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What is a Colonoscopy?


A colonoscopy is a medical procedure used to examine the inside of the large intestine (colon) and rectum.

During the procedure, a long, flexible, and lighted instrument called a colonoscope is inserted through the rectum to visualize the entire colon.

The procedure is used to detect and diagnose conditions such as colon cancer, inflammatory bowel disease (IBD), diverticulosis, and to remove polyps or other growths.

Why is a Colonoscopy Important

A colonoscopy is important because it allows the doctor to visually examine the inside of the colon for any abnormalities such as polyps, tumors, or inflammation.

It can help diagnose various conditions such as colon cancer, inflammatory bowel disease (IBD), and diverticulosis.

It is also used as a screening tool to detect colon cancer in its early stages, when it is most treatable.

Additionally, if any abnormal growths are found during the procedure, they can be removed immediately, reducing the risk of future complications.


How to Prepare for a Colonoscopy

To prepare for a colonoscopy, you will need to follow specific instructions provided by your doctor to clean out your colon, which typically include:


  • Diet changes: Avoid solid foods for 1 – 2 days before the procedure and follow a clear liquid diet. 
  • Laxatives: Take prescribed or over-the counter laxatives to empty your bowels. 
  • Hydration: Drink plenty of liquids to stay hydrated 
  • Avoid certain medications: Stop taking certain medications such as blood thinners before procedure. 
  • Fast: Don’t eat or drink anything for 8 – 12 hours before the procedure. 

It’s important to follow the instructions provided by your doctor closely, as a clean colon is essential for a successful and safe colonoscopy.

Additionally, let your doctor know of any medications you are taking, and if you have any medical conditions or allergies.


What Happens During a Colonoscopy

During a colonoscopy, the patient is positioned on their side on an exam table and given sedation to relax and make the procedure more comfortable.

The doctor then inserts the colonoscope through the rectum and guides it through the colon.

The scope has a light and camera, allowing the doctor to see the inside of the colon and take images for later review.

If any polyps or other growths are found, the doctor can remove them during the procedure using instruments passed through the colonoscope.

The procedure typically lasts 30 minutes to an hour.

After the procedure, the patient should rest for a short time under observation, until the sedation wears off.

The patient may feel some bloating or mild cramping, but these symptoms typically resolve quickly.

The doctor will discuss the results of the colonoscopy with the patient, including any findings and the need for any further tests or treatments.


Risks and Potential Complications

A colonoscopy is a generally safe procedure, but like any medical procedure, there are some risks and potential complications.

These include:

  • Bleeding: There is a small risk of bleeding after the removal of a polyp or growth.
  • Perforation: In rare cases, the colonoscope may cause a tear in the colon, which can cause peritonitis (an infection of the abdominal cavity). 
  • Reaction to sedation: Some people may have an adverse reaction to the sedation used during the procedure. 
  • Discomfort: Some patients may experience discomfort or mild pain during or after the procedure. 
  • Missed lesions: While a colonoscopy is highly effective, it is not foolproof and there is a small risk that a lesion or growth may be missed.

It is important to discuss any concerns or questions about the risks and potential complications of a colonoscopy with your doctor before the procedure.

Your doctor can also explain what to expect during and after the procedure and answer any questions you may have.




How to Care for Yourself After a Colonoscopy

After a colonoscopy, you should follow these steps to ensure a smooth recovery:

  • Rest: Take it easy for the rest of the day and avoid strenuous activities. 
  • Hydration: Drink plenty of clear liquids to stay hydrated. 
  • Resume normal activities: Gradually return to your normal diet and activities but avoid solid foods for a few hours after the procedure. 
  • Follow-up care: If you had any polyps or growths removed during the procedure, your doctor will let you know if any follow-up care is needed. 
  • Report any symptoms: If you experience any symptoms such as severe abdominal pain, fever, or heavy bleeding, contact your doctor immediately. 

It is important to follow your doctor’s instructions and listen to your body as you recover from a colonoscopy.

If you have any concerns or questions about your recovery, do not hesitate to reach out to your doctor for advice.


Alternatives to a Colonoscopy

There are several alternatives to a colonoscopy, including:

  • Fecal Occult Blood Test (FOBT): A simple blood test to detect blood in the stool, which can be a sign of colon cancer. 
  • Stool DNA test: A test that looks for abnormal DNA in the stool, which can indicate the presence of colon cancer or precancerous polyps. 
  • Flexible Sigmoidoscopy: Similar to a colonoscopy, but only examines the lower part of the colon. 
  • CT Colonography (Virtual Colonoscopy): A non-invasive test that uses X-rays and computer software to produce images of the colon. 
  • Double-Contrast Barium Enema (DCBE): An X-ray test that uses barium to highlight the inside of the colon.

It’s important to discuss your options with your doctor, who can help determine which test is best for you based on your individual needs and risk factors.

Keep in mind that while these tests can be used to detect colon cancer or precancerous growths, a colonoscopy remains the most effective way to examine the inside of the colon and remove any growths or polyps if necessary.



When to Schedule Your Next Colonoscopy

The recommended interval for scheduling your next colonoscopy depends on several factors, including:

  • Age: For average-risk individuals, the American Cancer Society recommends a first colonoscopy at age 45 or earlier if there is a family history of colon cancer. 
  • Risk factors: If you have any risk factors for colon cancer, such as a family history, personal history of polyps or colon cancer, or inflammatory bowel disease, your doctor may recommend a more frequent screening schedule. 
  • Results of previous colonoscopies: If no polyps or growths were found during your previous colonoscopy, your doctor may recommend scheduling your next colonoscopy in 10 years.If polyps were found and removed, the recommended interval may be shorter, based on the size, number, and type of polyps.

It is important to discuss your individual screening schedule with your doctor, who can help determine the right time for your next colonoscopy based on your individual health history and risk factors.




For any additional information regarding a Colonoscopy procedure, it’s best to find a trusted and experienced Gastroenterologist who can answer your questions clearly, recommend appropriate solutions, and perform tests with precision and expertise.

Dr. Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond.

Dr Eduan prides himself on his ability to help his patients to the best of his ability by embracing good listening skills, effective communication, compassion and knowledge and skill honed during years of private gastroenterology practice.


If you would like to book an appointment with a gastrointestinal (GI) specialist or would simply like more information on a particular GI topic, don’t hesitate to use our online booking form
or call Dr. Deetlefs at 021 551 867. 


The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.