Back

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.

When should you choose sedation for an examination?

The examination can be performed under sedation if you experience strong fear or anxiety about the procedure or would prefer to undergo the examination without pain or discomfort. Sedation may also be a good option if a previous examination was painful, uncomfortable, or could not be completed.

What is anesthesia?

  • During an endoscopic examination, we use short-acting intravenous anaesthesia, also known as sedation. The sedative medication is administered through a vein, allowing you to fall asleep quickly and deeply.
  • This differs from the general anaesthesia used for many major operations: anaesthesia for an endoscopic examination is short-acting, and the patient breathes independently. Your vital signs are continuously monitored throughout the procedure.
  • While under sedation, you will not feel any pain or discomfort and will not remember anything about the examination.
  • Intravenous anaesthesia is widely used today and, when appropriately selected for the patient, is generally well tolerated and safe.
  • After the examination, you will usually remain in the recovery area for approximately one hour.
  • You may leave only when accompanied by another person, and you must not drive a car or operate other vehicles for 24 hours.
  • You must not consume alcohol for 24 hours. It is also recommended that you avoid responsible work and making important decisions during this time.

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 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 3–4 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