What is a Colonoscopy?
A Colonoscopy is a test, which allows the Endoscopist to look
directly at the whole of the large bowel (Colon). In order to do this, a
flexible tube the thickness of a finger, is carefully passed through the
anus into the rectum and into the large bowel. This can be
uncomfortable as bends in the colon are negotiated and air is used
to inflate the colon. The Colonoscope has a small camera attached
which is connected to a monitor system where images can be seen.
In order for the test to be successful, it is important that you take the
Plenvu® bowel preparation as directed. This will assist in cleaning
your bowel, enabling us to make a correct diagnosis.
Benefits
By examining your bowel the cause of your symptoms may be found.
Images and biopsies (samples) may be taken and sometimes polyps
(small growths in the bowel) can be removed or other treatments
performed.
Risks
A Colonoscopy is a safe examination but rarely, a complication such
as bleeding or perforation may occur (1 in 1500, or if polyps removed
1 in 200). Other risks are discomfort, bloating and pain. Entonox®
(gas and air) may cause nausea, dizziness and euphoria. Sedation
may cause nausea and vomiting, and rarely you may become over
sedated which can reduce your breathing rate.
Alternative treatments
There may be alternatives to this procedure and sometimes a
dedicated bowel CT scan is done instead. Your referring clinician
has advised that this is the most appropriate test for you. If you
would like to discuss alternatives further please speak to your
referring clinician.
Your Appointment
Please make sure you follow the instructions in this leaflet and on
your appointment letter. If you are unable to make your appointment
or need to change your appointment time, please telephone using
the numbers listed on the back page of this leaflet.
Your appointment time takes into account the time required to admit
you onto the unit. You should therefore not expect to immediately go
through for the test when called. You will be assigned to a Morning
or Afternoon Endoscopy session and will be in the department for
up to 4 hours. Please note we usually have 6 different lists running
consecutively, which may mean some people will have to wait longer
than others, even with the same appointment time.
Please note that the time of day that you will need to start taking
the Plenvu® solution differs between a morning and an afternoon
appointment. Please follow the instructions carefully.
Please be aware we are a Teaching Hospital and may have trainees
in any areas of your pathway. They will always be supervised and
they will always be working at an appropriate level for their training
stage. If you would rather not have a trainee involved in your care
please let the staff know your wishes. This will not affect your care.
Please bring a list of all your medications on the day. Please leave valuables and jewellery at home where possible
as we unfortunately are unable to look after these.
What to expect on the day
Before the procedure a nurse will take you into a room and explain
the test and ask you some health questions.
You will be asked to sign a consent form and change your
underwear to some procedural dignity shorts that we supply.
A cannula will be inserted in preparation for your procedure
(a small plastic tube).
We will transfer you to the waiting area and from here you will be
called into the procedure room for your test.
In the endoscopy room the procedure will start with you lying on your
left side on a trolley. You may be asked to change position during the
procedure.
Colonoscopy with Entonox®
If you are having Entonox® (gas and air) instructions will be given on
how to self administer this before your Colonoscopy starts.
Entonox® is inhaled through a mouthpiece to relieve pain.
A cannula (small plastic tube) will be inserted just in case any
medication is needed during your Colonoscopy.
After the procedure you will be transferred to our recovery area for
about 30 minutes where you will be given a drink and some biscuits.
The nurse will prepare your results and discharge advice.
Recovery from the effects of Entonox® is rapid and you will be able
to drive 30 minutes after stopping Entonox®, providing you have had
a straightforward Colonoscopy.
You may feel bloated with wind-like discomfort. This is normal and
usually settles quickly. If you have a biopsy taken or a polyp removed
it is common to pass small spots of blood from your bottom for a day
or two following the procedure.
Details of your results and discharge advice will be given before
leaving the unit. Biopsy results will be communicated by the referring
clinician at a later date. You do not need a responsible adult to accompany you from the unit
if you have Entonox® but you may wish to have someone accompany
you on the day.
Colonoscopy with Sedation
You will need a cannula (small plastic tube) in your hand or arm
through which a mild sedation and analgesia (pain relief) is given.
This should relax you but will not put you to sleep. It is not a
general anaesthetic.
