoscope will then be gently inserted (also lubricated with gel) through your back passage and into your bowel. Air will be inflated into your bowel so that the lining can be clearly seen and to allow for easier movement of the endoscope. The endoscopist may ask you to move positions during the test between from the left lateral position (lying on the left side) to supine (lying on your back), and sometimes the right lateral position (lying on the right side). This is to aid visualisation of the colon & comfort. Sometimes the endoscopist may take a biopsy specimen from the lining of the bowel, which is sent off for further tests to help with the diagnosis.Depending on the findings, the procedure normally lasts for around 20-45 minutes. 

For some colonoscopy procedures, the specialist performing the procedure may apply a device  called "endocuff vision" to the tip of the colonoscope. This is a device with soft rubber arms which fold down as the scope is inserted. On withdrawal, the rubber arms gently hold open the colon. This has been shown in studies to improve views and increases the detection of polyps, which can be hidden behind folds. Click here if you would like further information

Video showing withdrawal of a colonoscopy - slowly to look for abnormalities. The final manoeuvre is a retroflexion to look at the blind spot area near the anus.

After the procedure

When can I eat?

Once you have recovered you will be offered a drink and light refreshments.

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If you have had a sedative, you may sleep for about an hour after the procedure, after which you will be offered a drink and some light refreshments.

Will I have any pain?

You should not have any pain but you may have some discomfort from wind, but this should settle after a while.

When can I go home?

This depends upon whether you had sedation.

Before you leave the Unit, a member of the team will explain what happened during the procedure and whether you need any further appointments. However, if a biopsy or polyps were removed during the procedure, the results will take a further 10-14 days to become available.

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If you have had Entonox only, you do not need to be accompanied home and will be allowed to leave the Unit once you are feeling well enough to do so.


If you have had sedation it can make you drowsy for up to 24 hours after the procedure. Therefore you must be collected and accompanied home.  If you live alone it may also be a good idea to arrange to stay with a friend or relative.

For 24 hours after sedation you must not: 
 

  • drive

  • drink alcohol

  • operate heavy machinery

  • sign any legally binding documents

After you go home

If you have had a biopsy or polyp removed during the procedure you may notice some bleeding or spotting from the rectum, this usually settles within 24 hours. 

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You will be able to return to your normal activities, both at home and at work, when you feel comfortable.

If you have a question or concern after the test, please phone the Endoscopy Unit.

You must consult your nearest A&E department if you: develop severe chest pain, a fever or pass large amounts of blood after the procedure.

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