Quick answer: Before a colonoscopy in the morning, you must follow a special diet, take a bowel preparation, and – due to the anaesthesia – you must not eat or drink anything for 5–6 hours before the procedure. Proper preparation is essential for an accurate diagnosis.
If you’ve been told you need to have a morning colonoscopy – in other words, a colonoscopy – you’re likely to have a few questions: what can you eat, what can you drink, and when should you stop eating? This article takes you step by step through the entire preparation process so that there are no surprises on the day of the examination.
Preparations for a morning colonoscopy do not begin the night before – but several days in advance. Diet, bowel preparation and medication all affect the success of the examination. If any of these steps are missed, the doctor will not be able to see the bowel wall properly, and the examination will have to be postponed.
A colonoscopy is the most effective method for the prevention and early detection of bowel cancer. Using a flexible endoscope with a camera, just 9–12 mm in diameter, the doctor can examine the entire inner surface of the large bowel and, if necessary, remove any polyps immediately. The cleaner the bowel, the more accurate the examination. This is why every patient receives such detailed preparation instructions before the examination.
What happens during a morning colonoscopy?
A colonoscopy is a diagnostic and therapeutic procedure during which the doctor inserts an endoscope through the rectum. A high-resolution camera at the tip of the instrument transmits a real-time image to a monitor, allowing the doctor to see even the smallest changes in the mucous membrane.
The examination does more than just allow for visual inspection. Through the endoscope’s working channel, it is also possible to take tissue samples (biopsies), remove polyps (polypectomy) and stop bleeding – all in a single session.
When is a colonoscopy recommended?
Doctors typically recommend this test in the following cases:
- Persistent changes in bowel habits (e.g. alternating constipation and diarrhoea)
- Visible or hidden blood in the stools
- Weight loss of unknown cause and iron-deficiency anaemia
- Chronic diarrhoea, suspected inflammatory bowel disease
- Screening for those aged 50 and over, or following a positive screening test (FIT)
- Follow-up after the removal of polyps
This examination is not recommended in cases of suspected bowel perforation, or during the active, suppurative phase of acute diverticulitis.
Before a morning colonoscopy: when and what can you eat?
From a dietary perspective, bowel preparation can be divided into four distinct stages. The change in diet does not begin on the morning of the day before the examination, but rather in the weeks leading up to it.
5 days before the examination
During this period, your diet can remain largely as normal, but you should avoid small seeds and foods with shells. Remnants of these can get stuck in the folds of the bowel and make it difficult to see clearly. Prohibited: muesli, seeded bread, walnuts, hazelnuts, beans, sweetcorn, tomatoes, Brussels sprouts, grapes, kiwis, strawberries, cucumbers, beetroot.
3 days before the examination
From this point onwards, you may eat low-fibre, easily digestible foods. Recommended: white bread, rice, boiled pasta, poached chicken breast or fish, plain yoghurt, boiled potatoes (without the skin). You should avoid wholemeal bread, red meat, raw vegetables, mushrooms, onions and spinach.
1 day before the examination
Breakfast is allowed – for example, toast with ham or soft-boiled eggs. For lunch, only clear, strained meat stock may be consumed, without vegetables or pasta. You must not have dinner.
On the morning of the examination
If you are having a colonoscopy in the morning, you must not eat anything on the day of the procedure. If the procedure under general anaesthesia is scheduled for the morning, you will generally need to stop drinking fluids 5–6 hours before the procedure, in accordance with the anaesthetist’s instructions. This time will always be determined on an individual basis by your treating doctor.
What can you drink before a morning colonoscopy?
Bowel cleansing leads to increased fluid loss, so you should drink at least 2–3 litres of fluid the day before – roughly one glass per hour.
Permitted drinks:
- Still mineral water
- Strained apple juice or white grape juice
- Herbal and fruit tea (with sugar)
- Strained meat stock
Drinks to avoid:
- Coffee and black tea
- Red and dark-coloured soft drinks (e.g. cola, sour cherry juice, grape juice)
- Fruity, cloudy fruit juices (orange juice, apricot juice)
- Milk and milk-based drinks
- Coloured cordials
The bowel cleanse is successful if the fluid passed is yellowish and completely clear. If it remains dark or contains lumps, the preparation was not carried out correctly.
The bowel cleansing process: the correct use of laxatives
The basis of bowel cleansing is a prescription laxative, which is prescribed by a doctor on an individual basis. In the past, patients had to drink 4–6 litres of a polyethylene glycol (PEG)-based solution over a period of 3–4 hours. Nowadays, small-volume, split-dose preparations are also available, which are less taxing.
The bowel preparation should always be taken counting backwards from the time of the examination. For a morning colonoscopy, the preparation is administered the evening before. It must be taken exactly as prescribed and in full – even if your stools appear clear early on. It is recommended that you stay at home whilst the bowel is being cleansed, and you should also be prepared to use the toilet during the night.
The quality of bowel preparation is measured using the Boston Bowel Preparation Scale (BBPS) scoring system: the optimal result is a total score of over 6, which requires a score of at least 2 in each of the three bowel segments.
Which medicines need to be adjusted before a morning colonoscopy?
Managing medication taken on a regular basis requires particular attention. The table below summarises the most important steps to take:
- Copper products: You must stop taking it at least 5 days before the test. Iron turns the stools black and makes them sticky, which makes an accurate diagnosis impossible.
- Blood thinners (coumarin-type): Treatment should generally be suspended 5 days before the test; in cases of high risk of thrombosis, the use of low-molecular-weight heparin (LMWH) may be necessary. You should always consult your doctor.