You will be awake and aware during the procedure with sedation.
Sedation may cause loss of memory and judgement for 24
hours after the test. You must not:
• Drive
• Drink alcohol
• Operate machinery
• Sign legal documents
If your job involves any of the above you will need to take the day off
work following the sedation.
After your procedure you will be transferred to our recovery area for
approximately 30 minutes where you will be given a drink and some
biscuits. The nurse will prepare your results and discharge advice.
You may feel bloated with wind-like discomfort. This is normal and
usually settles quickly. If you have a biopsy taken or a polyp removed
it is common to pass small spots of blood from your bottom for a day
or two following the procedure. You will need a responsible adult to accompany you from
the unit because of the effects of the sedation and also have
someone at home overnight after having sedation.
Details of your results and discharge advice will be given before
leaving the unit. Biopsy results will be communicated by the referring
clinician at a later date.
Plenvu® Information
In order to examine the whole of the bowel it must be clear of all
waste materials. This is achieved by using a combination of
changing what you eat and taking laxative medicines.
Plenvu® works by loosening your stools. This is unpleasant but
necessary and may last up until the time of your appointment. Easy
access to your toilet will be required for most of the day.
You might like to use a barrier cream to prevent a ‘sore bottom’.
A product such as petroleum jelly can be effective.
7 days before your Colonoscopy appointment please stop taking
iron tablets. Please also stop taking any laxatives that will cause bulk
in your bowels (such as Fybogel®).
4 days before your Colonoscopy appointment please stop taking
medication that might constipate you for example Codeine, Cophenotrope
(Lomotil®), Loperamide (Imodium®) or Kaolin and
Morphine mixture, Cholestyramine or Colesevelam.
Taking other medication
If you are taking other medication, please take it at least one hour
before or at least one hour after taking Plenvu®, otherwise they may
be flushed through your digestive system and not work so well.
Take any medication you are on up to 2 hours before your
appointment with water. If you are taking medication for
DIABETES please refer to the specific diabetic instructions
towards the end of this leaflet.
Oral Contraception
If you are taking an oral contraceptive pill, diarrhoea can make it
less effective. Continue taking the pill but use other precautions for
the rest of that cycle.
Important: No alcohol should be consumed on the day before and
on the day of the procedure.
Important notes on Plenvu®
DO NOT TAKE PLENVU® IF:
• You are allergic to any of the ingredients.
• You are pregnant.
• You are on dialysis.
• You are taking medication for an organ transplant.
• You have not passed wind or opened your bowels in the last
five days leading up to your bowel preparation time.
Please contact the Endoscopy Booking Assessment Nurse via
the phone number on the back of this leaflet if any of the above
cautions apply to you.
Some Possible side effects of Plenvu®
Abdominal pain, abdominal distension, sleep disturbances,
dehydration, dizziness, tiredness, feeling generally unwell, soreness
of the anus, nausea, vomiting, headache and indigestion. If you
experience any of these symptoms try taking the Plenvu® more
slowly. There is a small possibility that the medication can cause low
blood pressure or kidney problems. Rarely are people allergic to
Plenvu®. They may experience a rash or itching, swelling of the face
or ankles, palpitations or shortness of breath. If any of the side
effects become serious, stop taking Plenvu® and seek medical
advice.
Pre Colonoscopy Diet
Three days before your test please follow a low residue diet, which
consists of the following:
• Fats (use sparingly) - Butter or margarine.
• Rice - Plain boiled white rice.
• Eggs - Boiled or poached.
• Meat / Fish - Chicken (skinless) or white fish.
• Cheese - Cream, cottage cheese, tofu or cheese sauce.
• Bread - White bread or toast.
• Cereals - Crisped rice cereal, cornflakes (no bran).
• Pasta - Plain macaroni, spaghetti, noodles.
• Potatoes - Boiled, creamed, mashed or baked (no skins).
• Dessert - Clear jelly (not red jelly) natural plain yogurt, ice
cream or custard.
Foods to avoid:
Red meat, sausage, pies, any fruit or salads, most vegetables,
potato skins, chips, wholemeal or brown bread, nuts, pulses, baked
beans, wholemeal pasta, brown rice, puddings containing fruit and
nuts, cakes, biscuits and yoghurts.
