by Deirdre Clune, Advanced Nurse Practitioner
You completed your BowelScreen home test, and you’ve now received a letter with the result. The test showed some traces of blood in your sample and you are being invited to have another test called a colonoscopy.
So what is a colonoscopy?
A colonoscopy is a test to look at your bowel using a small camera. The test looks for any small growths called polyps, or signs of disease, such as bowel cancer. If polyps are found they are usually removed during the test. This will reduce the risk of cancer developing. If they are not removed they might turn into cancer. If bowel cancer is found early, it’s easier to treat and there’s a better chance of recovery.
Where is the test done and how do I get my appointment?
You will have to go to a hospital endoscopy unit to have the test. A nurse will call you to organise a date and place for your colonoscopy. You will be asked for some information about your health and any medicine you are taking. The nurse will explain what will happen during your test and will talk you through how to get ready for the test.
You can ask the nurse any questions you have.
How do I get ready for the test?
The test is a day procedure. You will not need to stay overnight at the hospital.
After your appointment is made, you will receive some medicine in the post. This is called a bowel preparation which is a strong laxative. You will take this the day before the test to empty your bowel. The test works best when your bowel is empty and there is nothing to block the camera going into the bowel and having a look.
You should try to eat very little fibre for about five days before your colonoscopy. Try to avoid raw fruit and vegetables, nuts and seeds and tough meats.
You will have to stop eating solid food and drinking thick liquids for 24 hours before your test.
What do I have to do the day before my test?
You can have liquids (except milk). You can drink water, black tea, black coffee, flavoured waters, jelly and clear soups.
You will need to drink the bowel preparation that you received. This is a powder that you will mix with water. Follow the instructions that the nurse gave you about what time to start drinking the mixture as this will depend on the time of your appointment the following day.
Drink the mixture slowly. If you drink it too quickly, it can cause an upset tummy. Most people do not like the taste of the medicine. Some people find it helpful to use a straw, to sip some water after each sip of medicine, or to hold your nose while drinking.
When you start to drink the medicine, make sure you are close to a bathroom. Remember, this medicine is used to empty your bowel. Going to the bathroom a lot may cause the area around your back passage to become sore. It can be a good idea to have a topical ointment available to use. This is a skin cream that helps with itchy or irritated skin and is available over the counter from pharmacies.
What happens when I arrive at the hospital for my test?
When you arrive at the colonoscopy unit in the hospital, a nurse will meet you and answer any questions you may have. Your blood pressure, heart rate and temperature will be taken. The test will be explained to you, and you will be asked to sign a consent form. This gives your permission to have the test.
You will have a choice of doing the test with sedation or no sedation. If you want to be sedated, you will be given a medication to relax you and make you feel more comfortable during the test. You will not be asleep. The medication is given to you through a small tube placed in a blood vessel in your arm.
If you are sedated for the test, you may be drowsy afterwards for some time. You will not be able to drive, operate machinery, look after very small children, or sign any legal documents for 24 hours. You will need someone to collect you if you have been sedated. The hospital will be able to tell you the best time for someone to collect you.
Who does the test and what happens?
The test is done by a doctor or an advanced practice nurse, called an endoscopist.
You will be asked to take off all your clothes and put on a paper gown and pants. You can bring a dressing gown and slippers with you to put on over these while you are waiting for your test.
You’ll be asked to lie on your side for the test with your knees bent up to your chest. You will then be given the sedation. A thin flexible tube called a colonoscope is passed into your bottom and up into your bowel. There is a camera on the end of the tube with a light that shows the endoscopist the inside of your bowel on a screen.
During the colonoscopy your bowel will be filled gently with air. This helps to show the lining of the bowel more clearly. The air can give you a bloated or crampy feeling in your tummy. This is normal.
If the doctor or nurse finds any small growths called polyps during the test, these are usually removed and tested. Sometimes small samples of the lining of your bowel are taken during the test. These samples are sent to a laboratory to be looked at more closely and tested.
How long does the colonoscopy last and is it painful?
Generally the test can take up to 20 minutes. This can be longer if the bowel is not fully empty or if there are polyps to be taken out.
A colonoscopy should not be painful. Some people find it a little uncomfortable. If the bowel is not fully empty, the test can take a little longer and more air may be needed. This can make it more uncomfortable. You can tell the doctor or nurse if you get too uncomfortable or have any concerns during the test. They can help to make it more comfortable for you such as removing some of the air or changing your position on the bed.
What happens after the colonoscopy?
After the test you will be moved to a recovery area to let the sedation wear off a little. During this time a nurse will monitor your blood pressure, heart rate, and breathing. This can take up to an hour, but usually after about 30 minutes you will be able to sit up, have a drink and a snack, and then go home.
Before you leave, you will be told what was seen during the test and if any samples were taken or if any polyps were removed. You will be given a leaflet with some telephone numbers to contact in case you have any problems after leaving the hospital.
A copy of your report will be sent to your GP. The results from the tissue samples or polyps taken can take a few weeks. These results will be sent to you and your GP.
Where can I get more information?
Find out more about a colonoscopy and watch a video here.