- DOACs (new-generation anticoagulants): Diagnostic tests can still be carried out whilst taking them, but in the event of a planned procedure (e.g. polyp removal), treatment should generally be suspended 48 hours beforehand.
- Clopidogrel: If a procedure is expected, you must stop taking it at least 10 days before the examination.
- Diabetes medicines: Bowel preparation and the examination should be postponed on the day of the procedure; those taking insulin should consult their diabetologist.
- Daily routine medication (blood pressure-lowering, cholesterol-lowering, anti-asthmatic): these may be continued as usual.
What laboratory results are required before the examination?
To undergo a colonoscopy, recent laboratory test results – usually from within the last month – are required. These typically include the following:
- Blood test
- INR value (coagulation test)
- Kidney function
In the case of an examination under anaesthesia, an ECG and a consultation with an anaesthetist are also required. These can also be carried out at Endomedix – patients are supported throughout the entire preparation process required for the examination.
What should you bring with you, and what should you wear on the day of the examination?
It is advisable to wear loose-fitting clothing that is easy to take off and put on, as you will need to undress from the waist down for the examination. Please bring the following documents and items with you:
- Identity card
- Laboratory results and any previous findings
- Referral from a GP
- List of medicines taken
- A change of underwear, slippers, a few glucose tablets
- Drinking water following the test
Important: Following an examination under anaesthesia, you may only leave the facility accompanied by someone, and you must not drive a motor vehicle on that day.
Why should you opt for a colonoscopy under general anaesthetic?
A colonoscopy can be performed either whilst the patient is awake or under short-acting intravenous anaesthesia. If anaesthesia is used, the patient sleeps deeply during the procedure, feels nothing, and, following a short period of observation after the procedure, can go home with a companion.
Anaesthesia and sedation are not the same thing. During sedation, the patient is semi-conscious and may experience a feeling of discomfort or cramps. In contrast, general anaesthesia involves a complete loss of consciousness, from which the anaesthetist wakes the patient in a controlled manner.
At Endomedix, for professional reasons, only general anaesthesia is used; sedation is not. This means that the examination is entirely pain-free and stress-free, and is supervised by a qualified anaesthetist throughout the entire procedure. Endomedix’s gastroenterologists have extensive clinical experience in sedated colonoscopy and carry out the examination using state-of-the-art technology in a discreet and comfortable setting.
Book an appointment at Endomedix!
The Endomedix Gastroenterology Centre operates a nationwide network – with centres in Budapest, Debrecen, Dombóvár, Miskolc, Siófok, Szolnok, Veszprém, Győr, Gyula and Esztergom. Patients can expect short waiting lists, appointments within 48 hours and an exceptional team of specialists.
Appointments can be made on working days, Monday to Friday, between 09:00 and 17:00 at the (1) 413-2500 You can book by phone or online. Don’t delay – early detection saves lives.
What can I expect after the examination?
The effects of the anaesthetic wear off within a few hours. The air injected into the bowel may cause bloating and cramps in the period following the examination – these symptoms will subside as the air is passed.
You are usually allowed to eat straight after the examination, but it is advisable to start with light, non-bloating foods. If a polyp has been removed, your doctor may prescribe a special, gentle diet to follow for a few days. Late bleeding (7–10 days after the examination) may also occur following polyp removal; if this happens, contact your doctor immediately.
You must show the test results and the histopathology report received following the examination to your doctor, who will arrange the date of your next check-up.
Don’t put it off any longer – a colonoscopy first thing in the morning could save your life
A colonoscopy can be an uncomfortable but life-saving examination. When carried out as a screening test, a colonoscopy reduces the incidence of bowel cancer by 50–90% and reduces mortality by approximately 60% – and the protective effect can last for up to 10 years. If you are due for a colonoscopy in the morning, following the preparation instructions exactly is the only thing that really determines the accuracy of the examination.
Endomedix’s specialists are there to support you every step of the way – from bowel preparation through to the examination under anaesthesia and the interpretation of the results. Book an appointment online now!
Frequently asked questions (FAQ)
What can you eat the night before a colonoscopy?
You must not eat any solid food the evening before. Strained, clear meat stock is permitted for lunch, but not for dinner. You may drink fluids – water, strained fruit juice, tea – until the time specified by your doctor.
How long should I fast before a colonoscopy in the morning if I’m having a sedative?
You should generally stop eating and drinking completely 5–6 hours before an anaesthetised examination. The exact time will be determined by the anaesthetist on a case-by-case basis, so you should always follow their instructions.
When is a colon cleanse successful?
The bowel preparation is considered adequate if the final result is a completely clear, yellowish liquid. If the stool remains dark, lumpy or cloudy, the preparation has not been sufficient and the effectiveness of the examination cannot be guaranteed.
Do I need to stop taking my blood pressure medication before the test?
No. You can continue to take your regular daily medication – such as blood pressure medication, cholesterol-lowering drugs and asthma medication – as usual. Exceptions include iron supplements, blood thinners and medicines for treating diabetes – you should discuss the management of these with your doctor.
Why is it important to have someone accompany you after a colonoscopy under general anaesthetic?
The effects of the anaesthetic continue to affect reaction times and decision-making ability even after the procedure. For this reason, following an anaesthetic procedure, you may only leave the facility accompanied by someone else, and you must not drive a motor vehicle on the same day.
When should you visit Endomedix for a colonoscopy?
If you are over 50 and need a screening test, have noticed blood in your stools, have experienced a persistent change in your bowel habits, or have been called in for a follow-up after a polyp removal – at Endomedix you can get an appointment within 48 hours. During the preliminary consultation, the specialist will provide you with personalised information about how to prepare for the examination and what to expect.
