For the best results and to prevent the need to cancel or reschedule your colonoscopy, please follow your Sutter Maternity & Surgery Center of Santa Cruz doctor's instructions.
Your doctor's office will provide you with instructions about prescription medications you can and can't take before your procedure. Your doctor will also give you a prescription for preparation medication that will cleanse your system in advance of your procedure.
You will receive additional instructions from your prescribing doctor if you are taking diabetic medications, anticoagulants (blood thinners), or you have bleeding or clotting problems.
Things you Must Avoid for the Procedure:
- Aspirin, NSAIDS like ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn).
- You may also need to avoid iron, fish oil, seeds, nuts, popcorn, quinoa and vitamin E.
- Your doctor may have you stop taking some of your medications or have you avoid certain foods for up to seven days before your procedure.
- Most doctors will require fasting to some extent and no liquids before your procedure.
- You must not eat solid foods before your procedure. Eating any solid foods may result in your procedure being canceled.
You must arrive at your given location one hour before your scheduled procedure time. Your entire stay will be between two to two and a half hours.
For your safety Sutter Health requires you to have someone drive you home after your procedure.
You are not permitted to take a taxi, operate any mode of transportation yourself, or use any public transportation to get home after the procedure. A responsible adult will need to drive you home and someone should stay with you for at least two hours to make sure there are no issues following the sedation or procedure.
You may also prearrange a ride with Lift Line (831-688-9663), Paracruz (831-425-4664) or Care from the Heart (831-476-8316). These companies have medical training in transporting patients.
Before Your Procedure
While drinking the preparation medication:
- To improve the taste of your preparation medication, try adding a citrus-flavored powdered drink packet, chilling it before drinking, licking a lemon or lime wedge after drinks, or using a straw.
- Consider using petroleum jelly or diaper rash ointment around the anus before starting the prep and after each bowel movement to minimize irritation from passing many bowel movements.
- To prevent dehydration, drink plenty of fluids before and after the procedure. Your body can lose significant amounts of fluids during the bowel preparation process.
- Feelings of bloating, nausea, abdominal cramping or chills are common. This should decrease over the course of the bowel preparation.
- If you develop severe nausea or vomiting, stop drinking the bowel prep for 30 minutes and then start again once you are feeling better. If you feel you can’t complete the prep, call your provider.
What to Expect Upon Arrival for Your Procedure
- Prior to the procedure, a nurse will ask you questions to ensure that you understand the procedure and the reason for it, and to ensure that you prepared properly for it. The gastroenterology doctor will also review the procedure with you.
- The nurse will start an intravenous line to administer medications. The intravenous line is similar to having blood drawn. Your vital signs (blood pressure, heart rate and oxygen saturation) will be monitored closely before, during and after the procedure.
- The colonoscopy will be performed while you are lying on your left side. Medications to help you relax (sedative) and narcotic (to help with discomfort) will be administered intravenously. Some people sleep during the examination, while others are very relaxed, comfortable and awake. This is NOT general anesthesia.
- Most colonoscopies last 30 minutes and are followed by 30 minutes in the recovery area.
After the Procedure
- Rest for the remainder of the day.
- Do not participate in any activities that require coordination or judgment. You may return to regular activities the day after the procedure.
- If a polyp is removed, we recommend no travel for two weeks from your date of procedure. Check with your doctor if you are planning to travel internationally.
- Some bloating, gas or mild cramping is normal and should diminish.
- At the conclusion of your procedure, you will receive specific information about findings, post-procedure instructions and precautions.
Frequently Asked Questions
What is a colonoscopy?
A colonoscopy is a routine and commonly performed procedure, in which a highly trained doctor (called a gastroenterologist) will insert a colonoscope (a flexible tube containing a camera at the tip) into the rectum and colon (large intestine), to carefully inspect the colon. The scope is about the width of your finger, and the procedure is typically painless, as patients are sedated. A typical colonoscopy takes about 20 to 30 minutes.
Why is a colonoscopy recommended?
The most common reason to have a colonoscopy is as a screening test for colon and rectal cancer. Colorectal cancer is the third leading cause of cancer deaths in the United States and the average risk for developing colorectal cancer is about 6 percent. Colonoscopy is a safe, proven and effective means to detect colon cancer. Colonoscopy can also be useful for the evaluation of conditions, such as bleeding, chronic diarrhea and anemia (low blood counts).
What is a polyp?