Instructions for a morning appointment
The day before your examination
Eat your breakfast before 9am. Do not eat anything after 9am.
Do not eat food again until after your examination even if you feel
hungry. Your bowel must be completely empty for the examination to
be successful.
You may drink clear soup, Oxo, Bovril, soft drinks (not red coloured),
black tea or coffee (no milk). You may add sugar if you like. You may
drink as much as you like of these fluids.
Senna tablets and Plenvu® bowel preparation are provided.
Each box of Plenvu® contains 3 sachets making up a Dose 1
(1 Sachet) and Dose 2 (Sachet A and B) to be taken together.
Please follow the instructions carefully to make sure your
bowel is empty. This is essential for a proper examination.
2pm
Take 6 Senna 7.5mg tablets with plenty of water.
During the day drink at least a glass of water (about 250 ml) or other
clear fluid every hour whilst the effects of the medication persist.
5pm
Open and empty the contents of Plenvu® Dose 1 sachet into a
container that will take at least 500mls of liquid.
Add water (not chilled) to make up to 500ml and stir until the powder
has completely dissolved. Once dissolved (this may take up to 8
minutes) the solution can be refrigerated. You may add cordial to
taste (not blackcurrant) if you require.
Drink the 500ml of the Plenvu® mixture slowly over a period of 60
minutes.
You must drink a minimum additional 500ml water or clear fluids with
each dose. This will prevent you from becoming dehydrated.
When you start taking Plenvu® it is important that you stay close
to a toilet. At some point you will start having very watery bowel
movements. This is normal and indicates that the Plenvu® is working.
8-9pm
Open and empty the contents of Plenvu® Dose 2 (Sachets A and B)
into a container that will take at least 500mls of liquid.
Add water (not chilled) to make up to 500ml and stir until the powder
has completely dissolved. Once dissolved (this may take up to 8
minutes) the solution can be refrigerated. You may add cordial to
taste (not blackcurrant) if you require.
Drink the 500ml of the Plenvu® mixture slowly over a period of 60
minutes.
You must drink a minimum additional 500ml water or clear fluids with
each dose. This will prevent you from becoming dehydrated.
When you start taking Plenvu® solution it is important that you stay
close to a toilet. At some point you will start to experience watery
bowel movements. This is normal and indicates that the Plenvu®
solution is working.
You can go to bed when you have stopped going to the toilet.
If you follow these instructions your bowel should be clear to enable
a successful examination.
You may continue to drink water up to 2 hours before your
procedure.
Instructions for an afternoon appointment
The Day before your examination
Eat your lunch before 12 Noon (midday). Do not eat anything
after 12 Noon.
Have a light lunch of foods permitted within the low residue diet
Do not eat food again until after your examination even if you feel
hungry. Your bowel must be completely empty for your examination
to be successful.
You may drink clear soup, Oxo, Bovril, Soft drinks (not red coloured),
black tea or coffee (no milk). You may add sugar if you like. You may
drink as much as you like of these fluids.
Senna tablets and Plenvu® bowel preparation are provided.
Each box of Plenvu® contains 3 sachets making up a Dose 1
(1 Sachet) and Dose 2 (Sachet A and B) to be taken together.
Please follow the instructions carefully to make sure your
bowel is empty. This is essential for a proper examination.
2pm
Take 6 Senna 7.5mg tablets with plenty of water.
During the day drink at least a glass of water (about 250ml) or other
clear fluid every hour whilst the effects of the medication persist.
7pm
Open and empty the contents of Plenvu® Dose 1 sachet into a
container that will take at least 500mls of liquid.
Add water (not chilled) up to 500ml and stir until the powder has
completely dissolved. Once dissolved (this may take up to 8 minutes)
the solution can be refrigerated. You may add cordial to taste (not
blackcurrant) if you require.
Drink the 500ml of the Plenvu® mixture slowly over a period of 60
minutes.
You must drink a minimum additional 500ml water or clear fluids with
each dose. This will prevent you from becoming dehydrated.
