What to expect from your first colonoscopy

Going into hospital for a colonoscopy might not be anyone’s idea of fun, but planning ahead of time can help decrease any anxiety you might be feeling. “The idea of going into theatre is often daunting, but remember, for surgeons and nurses, this is their everyday business,” shares Jessica Stokes-Parish, a practising intensive care nurse and assistant professor of medicine at Bond University.

One of the best ways to allay your fears is to ask your doctor plenty of questions.

“Ask them why they want you to have it, how urgently it needs to happen – pepper them with questions, so you feel comfortable with what you’re going into,” she adds.

Let’s take a closer look at some common questions you may have about the procedure.

• What is a colonoscopy

• How do you know if you need a colonoscopy?

• How long does a colonoscopy take and what’s involved?

• How do I prepare for a colonoscopy?

• What happens after the colonoscopy?

• What are the side effects of a colonoscopy?

• How much does a colonoscopy cost?

A colonoscopy is a medical procedure during which doctors examine the bowel for signs of bowel cancer and, where possible, remove any polyps (growths on the colon that can sometimes become cancerous) and early cancers. It can also help determine a diagnosis for other symptoms, too, like unexplained diarrhoea, abdominal pain or bleeding. It’s a routine procedure and is critical in the early detection and treatment of bowel cancer and other gastrointestinal conditions.

There’s usually a couple of ways. One is that you’ve done a National Bowel Cancer Screening Program Home Test Kit, which is a test the government sends out to eligible Australians aged 50-74 every two years. The test is what’s called a faecal occult blood test, and it essentially looks for tiny amounts of blood in your bowel motions. It is the best way to detect bowel cancer early, which is when 90% of cases can be successfully treated. So if you get one, don’t throw it out!

Related: How a bowel cancer test can save your life

If those results come back positive, “you automatically get sent a letter to say that you need to see your GP and arrange a gastroenterologist appointment,” says Jess. “The gastroenterologist will then decide, based on your symptoms, whether you need a colonoscopy.”

Your GP may also refer you to a gastroenterologist for symptoms such as:

• rectal bleeding;

• blood, pus or mucus in your stool;

• unexplained abdominal pain or weight loss; and/or

• unexplained changes in bowel habits (for example, long-lasting diarrhoea)

If there is concern about other parts of your digestive system, you may be required to do an endoscopy and colonoscopy – an endoscopy uses a similar flexible telescope to examine your oesophagus, stomach and first part of the small intestine.

The actual colonoscopy usually takes between 15 and 45 minutes and is done under general anaesthesia, so you’re usually in and out of hospital in a day. After the anaesthetist puts you to sleep, a thin, flexible tube called a colonoscope is inserted into the anus, through the rectum and into the colon (the large bowel). It has a light and camera, which projects the image onto a screen so doctors can take a close look at what’s going on inside.

If polyps are found during the colonoscopy procedure, the doctor will likely remove them and send them to a lab to check for any signs of cancer.

Your doctor will give you detailed instructions about your colonoscopy prep, which includes starting a low-fibre colonoscopy diet a few days before the procedure. This includes foods like plain white bread, refined breakfast cereals such as Cornflakes or Rice Bubbles, white rice and pasta.

The day before your colonoscopy procedure, you’ll drink a ‘bowel preparation’ liquid. This will bring on diarrhoea quickly, so it’s best taken at home where you have a toilet close by. “You’re basically doing a gut cleanse so that when they insert the tube, they can get a very clear picture,” Jess explains. You won’t be able to eat solid foods from now until after your procedure, sticking with clear liquids such as broth, black tea and coffee and clear juice instead.

Related: 18 questions about your surgery you’ve been too embarrassed to ask

Plan to take things easy after your colonoscopy.

“You'll probably feel groggy due to the anaesthesia, and you might be pretty hungry,” says Jess.

You may also experience bloating, gas and mild cramping. About an hour afterwards, you may be offered a drink and something light to eat.

“Start with gentle foods,” advises Jess. You can often go home after about four hours, and you will need someone to pick you up.

“Don’t expect to drive for 24 hours,” advises Jess, and avoid taking public transport alone, operating machinery, signing legal documents or drinking alcohol in the 24 hours after the procedure.

You’ll get your results during a follow-up appointment with your doctor, who can go over what they did and advise any next steps, including if and when you need another colonoscopy.

A colonoscopy is critical in the early detection and treatment of bowel cancer and other gastrointestinal conditions

Side effects are rare, but complications can include bleeding, infection and perforation (when the colonoscope puts a hole in the bowel).

“Ask your doctor to provide you with a comprehensive summary of the risks beforehand,” says Jess. If you have any rectal bleeding or severe abdominal pain after the colonoscopy, Jess advises reporting it to the recovery staff. “If you’ve already left and it’s happening at home, go straight to your emergency department.”

If you have severe abdominal pain or bloating; persistent nausea or vomiting; black, tar-like stools; persistent bleeding from the anus; fever or chills; or any other symptoms that worry you up to 14 days post-op, contact your doctor immediately.

The cost will vary from person to person, but according to the Australian Government Department of Health, typical doctors’ fees for a colonoscopy with or without biopsy are around $1300.

In 2020, nib paid benefits for 34,143 colonoscopy hospital admissions. The average out of pocket expense for nib members was $330^*. Excluding hospital excess, 80.7% of members experienced no out of pocket expenses for the procedure.

If you have private health insurance, check with your provider to find out whether you’re covered for this procedure.

Related: How do I know if I’m covered for a procedure?

If you're an nib member heading to hospital soon, make sure you check out our Going to Hospital page. This tool gives you information on health insurance, tips on how to reduce out of pocket expenses and helpful questions to ask your specialist. To find out the details of your current policy, chat to someone about your upcoming hospital visit or get some guidance, call us on 13 16 42.

Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.

Jessica Stokes-Parish is a practising intensive care nurse and educator who holds a PhD in medicine from the University of Newcastle, as well as a bachelor of nursing, masters in nursing (advanced practice) and a graduate certificate in critical care nursing (intensive care). In addition to 10+ years of bedside nursing, her areas of focus include education for healthcare professionals, quality improvement for better patient outcomes and diversity in the health workforce. She is unashamedly a coffee snob, and you'll find her at her local drinking a piccolo or at home using her Aeropress.

^*This refers to Australian Residents Health Insurance member colonoscopy procedures. Average costs exclude any hospital excess paid.