Polyps are abnormal growths of tissue that form on the lining of the colon. While many benign polyps are harmless, others are considered precancerous. Precancerous polyps carry the potential to turn into cancer. They are generally slow growing, so a small precancerous polyp may take 10 to 15 years to turn into cancer. Approximately 30 percent of people age 50 and older have precancerous polyps. Colonoscopy permits the early detection and removal of polyps. Because almost all colorectal cancers start as small polyps, the removal of these polyps at the time of colonoscopy is an effective means to prevent colorectal cancer. The removal of polyps (polypectomy) is a painless procedure.
What can I expect during a colonoscopy?
A colonoscopy is generally a well-tolerated procedure. Most patients are given a sedative and pain medication through an IV that is placed by the nurse before the procedure. Because of these medications, most patients do not experience pain or remember the procedure. You will typically lie on your left side during the procedure, although in some cases, you may be repositioned. After your colonoscopy, you will spend about 30 minutes in the recovery area. During a colonoscopy, your doctor carefully inspects the colon and may remove polyps (polypectomy) or take biopsies (painless removal of a small sample of the tissue lining).
What are the risks of complications of colonoscopy?
A colonoscopy is a safe and routine procedure, but like any procedure, it does carry some risks, which are small and uncommon. Statistics show that our rate of major complications (one in 2,000) is significantly lower than the national average. The most serious complication is a perforation, or a tear of the wall of the colon. In some cases, this might require emergency surgery. Bleeding is another possible complication, which can occur at the site where a polyp is removed or biopsied. Bleeding typically stops on its own, but may require additional treatment.
Will I be sleeping during the procedure?
Patients receive a sedative (medication related to Valium) and a pain killer (medication related to morphine) during the procedure. This type of sedation is called moderate sedation, sometimes described as "twilight sleep." Most patients are very comfortable, experience no pain and have no memory of the procedure. Technically, patients are conscious during these procedures, are able to respond to questions, and can maintain their blood pressure and breathing at safe levels on their own. Some patients may wake up toward the end of the procedure. They may even watch the procedure on a monitor (most patients find this very interesting) and remain completely comfortable. If needed, sedatives can be increased. This type of sedation is different from general anesthesia, which is a deeper level of sedation in which patients are unconscious. In these cases, an anesthesiologist is needed to help the patient to regulate their blood pressure and breathing. Any form of sedation does carry risks, but these risks are very low with moderate sedation.
What can I expect after a colonoscopy?
You will be monitored closely in the recovery area as the sedatives wear off. You may experience some cramping and bloating and you will be encouraged to pass flatus, which will help you to feel better. Because sedatives may impair your judgment and coordination, you will be required to have someone drive you home and to stay with you for a short time after the procedure. There are generally no restrictions on what you can eat after a colonoscopy. Your doctor will give you specific instructions on whether you should take or avoid certain medications, depending on the findings of your colonoscopy. If your doctor took biopsies or removed polyps, you will be contacted separately with those results.
Is a colonoscopy perfect?
On rare occasions, the scope cannot be advanced all the way around the colon. In cases like this, your doctor will discuss with you different alternatives. Colonoscopy has been considered the “gold standard” for examination of the colon and rectum, however, polyps and other findings can sometimes go unseen at the time of colonoscopy. You can minimize this risk by taking your bowel preparation as instructed in order to clean the colon as effectively as possible.
Do I have to drink ALL of the preparation medication?
Yes, you need to finish all of the prep. National studies have demonstrated that the most effective way to cleanse the colon is to take the entire bowel preparation solution split into two separate doses. This ensures the colon is clean and minimizes the need to reschedule your procedure.
Do I need to be at home for the prep?
It’s best to be at home when you begin the prep as bowel movements start very quickly.
If I take a lot of medications, do I stop them all?
Please take all of your medications as prescribed by your other doctors, unless specifically instructed by your gastroenterologist to do otherwise.
Can I have other fluids that are not clear?
The general rule is if you can see through it, you can have it. You should stay well hydrated while drinking the prep, so feel free to have as much of the clear liquid diet the night before as is tolerable to you.
What should I do for anal discomfort?
A&D ointment, Desitin and petroleum jelly can be applied to the affected area. Non-alcohol containing wipes (baby wipes) can be used for cleansing.
Why do I need a ride home and someone to stay with me after the procedure?
Medications commonly given during colonoscopy can temporarily impair judgment and coordination.
When can I return to work and normal activity?
You should be back to normal by the day following your procedure.