What is a colonoscopy?
Colonoscopy involves the use of a flexible tube with a camera to examine the large intestine. This is performed as a day case procedure under sedation. Just before the test you will be given sedation by injection into a vein and you will be sleepy during and half an hour after the test. Colonoscopy is a well-tolerated and safe procedure, however you might feel mild pressure, bloating or cramping during the test. Colonoscopy usually takes about 20 minutes, but may take up to an hour in some patients.
What preparation is required?
The day before the procedure you need to take a special preparation to clean out the bowel. The colon must be completely clean for the procedure to be accurate and complete. The bowel preparation will induce diarrhoea for a short period of time. You should stop iron tablets for 5 days before the procedure. Alert your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics before a colonoscopy as well. If you are diabetic, pregnant or take blood thinning medications such as; (Warfarin, Aspirin, Clopidogrel, Plavix) discuss this with us before the procedure.
What if the colonoscopy shows something abnormal?
If your doctor thinks an area needs further evaluation, he or she might pass an instrument through the colonoscope to obtain a biopsy (a sample of the colon lining) to be analysed. Biopsies are used to identify many conditions. Your doctor might also find polyps during colonoscopy, and he or she will most likely remove them during the examination. These procedures don't usually cause any pain. Polyps are abnormal growths in the colon lining that are usually benign (non-cancerous), but they can be malignant (cancerous). Removed polyps will be analysed by a pathologist and further treatment and follow-up may be required.
What are the possible complications of colonoscopy?
Complications with colonoscopy are uncommon. Some patients may not tolerate bowel preparation or have reaction to sedation. Occasionally, a complete examination of the colon is limited in some patients due to poor bowel preparation, very long or tortuous colon or other pathology. In these cases, the patient may be further assessed with CT colonography. Whilst colonoscopy is an excellent procedure to examine the colon, there is a small risk of that a polyp, cancer or other pathology is not detected by the procedure. Serious complications such as perforation (making a hole in the bowel) or major bleeding are extremely rare (risk about 1 in 1000 examinations), but if it occurs, may require surgery. The risk of these complications is slightly higher if polyps are removed.
What happens after a colonoscopy?
There may be mild, temporary abdominal discomfort and you may pass a small amount of blood. If you have severe pain or pass a large amount of blood you should contact your doctor on 9429 1002, or go to the nearest hospital emergency department. You will need a relative or a friend to accompany you home as it is not safe for you to drive that day due to sedation.
Bowel preparation for Colonoscopy
You will need to purchase a bowel cleansing preparation kit from a chemist -
‘PrepKit – C’ contains – 2 x Picoprep sachets and 1 x Glycoprep 70 gm sachet.
A prescription is not required.
From 2 (two) days before your colonoscopy: Do not have any seeds.
Day before your colonoscopy
In the morning mix the Glycoprep packet into 1 litre of water and refrigerate until required.
You may eat a light breakfast and a light lunch (i.e., stewed fruit, poached egg, clear soup…)
After lunch you may only have clear fluids (water, clear fruit juice, plain jelly, tea/coffee without milk, cordial, soft drinks and clear soup/broth - no red/purple colourings) in any quantity until midnight.
First dose at 3 PM
Mix 1 (one) sachet of Picoprep in a glass of water (250 ml) and stir until dissolved. Drink it slowly over 15 minutes, which is followed by at least 1 glass of clear fluids per hour.
The bowel prep will induce diarrhoea, which may take up to 6 hours.
Second dose at 6 PM
Drink 1 litre of chilled Glycoprep solution over one hour.
If you feel nauseated whilst drinking the Glycoprep, slow down the rate of intake.
At 7 pm, drink at least 2 glasses of clear fluids.
Third dose at 9 PM
Mix 1 (one) sachet of Picoprep in a glass of water (250 ml) and stir until dissolved. Drink it slowly over 15 minutes, which is followed by at least 1 glass of clear fluids per hour until you go to bed.
Alternatively, if you can’t be home by 3pm: take first dose at 5 PM, second dose at 7 PM and third dose at 9 PM. You should not eat or drink after 7am.