What is a Colonoscopy?

A colonoscopy is the procedure used to directly examine the inside of the bowel with the aid of a colonoscopy. This is a long thin fibre-optic instrument about the thickness of your index finger. The procedure takes about 30 minutes; the entire process may take approximately 2 hours.

It allows full color inspection of the inside of the bowel, and in most instances can provide substantially more detail and accuracy. It is also advantageous as it allows biopsy and removal of polyps to be carried out at the same time.

As colonic polyps carry a risk of cancer, it is recommended that all polyps found at the time of colonoscopy be removed. This is despite the minor risk of bleeding or perforation.

Adequate preparation is crucial

It is very important that the bowel is thoroughly emptied and cleaned for a successful colonoscopy. The adequacy of examination relies on un-obscured view of the bowel.

The bowel preparation will make you go to the toilet frequently so plan to say close to the toilet. If you have a colostomy or ileostomy, you may need to notify your stomal therapist for a special drainage bag.

What are the risks?

Colonoscopy is a very safe, but as with all medical procedures there is some risk. The sedative drugs can cause heart or lung complications. They are more likely in patients with underlying heart or lung disease.

Very rarely the colonoscope can make a hole in the bowel (1:1000 chance). Removal of polyps is associated with a risk of bleeding and slightly increased risk of making a hole in the bowel. Minor complications such as abdominal pain, dehydration and soreness at the site of the injection are more common. The risk of perforation is rare, but if it occurs, may require surgery.

Please tell your doctor if you are pregnant, or breast feeding, or have a cardiac pacemaker, or suffer from heart valve disease, or have diabetes, or take blood thinners.

 

IF YOUR PROCEDURE IS IN THE MORNING

Please read these instructions carefully as the success of the examination depends on the bowel being as clear as possible, otherwise the examination may need to be repeated.

3 Days before the examination:

Stop all iron containing medications. Continue with your regular medication.

2 Days before the examination:

Stop eating meat, brown bread, cereals, fruit or vegetables.
Do not have anything with seeds in it.
Do not have yellow cheese.
You may eat eggs, cottage cheese, plain yoghurt, white bread, white fish, chicken, well cooked peeled pumpkin or potato.
You may have clear jelly, milk and drink plentiful approved clear liquids*.

1 Day before the examination

Drink only approved clear liquids * for breakfast, lunch and dinner

Examples of clear liquids

Water	Bonox
Clear broth/bouillon	Clear fruit juices
Plain jelly (not red or purple)	Black tea or coffee (no milk)
Sports drinks (no red or purple)	Clear cordials (no red or purple)
Clear salty fluids (chicken soup)	Lucozade

 

1. FIRST Dose PICOPREP Preparation 1.00 pm

Add the entire contents of ONE sachet of PICOLAX in a large glass (120ml) of water. Stir until effervescence ceases. Drink the mixture gradually but completely.

This can be followed by as many glassfuls of water or approved clear liquids as desired in order to satisfy thirst.

Drink at least a glassful of any approved clear liquid every hour (the more the better).

2. SECOND Dose PICOPREP Preparation 7.00 pm

Repeat procedure as above.

3. THIRD Dose PICOPREP Preparation 9.00 pm

Repeat procedure as above.

No liquids after midnight.

Have approved medications with a sip of water in the morning of procedure.

 

IF YOUR PROCEDURE IS IN THE AFTERNOON

Please read these instructions carefully as the success of the examination depends on the bowel being as clear as possible, otherwise the examination may need to be repeated.

3 Days before the examination:

Stop all iron containing medications. Continue with your regular medication.

2 Days before the examination:

Stop eating meat, brown bread, cereals, fruit or vegetables. Do not have anything with seeds in it. Do not have yellow cheese. You may eat eggs, cottage cheese, plain yoghurt, white bread, white fish, chicken, well cooked peeled pumpkin or potato. You may have clear jelly, milk and drink plentiful approved clear liquids*.

1 Day before the examination

Drink only approved clear liquids * from 1.00 pm. Examples of clear liquids

Water	Bonox
Clear broth/bouillon	Clear fruit juices
Plain jelly (not red or purple)	Black tea or coffee (no milk)
Sports drinks (no red or purple)	Clear cordials (no red or purple)
Clear salty fluids (chicken soup)	Lucozade

 

1. FIRST Dose PICOPREP Preparation 5.00 pm

Add the entire contents of ONE sachet of PICOLAX in a large glass (120ml) of water. Stir until effervescence ceases. Drink the mixture gradually but completely. This can be followed by as many glassfuls of water or approved clear liquids as desired in order to satisfy thirst. Drink at least a glassful of any approved clear liquid every hour (the more the better).

2. SECOND Dose PICOPREP Preparation 9.00 pm

Repeat procedure as above.

3. THIRD Dose PICOPREP Preparation 7.00 am

(Morning of procedure)- Repeat procedure as above No liquids after 8am Have approved medications with a sip of water in the morning of procedure

AFTER THE COLONOSCOPY

When the procedure is finished you will return to the post procedure area where we will ask you to fast until the effects of the sedation have worn off. We suggest that during this time you rest on your bed and try to relax. After this time, you will be given something to eat and drink. Then you will be allowed to go home.

You must not drive a car, operate machinery or undertake any legal decisions for 24 hours after the procedure. Arrangements must be made for a friend or relative to pick you up from the hospital.

IF you have any questions about the colonoscopy or information you have just read, please ask the nursing staff or your doctor as we are more than happy to answer any questions you may have.

DISCHARGE

Should you have severe abdominal pain, bleeding from the back passage, fever or other symptoms that concern you, please contact the doctor immediately or go to your nearest hospital emergency department.

You should not plan to travel too far from medical aid for the next two weeks following the procedure as there is a risk of bleeding particularly if a polyp has been removed.

There may be some spotting of blood in the first 24 hours. This is not abnormal and not a cause for alarm. If this does NOT stop or causes concern, please seek medical attention.

Alternate bowel preparation (Diacol tablets – 32 tablets)

Morning colonoscopy

• 2 days before your colonoscopy please purchase from the chemist and take 2 Dulcolax (bisacodyl) tablets at 7pm. This will help kick-start the process
  • STOP taking brown bread, meats, seeds, cereals and fruits.
  • You may have steamed white fish, chicken, white bread, pasta rice, skim milk, clear jelly before 7pm.
  • No solid food after 7pm.
• 1 day before your colonoscopy please start the Diacol (sodium phosphate monobasic, sodium phosphate dibasic) tablets. It is crucial that you continue to drink 2 to 3 glasses of clear fluid every couple of hours to ensure that the preparation works and that you are well hydrated
  • Starting at 2.30pm (Afternoon) take 4 Diacol tablets
  • 2.45pm take 4 Diacol tablets
  • 3.00pm take 4 Diacol tablets
  • 3.15pm take 4 Diacol tablets
  • 3.30pm take 4 Diacol tablets
• On the day of your colonoscopy
  • 3.30am (early morning) take 4 Diacol tablets
  • 3.45am take 4 Diacol tablets
  • 4.00am take 4 Diacol tablets
• Remember to fast (no food or water) at least 4 hours prior to your procedure.
• Your stools should be watery and clear light yellow in colour. If it is not clear, notify the hospital staff and they may use a Fleet enema to assist.