A colonoscopy is an important diagnostic procedure that helps to detect various diseases of the large intestine. However, many patients are anxious about the procedure – they are afraid of pain, discomfort and what might happen to them during the procedure.
This article will help you understand what to expect if you are due to have a colonoscopy. We explain in detail the potential risks and side effects of the procedure, as well as the differences between a colonoscopy performed without anaesthesia and one carried out under anaesthesia. Our aim is to alleviate your fears by providing clear, easy-to-understand information.
What is a colonoscopy?
A colonoscopy is a procedure in which the doctor examines the inside of the large bowel using a thin, flexible tube (a colonoscope). There is a camera at the end of the instrument, which allows the doctor to see the bowel wall in detail and, if necessary, take a sample or remove minor lesions.
The test is typically recommended in the following cases:
Colon screening (particularly for those aged 50 and over)
Rectal bleeding
Persistent diarrhoea or constipation
Iron deficiency anaemia
Detection of suspicious lesions
Assessing the risk of bowel cancer
Potential risks of a colonoscopy
Although a colonoscopy is generally a safe procedure, as with any medical procedure, there are certain risks involved. It is important to know that these are rare, but it is worth being aware of them.
Perforation (intestinal perforation)
A perforation occurs when the colonoscope accidentally pierces the wall of the bowel. This is a serious complication that requires immediate medical attention.
Prevalence: In the case of diagnostic (examination-only) colonoscopy, it occurs in approximately 1 in 500 cases. This represents a risk of 0.2%.
When does the risk increase?
If a polyp (a growth on the mucous membrane) is removed during the examination
If the procedure is carried out using an electric current
If the patient has previously had enteritis or another bowel condition
Symptoms: Acute abdominal pain, fever, nausea and vomiting. These symptoms usually appear within 6–24 hours of the examination.
Bleeding
Bleeding is the second most common complication, particularly when a polyp is removed during the examination.
Prevalence: Bleeding may occur in 1–2% of patients following polyp removal.
When will it be available?: Bleeding often does not start immediately after the procedure, but 7–10 days later.
What should I do?: If you notice a significant amount of blood in your stools, or if you feel dizzy or weak, seek medical advice immediately.
Transmural burn syndrome
This is a rare but important complication that may occur when an electric current is used during the procedure (for example, to remove a polyp or to stop bleeding).
What’s going on?: A localised, limited injury occurs in the intestinal wall, which does not result in complete perforation but causes inflammation.
Symptoms: Localised pain, fever and an elevated white blood cell count 6–24 hours after the procedure.
Treatment: It can usually be treated with antibiotics and close monitoring, but hospital treatment may also be necessary.
Other risks
Cardiovascular complications: The medicines used during anaesthesia can, in rare cases, cause a drop in blood pressure, heart rhythm disturbances or breathing problems. Your blood pressure, heart rate and breathing will therefore be monitored continuously throughout the procedure.
Infection: Although it is extremely rare, bacteria may enter the bloodstream. This is treated with antibiotics.
Possible side effects of the test
Side effects are less severe than complications and do not usually require medical intervention.
Bloating and cramps
During the examination, air is blown into the large bowel to provide a clearer view of the bowel wall. This may cause temporary bloating and discomfort.
What can you do?: Try walking around after the examination to help the air to escape. The symptoms usually subside within a few hours.
Light bleeding
If a polyp has been removed, a small amount of blood may appear in the first few stools. This is usually normal.
When should you be concerned?: If the bleeding gets worse, does not stop, or if you experience any other symptoms (dizziness, weakness), contact your doctor.
Fatigue
Due to the effects of the anaesthetic, you may feel tired and drowsy after the examination.
Important: On the day of the examination, do not drive a car or carry out any activities that require concentration.
An examination without anaesthesia or under anaesthesia?
A reflection examination can be carried out either without anaesthesia or under anaesthesia, although the latter involves higher costs. Let’s take a look at the differences.
Examination without anaesthesia
Benefits:
Lower costs
There is no need for a longer observation period
You can go home straight after the examination
There are no side effects caused by the anaesthetic
He can drive a car
Disadvantages:
Discomfort or pain during the examination
It might be a more stressful experience
It may be more difficult to complete the entire examination
Who is it recommended for?: For those who have a high pain tolerance, do not suffer from severe anxiety, and wish to keep costs down.
Examination carried out under anaesthesia
Benefits:
You will not experience any discomfort during the examination
A less stressful experience
It makes the doctor's job easier
Disadvantages:
Higher costs
Risk of cardiac and respiratory complications (rare)
A longer observation period is required
You must not drive on the day of the examination
An escort is required
What you need to know about anaesthesia: You will be under general anaesthesia for the duration of the examination, so you will not feel any discomfort throughout the procedure. After the examination, you will remain under observation for 30–60 minutes until the effects of the anaesthetic have worn off.