When you start taking Plenvu® it is important that you stay close
to a toilet. At some point you will start having very watery bowel
movements. This is normal and indicates that the Plenvu® is working.
On the Day of your Colonoscopy
6am
Remember do not eat anything.
Open and empty the contents of Plenvu® Dose 2 (Sachets A and B)
into a container that will take at least 500mls of liquid.
Add water (not chilled) to make up to 500ml and stir until the powder
has completely dissolved. Once dissolved (this may take up to 8
minutes) the solution can be refrigerated. You may add cordial to
taste (not blackcurrant) if you require.
Drink the 500ml of the Plenvu® mixture slowly over a period of 60
minutes.
You must drink a minimum additional 500ml water or clear fluids with
each dose. This will prevent you from becoming dehydrated.
When you start taking Plenvu® solution it is important that you stay
close to a toilet. At some point you will start to experience watery
bowel movements. This is normal and indicates that the Plenvu®
solution is working.
If you follow these instructions your bowel should be clear to enable
a successful examination.
You may continue to drink water up to 2 hours before your
procedure.
Specific instructions for patients who have Diabetes
If you have diabetes, please read the ‘extra’ leaflet sent alongside
this leaflet.
This leaflet is specific to controlling your diabetes through the various
procedures available within our unit and you will have been sent the
one that corresponds with your specific procedure:
• Guidance for Managing Diabetes for Sigmoidoscopy / Colonoscopy
This will give you clear instructions on what to do with your
medication (including insulin) during the preparation for your test.
If you have not received a copy of this leaflet, please contact the
Gastroenterology & Endoscopy Unit, via the phone numbers listed
on the back of this leaflet and request a copy.
Frequently asked questions
How long does the procedure take?
A Colonoscopy lasts between 30 and 60 minutes. You will be in the
department for up to 4 hours.
Does it hurt?
Sometimes patients find the test painful but gas and air (Entonox®) or
sedation is available to use for pain relief if needed.
Do I have to have the test?
No. The choice is yours, please refer to page 3 for alternatives and
the reason why this test is appropriate.
Can I take my tablets as normal?
Yes unless instructed otherwise. Please take the tablets at least one
hour before or at least one hour after taking Plenvu®. Diabetic
patients please read page 14 for diabetic medication instructions.
Will I be asleep for this procedure?
No. Gas and air (Entonox®) or sedation is available (if your
circumstances permit), but you will be awake throughout the
procedure.
How can I make the Plenvu® more palatable?
It is important to sip the Plenvu® and not gulp it down to reduce
nausea. A straw is sometimes helpful to drink the Plenvu® with and
you can add cordial (not blackcurrant) to taste if you prefer.
What shall I wear to attend the procedure?
Please wear loose comfortable clothing. You will be asked to wear
dignity shorts under your own clothing before the procedure. On
entering the procedure room you will be asked to remove your lower
clothing (keeping your dignity shorts and your top clothes on).
Procedure Outcome
Details of your results and discharge advice will be given before
leaving the unit. Biopsy results will be communicated by the referring
clinician at a later date.
If you have any issues or need advice after your procedure
please contact the Gastroenterology & Endoscopy Unit within
working hours (7.45am to 6pm) and ask to speak to the nurse in
charge. See contact phone numbers on the back of this leaflet.
If urgent out of hours advice is required please contact Ward 2
on 01253 953402.
Colonoscopy Illustration
Gastroenterology & Endoscopy Unit Location Map
Access from the main hospital multistorey car park
We are located in Area 6 - Gastroenterology & Endoscopy Unit,
highlighted in orange on the main hospital map. Follow the signs for the
Main Hospital up the escalator/lift towards Area 6, second corridor on the
left. Follow the signs down the link corridor, exit to the right via the side
door (external) which is signposted for Patient Entrance to Reception.
Access for drop off/collection only & disability parking
Enter via East Park Drive and follow the road up the hill, take the
second left signposted for Gastroenterology & Endoscopy Unit Drop
Off Only, follow the road round to the right.
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Author Gastroenterology Department
Approved by EUG Meeting
Date of Publication 12/12/2024
Reference No PL/1223 (v1)
Review Date 01/12/2027
