Colonoscopy

A colonoscopy is a modern intestinal examination used to evaluate the large intestine (colon), rectum, and the terminal part of the small intestine. It is the most accurate method for assessing the lining of the colon and the only diagnostic method that can reliably rule out colorectal cancer.

Colonoscopy helps identify the causes of gastrointestinal symptoms by detecting polyps, tumors, inflammatory changes, diverticula, or hemorrhoids. If necessary, polyps can be removed and tissue samples (biopsies) taken during the procedure.

When should you have a colonoscopy?

• long-term abdominal pain or diarrhea
• blood in the stool or unexplained weight loss
• symptoms of intestinal inflammation, such as bloating, intestinal cramps, or diarrhea
• a family history of colorectal cancer or polyps

Does insurance cover the procedure and anesthesia?

Yes. If you have employer supplementary health insurance, you must first start with a telephone consultation with a general surgeon. During this consultation, medical information is collected and the necessity of the procedure is determined.

What is anesthesia?narkoos?

• Under anesthesia, you will be fully asleep and will not remember the procedure. All vital reflexes remain intact, and you breathe independently. You will have no memory, pain, or sensation from the examination.
• After the procedure, you will stay in a recovery room for about one hour.
• You may leave only with a companion, and you must not drive for 24 hours.
• Alcohol consumption is not allowed for 24 hours after the procedure.
• Responsible work and important decision-making are also not recommended on the same day.

Preparation for anesthesia

• Do not eat or drink coffee, milk, or juice for 6 hours before the procedure
• Up to 2 hours before the procedure, you may drink only clear fluids in small amounts (water, tea, diluted juice)
• Avoid alcohol for 24 hours before and after the procedure

When cannot anesthesia be performed?

• are pregnant
• have a diagnosed neuromuscular or neurological disease
• have a known allergy to the medications used
• have a fever or respiratory infection on the day of the procedure

Why is bowel preparation important?

Proper bowel preparation is the most important requirement for a successful colonoscopy. Poor preparation is the main reason for incomplete or unsuccessful examinations.

If the bowel is not sufficiently clean, the examination may be less informative, polyp removal may not be possible, and up to 42% of flat polyps may be missed—these are among the most dangerous types in terms of cancer risk. Poor preparation is responsible for approximately 82% of incomplete procedures requiring repeat colonoscopy within one year.

Preparation starts at least 4 days before the procedure with dietary changes, followed by bowel cleansing the day before the examination.

4 days before the procedure, avoid:

• fruits, berries, vegetables
• mushrooms, nuts, seeds
• whole grains (bread, porridge, muesli)

Allowed foods:

• white fish, boiled chicken, eggs, cheese
• white bread, pasta, potatoes, jelly
• clear broth, ice cream

Day before the procedure

• Begin full bowel cleansing.
• Prepare the bowel cleansing solution according to instructions (e.g. Fortrans, Eziclen, Moviprep, Picoprep).
• Morning procedure (08:00–12:00): start drinking the solution the afternoon before (e.g. 14:00)
• Afternoon procedure (after 12:00): split the dose in two first part in the evening before second part in the early morning (at least 4–5 hours before the procedure)
• Only clear fluids are allowed: water, mineral water, apple juice, lemonade, sports drinks, jelly.
• Avoid red-colored drinks.
• Drink at least 1–1.5 liters of fluid.

Medication adjustments

• If you take blood thinners (Xarelto, Eliquis, Pradaxa, Plavix, Marevan), inform your doctor in advance to determine whether temporary discontinuation is necessary.
• Other medications (blood pressure or heart medications) may be taken with a small amount of water.
• Bring a complete list of your medications and doses.
• If undergoing anesthesia, weight-loss medications (e.g. Ozempic, Mounjaro) must be stopped so that no injection is taken within one week before the procedure.

How is the procedure performed?

The procedure usually takes 20–30 minutes. You will lie on your left side with your knees slightly bent.

Lubricating anesthetic gel is applied to the anal area and the colonoscope is inserted through the rectum into the large intestine. Water or gas is used to improve visibility, which may cause a feeling of fullness or urge to defecate.

What happens during the procedure?

• examination of the colon lining from the rectum to the beginning of the colon
• immediate removal of detected polyps using an electrosurgical snare
• tissue sampling (biopsies) if necessary
• marking and sampling of suspicious lesions for further analysis if a tumor is suspected

What you may feel after the procedure

• Mild abdominal discomfort and bloating are normal. Movement helps release gas; simethicone (e.g. Espumisan) may be used if needed.
• You may eat and drink immediately after the procedure.
• The next bowel movement may occur later than usual.

Important information after the procedure

• Follow preparation instructions carefully; seek advice if needed
• Mild gas pain or bloating may occur
• Do not drive after sedation or anesthesia
• Avoid heavy physical activity for 10 days if biopsies or polyp removal were performed
• If you have a referral from a family doctor and wish to receive immediate results and treatment recommendations from the performing doctor, this can be arranged when booking.
• For private procedures, the doctor provides results and a treatment plan immediately after the examination.
• Biopsy results are ready within 2–3 weeks and are communicated either by the referring physician or the performing doctor.

Seek emergency care immediately if you experience after the procedure:

• severe persistent abdominal pain
• vomiting, 
• heavy rectal bleeding
• high fever with chills