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Colonoscopy/endoscopy

Download our colonoscopy procedure and patient instructions guide to know how to prepare and what to expect during a colonoscopy.

Endoscopy

Upper gastrointestinal endoscopy is also called an upper GI endoscopy. It is also called an EGD, which stands for esophagogastroduodenoscopy. An endoscope is put into your mouth. This scope is a long, soft tube with a tiny lens connected to a light source. Pictures may be taken of your esophagus, stomach and upper intestine (bowel). Caregivers may take a tissue sample during the test. This sample will be sent to a lab for tests.

Colonoscopy

Colonoscopies let a doctor closely look at the inside of the entire colon and rectum. The doctor is looking for polyps, which are small growths that over time may become cancer. The doctor uses a thin (about the thickness of a finger), hollow, lighted tube that has a tiny video camera at the end. This tube is called a colonoscope. The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly.

The exam itself takes about 30 minutes. Patients are given medication to help them relax and sometimes sleep while it is being done.

Your doctor will decide how often you need this test. It's important that you talk with your doctor to understand your risk for colon cancer, the guidelines you should follow and when you need to start testing.

Colonoscopy prep FAQ

Will it hurt?

Most people don't find these exams painful, although some people have more discomfort than others. Patients will be given medication to make them comfortable through a colonoscopy.

During this test, air is pumped into the cleaned out colon to keep it open so that doctors can get the best pictures. The air pressure may cause some discomfort and cramping.

As with most medical tests, complications are possible with both of these tests. Some can be serious—for instance bleeding and puncture of the colon—but they're very uncommon.

Who will do the exam?

Colonoscopy is almost always done by a doctor, usually a gastroenterologist (a doctor whose specialty is the digestive tract) or a surgeon.

Will I be in a private room?

Colonoscopy is done in a private area in the hospital outpatient department. The patient's privacy is very important. If you have concerns, talk with the doctor about where and how the procedure will be done.

How do I prepare for the test?

Many people consider the bowel preparation (often called the bowel prep) the worst part of this test. For the doctor to see your insides clearly and get good pictures, your bowels need to be as cleaned out as possible. You probably will be told to avoid certain foods and medicines and might be put on a clear liquid diet for one or more days before these exams. You will take very strong laxatives, and you might also need enemas to clean out your colon. When you choose a day for your exam, pick one that will allow for you to be at home the day or evening before the test when you do the preparation.

You will get instructions from your doctor's office ahead of time. Read them carefully, since you will probably need to buy special supplies (like clear liquids, soups and gelatin) and get laxatives or enemas. If any of the instructions are not clear or you do not understand them, call the doctor's office and go over them step-by-step with the nurse. This is your chance to discuss any concerns about the bowel prep you may have.

Preparing for colonoscopy makes you go to the bathroom a lot! As soon as you take the laxatives, you'll need to stay close to a bathroom. They can start working pretty quickly. They may still be working the next morning when you go for your colonoscopy appointment. Don't be embarrassed to ask for a bathroom when you get here. The staff is used to it.

How will I feel afterward? Will I need someone to drive me home? Will I need to miss work?

Most people feel OK after a colonoscopy. You could feel a bit woozy from the medications that help you relax. You may have some gas because of the air that was pumped into the bowel, which can cause cramping and discomfort. Because of the medications given for the test, you will need someone to take you home. Because a colonoscopy is usually done with medications that make you sleepy, most people miss work the day of the test.

What if they find something?

If a small polyp is found, your doctor will probably remove it during the test. Over time, some polyps could become cancer. If your doctor sees a large polyp, a tumor or anything else abnormal, a biopsy (by-op-see) may be done. For the biopsy, part or all of the polyp or abnormal area is taken out through the colonoscope. It is then sent to the lab for a doctor to look at under a microscope.

Why are these tests so important?

Colorectal cancer screening helps people stay well and saves lives. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer or finding it early when it is easier to treat. There are several basic types of screening tests.

Tests that mainly find cancer: These involve testing the stool (feces) for signs that cancer may be present. These tests are easier, but they are also less likely to detect polyps.

Removing polyps can help prevent colorectal cancer from ever starting. And cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive five years later. And many will live a normal lifespan.

Too often people don't get any of these screening tests, and then the cancer can grow and spread without being noticed. Early on, colorectal cancer doesn't usually cause any changes that are noticed (symptoms). In most cases by the time people do have symptoms, the cancer is advanced and very hard to treat.

Regular screening is the most reliable way to find these cancers in the early stages. Ask a doctor about the best screening plan for you.

If I don't completely finish my bowel prep (if I throw up), can I still come in for my colonoscopy?

Yes, as long as you get enough down to start having frequent watery/clear bowel movements, the prep should be adequate.

I am having too much nausea and have been able to take less than half the prep. Can I still come in for my colonoscopy?

If you don't like the taste of the liquid in the bowel prep kit, drink the liquid very cold (or on ice) and use a straw to help bypass some of your taste buds. Drink quickly rather than slowly.

If you still feel you cannot finish enough of the prep, please call 218.736.8049.

I have not been following a low residue diet, nor a clear liquid diet prior to my procedure. Should I reschedule my colonoscopy?

The low residue diet is recommended as one part of your overall preparation for colonoscopy. Following the low residue diet provides added assurance that your preparation will be adequate. The most important aspect of the preparation is the laxative solution itself, which you have been instructed to drink.

Whether or not you complete this solution as instructed is what will determine the success of your preparation. Do your best to follow our dietary recommendations, but if for some reason you can't, we probably won't need to reschedule you.

Can I still have my colonoscopy if I'm sick?

If you are sick, you may keep your scheduled appointment as long as you are not vomiting or experiencing a fever or a cough with sputum/phlegm.

Please call us at 218.736.8185 first thing in the morning if you feel you need to reschedule.

I've been taking aspirin/NSAIDs in the days before my colonoscopy; can I still come in for my procedure?

Yes. Generally, this will not be a problem, and if we remove a polyp then we will ask you not to take aspirin or NSAIDs for one week.

I've been taking multivitamins with iron in the days before my colonoscopy; can I still come in for my procedure?

Yes, but stop taking the vitamins right away. If you find your stool is generally very black when taking iron, it might be better to reschedule the colonoscopy for when you have stopped the iron for a week and your stools are brown.

I've been taking Coumadin in the days before my colonoscopy; can I still come in for my procedure?

You should check with the doctor who prescribed the Coumadin about how far in advance you should stop taking it prior to a colonoscopy.

For most procedures, you can still come in as scheduled but should realize that under certain circumstances you might be at increased risk for bleeding. Your doctor may also want to postpone certain therapeutic procedures (for example, removing a large polyp).

I have diabetes. When do I stop taking my medication? When is the last meal that I can eat?

Every patient's case is different. We strongly recommend that you discuss your diet and colonoscopy prep with your primary care physician prior to scheduling your colonoscopy.

Should I take my blood pressure and/or heart medicine in the morning before my colonoscopy?

Yes. You should take all hypertension and cardiac medications at your usual times with a small amount of water.