How is a colonoscopy performed?

Your colonoscopy will be performed in a hospital or outpatient setting. The procedure takes about 30 minutes and generally includes these steps:

  1. You will dress in a patient gown. 
  2. You will lie on your left side on a procedure table and pull your knees up to your chest.
  3. You will have a light sedative to make you drowsy and relaxed and a pain medication. Deeper sedation or anesthesia is sometimes used, which makes you more relaxed and unaware of the procedure.
  4. Your doctor will gently insert the colonoscope through the anus and into the rectum and colon. The image is transmitted onto a video screen.
  5. Your doctor will insert air into the colon. Stool and fluids are removed through the colonoscope as needed. This improves the view of the intestinal lining.
  6. Your doctor will slowly and gently pull the colonoscope out of the colon and rectum, examining it for any abnormalities. This is when the most careful examination is carried out and images are taken. Other procedures may be performed during this time, such as a tissue biopsy.

Will I feel pain?

Your comfort and relaxation are important to you and your care team. You may feel pressure and brief cramping during the procedure. Your doctor will give you enough pain and sedative medications so you stay comfortable. Tell your doctor if you are uncomfortable in any way.

What are the risks and potential complications of a colonoscopy?  

Complications of a colonoscopy are uncommon, but any procedure involves risks and the possibility of complications that may become serious in some cases. Complications can develop during the procedure or recovery. Risks and potential complications of a colonoscopy include: 

  • Adverse reaction or problems related to sedation or medications, such as an allergic reaction and problems with breathing
  • Bleeding
  • Dehydration due to taking enemas and laxatives before the procedure
  • Gastrointestinal disturbances, such as nausea, vomiting, and rectal discomfort
  • Infection 
  • Puncture of the large intestine

Reducing your risk of complications

You can reduce the risk of certain complications by: 

  • Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
  • Taking your medications exactly as directed
  • Telling all members of your care team if you have any allergies 

How do I prepare for my colonoscopy?

You are an important member of your own healthcare team. The steps you take before your colonoscopy can improve your comfort and help get the most accurate test results. 

You can prepare for a colonoscopy by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Completely cleansing your intestines as directed by your doctor. This may include a combination of enemas, laxatives, and not eating solid foods for a day.
  • Drinking plenty of clear fluids to be well hydrated 
  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you individualized instructions for taking your specific medications and supplements.

Questions to ask your doctor

Preparing for a colonoscopy can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment.  Contact your doctor with concerns and questions before a colonoscopy and between appointments. 

It is also a good idea to bring a list of questions to your appointment. Questions can include:

  • Why do I need a colonoscopy? Are there any other options for diagnosing or treating my condition?
  • How long will the procedure take? When can I go home?
  • What restrictions will I have after the procedure? When can I return to work and other activities?
  • What kind of assistance will I need at home? Will I need a ride home?
  • How should I take my medications? 
  • How will you treat my pain?
  • When will I receive the results of my test?
  • When should I follow up with you?
  • When and how should I contact you? Ask for numbers to call during and after regular hours.