Reversing the effects of the anaesthetic: In severe cases, if the anaesthesia is too deep, the effects of the anaesthetic can be reversed using drugs (flumazenil and naloxone). However, these are only used when necessary, not as a matter of routine.
Which one should you choose?
The decision depends on your personal preferences, your state of health and your budget. Discuss with your doctor which option is best for you.
Important: If you opt for sedation, make sure there is someone to accompany you home after the examination.
How should you prepare for the examination?
Proper preparation reduces the risk of complications and helps to ensure that the examination is successful.
Bowel movement
Your bowel must be completely clear before the examination. To ensure this, you will need to take a special laxative the day before the examination.
Tips:
Please follow the instructions carefully
Drink plenty of fluids
Be prepared to go to the toilet more often
Please stay at home today
Medicines
Certain medicines need to be adjusted before the test:
Blood thinners (e.g. aspirin, warfarin): You should stop taking them 7–10 days before the test to reduce the risk of bleeding. Your doctor will tell you when you can start taking them again.
Other medicines: Discuss with your doctor which medicines you should take and which you should stop taking on the day of the test.
Meals
On the day before the examination, you may only drink clear liquids (water, tea, soup). You must not eat or drink anything for 6–8 hours before the examination.
When should a colonoscopy NOT be carried out?
In certain cases, a colonoscopy is contraindicated because it would pose too great a risk:
Suspected intestinal perforation: If there is a possibility that the bowel has already perforated, the examination may make the condition worse.
Severe colitis: The examination may cause further injury.
Acute diverticulitis: In the event of inflammation of diverticula (pouch-like protrusions) in the large bowel, the examination may cause a perforation.
A recent heart attack: You will need to wait a few weeks before having the test following a recent heart attack.
What to do after the test?
During the first few hours
Rest until the effects of the sleeping pill have completely worn off
Do not drive or carry out any dangerous activities
Drink plenty of fluids
You can have a light meal if you’re hungry
When should you see a doctor straight away?
Call your doctor or go to A&E if you experience any of the following symptoms:
Severe abdominal pain
Fever (above 38°C)
Significant rectal bleeding
Vomit
Dizziness, fainting
Difficulty breathing
Results
The doctor will usually discuss the findings of the examination with you straight away. If a tissue sample has been taken, the results will be available in 7–10 days.
Endomedix: Expertise and care
If you are due to have a colonoscopy, it is important to have the procedure carried out at a centre where experienced specialists work and which is equipped with modern equipment. Endomedix’s gastroenterology centres meet these requirements.
Why choose Endomedix?
Experienced doctors who have been performing colonoscopies for many years
Modern, well-equipped clinics
Personalised care
Detailed information about the investigation
Both examinations carried out without anaesthesia and those carried out under anaesthesia are available
The specialists at Endomedix understand that a colonoscopy can be stressful, and they do everything they can to make the procedure as comfortable as possible for you.
Frequently asked questions
Is a colonoscopy painful?
Without anaesthesia, you may experience some discomfort, pressure or mild pain. With anaesthesia, you will not feel any pain during the examination.
How long will the test take?
It usually takes 20–45 minutes, but it may take longer if a polyp is being removed.
When can I have something to eat after the examination?
Provided there are no complications, you can eat as soon as the anaesthetic has worn off.
How often should the test be repeated?
That depends on what was found during the investigation:
If everything went well: in 10 years’ time
If a small polyp has been removed: in 3–5 years’ time
If one large or several polyps have been found: in 1–3 years’ time
Are there any alternatives to a colonoscopy?
Yes, for example a CT colonography or a faecal occult blood test, but these are less accurate, and even if an abnormality is found, a colonoscopy will still be necessary.
Let’s turn your fears into reality: Don’t be left alone with your questions
A colonoscopy can be daunting, but you should know that it is an extremely useful and generally safe procedure. Most complications are rare, and in the majority of cases they can be prevented or managed effectively.
Key steps:
Talk to your doctor: Please share your concerns and feel free to ask any questions.
Make sure you’re properly prepared: Follow the instructions for bowel preparation and taking your medication.
Choose an experienced professional: Have the examination carried out at a place where you will receive professional care.
Decide on the issue of anaesthesia: Please consider whether you would like the examination to be carried out under anaesthesia or without it.
If you are worried about the risks of a colonoscopy, you should know that you are not alone. Many people experience similar fears, but having the test done can help prevent serious illnesses, such as bowel cancer.
Don’t let fear stop you from looking after your health. Feel free to contact the specialists at Endomedix, who will help you through this important examination.
