Bowel cancer, also known as colorectal cancer, can affect any part of the colon or rectum; it may also be referred to as colon cancer or rectal cancer, depending on where the cancer is located.
Bowel cancer screening is for people who do not already have bowel cancer, symptoms of bowel cancer, or any reason to have a high risk of bowel cancer.
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Bowel Cancer Australia provides essential support services uniquely designed for bowel cancer patients via our confidential Helpline with specialist telehealth support, as well as a national Peer-to-Peer Support Network and Buddy Program.
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One of the best ways to reduce anxiety about having a colonoscopy is to have a plan.
Although the procedure takes less than half an hour, the preparation involves several things that can’t be left until the last minute.
Don’t wait until the day before the procedure to read the bowel preparation instructions.
Review the instructions about the colonoscopy process at least two weeks ahead of time to ensure that you know what to do with your diet and medications, especially if you have diabetes, hypertension, heart, kidney, or vascular problems, require blood thinners, or have other serious medical problems.
Providing information about your health to your colonoscopist well ahead of the colonoscopy, understanding the information about your bowel preparation, and following the specific plan provided to you by your colonoscopist are your primary responsibilities throughout the entire colonoscopy process.
Before scheduling your colonoscopy, you need to discuss with your colonoscopist how fasting, dehydration, and potential removal of pieces or parts of your bowel may affect any underlying medical conditions and medications.
Only under your colonoscopist’s instruction should you stop or change the dose of certain medications and supplements, such as anti-platelet agents, aspirin and other anti-inflammatories, blood thinners, diabetes medications and hypertension medications.
Even over-the-counter medications, herbal supplements and vitamins can impact the potential risk of colonoscopy.
These things need to be fully discussed with your colonoscopist and thought about well ahead of a colonoscopy.
A good bowel prep is essential to a good colonoscopy and critical to detecting bowel cancer or preventing it through the detection and removal of polyps.
In Australia, inadequate bowel prep is observed in around 7% of all colonoscopies. Bowel Cancer Australia’s resource can help you ‘bowel prep’ prior to colonoscopy.
When your GP refers you for a colonoscopy, you can choose to have the examination in a public or private facility.
Regardless of where you have your colonoscopy performed, the examination will be conducted in a private area.
If you have private health insurance and are planning to have your colonoscopy as a private patient, you should talk with your colonoscopist about where the procedure will take place and whether there will be any gap or out-of-pocket cost for you to pay to the colonoscopist or ancillary staff for the procedure.
You should also check with your health fund before the procedure to find out what your health insurance will cover.
Speak with the colonoscopist if you have concerns as to where and how the procedure will be done.
Once you’ve been referred by your GP for a colonoscopy, find out who will be performing the procedure.
Make sure your colonoscopy will be done by an experienced colonoscopist who is interested in constant improvement in the quality of colonoscopy that he or she provides.
A detailed conversation with your colonoscopist should help answer any outstanding questions or concerns.
For your safety, it is important to discuss your medical history and conditions, as well as the medications you are taking with your colonoscopist, so they can determine the bowel preparation that is best for you.
Several different types of bowel preparations are currently available, so be sure to ask your colonoscopist about the various options and the risks and benefits of each.
When your colonoscopist settles on a preparation for you, discuss how it works, how you’re supposed to take it, and any other questions you have about the process.
Certain medications, including over-the-counter items, may need to be adjusted prior to colonoscopy, because they can make the procedure more hazardous or increase your risk if polyps need to be removed.
If you are taking iron tablets, aspirin or anti-arthritis drugs, or any blood thinning medications (e.g. Warfarin), it is essential that you tell your colonoscopist.
Special arrangements may be necessary if you have diabetes or heart valve disease or have a pacemaker implanted, so it is important to discuss this with your colonoscopist before the colonoscopy is organised.
Your colonoscopist or a staff member of the facility where you are having the procedure will discuss the benefits and risks with you before you have a colonoscopy and you must give your permission before the procedure can be performed.
As with any invasive healthcare procedure or examination, there are risks associated with colonoscopy and with preparation for the procedure.
Before you can provide informed consent for colonoscopy, your colonoscopist must provide a clear and realistic explanation of the procedure, possible associated discomfort, the benefits, and a clear explanation of the risks and potential adverse events including: sedation reactions, bleeding (immediate and delayed); perforation; and missed pathology.
You have the right to withdraw your consent at any stage of the colonoscopy process and this should be understood by all members of your medical team.
Information about the risks and adverse events associated with bowel preparation for a colonoscopy can be found in the bowel preparation materials or Consumer Medicines Information (CMI) supplied by the manufacturer and from your pharmacy.
Every person’s feedback about their colonoscopy experience is unique and valuable. Help us ensure the patient voice is heard, so that future colonoscopy care reflects what patients want and need.
If you can choose a day for your colonoscopy, select one that allows you to be at home the day or evening prior to the procedure so that you can be near a toilet while you complete the bowel preparation.
Regardless of what time of day you plan to have your colonoscopy, if your bowel is not properly cleansed the examination will have to be rescheduled.
The time of day the colonoscopy is performed does not impact whether you have polyps but may play a role in whether they are detected.
Findings from several studies suggest that having a colonoscopy in the morning results in better polyp detection rates than those performed in the afternoon.
Researchers believe this may be due to inadequate bowel preparation in patients who must wait until later to have the procedure done. Alternatively, it has been suggested the lower number of detections were a result of colonoscopist fatigue.
Visit the pharmacy to pick up your bowel preparation as soon as your colonoscopy is scheduled.
Bowel preparation is a medicine your colonoscopist gives you to prepare your bowel for inspection during a colonoscopy.
Review the instructions about the colonoscopy process at least two weeks ahead of time to ensure that you know what to do with your diet and medications, especially if you have diabetes, hypertension, heart, kidney, or vascular problems, require blood thinners or have other serious medical problems.
Discuss any questions or concerns you have with your colonoscopist immediately.
Ensure you have the time and privacy needed to complete the bowel preparation with as little stress as possible.
Clear your schedule of any commitments and be at home when you are required to start the preparation.
If you have children or aging parents who require care, have someone else available to assist once you begin the bowel preparation and on the day of the procedure.
It is very likely you will be groggy and your reaction time slower than usual following the bowel preparation, sedation and procedure, so the best thing to do is keep activity to a minimum.
If you received sedation at the time of your colonoscopy, you will not be allowed to leave the colonoscopy facility or drive yourself home following the procedure.
You will not be allowed to take public transport, Uber, or a taxi home by yourself.
It may be an inconvenience, but for your own safety it is required that a friend or family member is there with you when you are discharged.
You must be accompanied and ideally that person will be able to stay with you upon your return home, to assist you as you recuperate.
Once you begin your bowel preparation medication, you won’t want to leave the house and you’ll need ready access to a toilet.
You’ll also want access to a few essentials that may make the experience easier.
Go over your preparation instructions so that you know how to take the preparation and have everything you need to complete the process, which may include the following items: