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Procedures

Colonoscopy

Colonoscopy is a safe and effective way of visually examining the lining of your lower gastrointestinal tract (colon and the end of your small intestine).

A colonoscope is a thin, flexible tube with a video camera and light at its end. Using various controls on the instrument, your specialist is able to guide the camera so as to carefully examine the lining of your bowel. Depending on the findings and the indication for the colonoscopy, biopsies (small tissue samples) may be taken, polyps (small growths) may be removed and in some instances, therapy may be delivered.

What is the reason for having a colonoscopy?

Colonoscopy can be performed for a variety of reasons, both to diagnose, evaluate, and treat conditions of the lower gastrointestinal tract. Common reasons for undergoing colonoscopy include a change in your bowel habit, rectal bleeding, and screening for colonic polyps or bowel cancer.

What are the risks of colonoscopy?

Colonoscopy is a generally safe procedure that is commonly performed and complications are rare.  Your doctor will discuss the risks and benefits with you and answer any question or concerns that you may have.

Common side-effects

Temporary side-effects following colonoscopy include a sense of abdominal bloating related to the use of air to inflate your bowel. You may also feel nauseated or sleepy due to the effects of the anaesthetic medications.

Complications

Perforation. 1:1000 cases. Perforation is a hole or tear in the bowel wall that may require an operation to repair.

Bleeding. Bleeding can arise at a polypectomy or biopsy site. Most bleeding is minor and requires no treatment but occasionally bleeding will require a repeat colonoscopy, blood transfusion, hospitalization, or surgery.

Infection. The colonoscope is a reusable instrument that is stringently disinfected, however there is a very small risk of infection being introduced during the procedure.

Failure of procedure. The colonoscopy may be unsuccessful (e.g. technical issues or bowel preparation) and may need to be repeated.

Reaction to anaesthetic drugs. Rarely patients may have a reaction to the sedation.

Aspiration. Although uncommon, it is possible that whilst sedated you can vomit and aspirate the contents into your lungs.

Missed lesions. There is a chance that important lesions, in particular bowel cancers and polyps, may be missed at colonoscopy. The risk of missing a lesion is between 2% and 8%.

Death. Death is extremely rare, although is a remote possibility with any interventional procedure.

How do I prepare for the procedure?

Bowel preparation is required to empty the large bowel of faeces to ensure adequate visualisation of the lining of the bowel. If your bowel preparation in inadequate, the examination may be unsuccessful, and a further procedure will be required.

Please read our full Colonoscopy Preparation Instructions.

You will be asked to fast with nothing to eat or drink for at least 6 hours prior to your procedure.

What do I do with my usual medications prior to the procedure?

Please inform your specialist if you are taking blood thinning or diabetic medications. You will be given specific instructions on the use of these medications prior to your procedure.

Your other regular medications should be continued unless your specialist provides you with specific instructions otherwise. Medications required on the morning of the procedure can be taken with a sip of water.

What happens on the day of the procedure?

You will be given an appointment time to come into hospital.  Prior to your procedure you will be seen by both nursing staff and your anaesthetic doctor, who will ask for further information regarding your past medical history, medications and any allergies that you may have. You will be asked to sign a consent form for the procedure if you have not already done so. You will also have a chance to see your Gastroenterologist prior to the procedure to discuss any questions that may have arisen.

What happens during the procedure?

We will make every effort to ensure that you are as comfortable as possible during your procedure. You will be asked to change into a hospital gown and then brought into the procedure room for your colonoscopy. A small drip needle will be inserted by your anesthetist, through which sedation will be given to make you comfortable during the test. Your vital signs (oxygen levels, blood pressure, and pulse) will be closely monitored whilst you are undergoing the procedure. Your specialist will examine your lower bowel using the colonoscope, and if necessary perform biopsies or removal of polyps.

How long does a colonoscopy take?

The time taken for colonoscopy varies, but is most often between 20 and 40 minutes. Colonoscopy is usually a day procedure so you will not need to stay in hospital overnight.

What happens after my colonoscopy?

You will be taken to the recovery area, where you will be closely observed by nursing staff as you recover from your anaesthetic. Once awake, you will be given something to eat and drink.  Your specialist will speak with you to inform you of your results and of the need for a follow-up test or appointment.

Going home after my colonoscopy?

You will be ready to go home from hospital around 2 hours after your procedure.

Due to the sedative medications given, you must not drive a car, operate heavy machinery or sign any important documents for 24 hours after the procedure.  Therefore, please arrange for someone to pick you up in order for you to go home.  You will also need a responsible adult to stay in the house with you the night after the procedure.

Most patients do not have any problems after colonoscopy, however if you experience any abdominal pain, rectal bleeding, fever or chills, or other concerning symptoms, then it is important that you seek medical attention immediately.

Further information about colonoscopy?

Further information on colonoscopy can be found through our information sheets or the Gastroenterological Society of Australia website:

http://membes.gesa.org.au/membes/files/ConsumerInformation/Colonoscopy.pdf

Bowel preparation for colonoscopy information sheets 

Direct Access Colonoscopy

The process

Each referral will be reviewed by a gastroenterologist to confirm suitability for Direct Access Colonoscopy. Practice staff will then contact the patient to arrange a convenient time for them to have their colonoscopy and answer any questions the patient may have.  Any patients considered not suitable for Direct Access Colonoscopy will be offered an appointment to see the Gastroenterologist prior to a colonoscopy being scheduled.

Prior to Direct Access Colonoscopy, patients will be sent an information sheet and instructions regarding bowel preparation via mail. The bowel preparation can be purchased from a chemist or from our rooms at 220 Melbourne Street, North Adelaide, SA 5006.

Once they arrive at hospital they will go to a Day Procedure area where the gastroenterologist will meet with them to review their medical history and discuss the procedure. The colonoscopy will then be performed. An anaesthetist will administer sedation during the procedure.

For further information on colonoscopy please see our Colonoscopy information sheet.

Results of the colonoscopy will be sent to the referring doctor and discussed with the patient on the day of the procedure. A follow-up clinic appointment will be arranged if the findings at colonoscopy require follow up.

Indications

  • A positive faecal occult blood test
  • Rectal bleeding in a patient over the age of 50 years
  • A prior history of colonic polyps or bowel cancer and require surveillance colonoscopy
  • A family history of bowel cancer

Conditional criteria

  • Are under 75 years of age
  • Are fit and healthy
  • Are capable and willing to consent in English
  • Are not taking “blood thinning” medication aside from aspirin
  • Have no history of heart disease, diabetes, stroke, epilepsy, kidney, liver disease or serious lung disease
  • Have somebody to transport the patient to and from hospital
  • Have private health insurance or be willing to pay private hospital fees

Referral

Patients must be referred by a registered medical practitioner to one of our gastroenterologists.

Referrals flagged for “Direct access colonoscopy”

Endoscopy

Gastroscopy (or upper endoscopy) allows visual examination of the lining of your upper gastrointestinal tract, including your oesophagus, stomach and duodenum.

An endoscope is a thin, flexible tube with a video camera and light at its end. Using the controls on the instrument, the endoscope is guided by your specialist, so as to carefully examine the lining of your upper gastrointestinal tract. Depending on the findings and the indication for the procedure, biopsies (small tissue samples) may be taken and in some instances therapy can be delivered.

What is the reason for having a gastroscopy?

Gastroscopy can be performed for a variety of reasons, both to diagnose, evaluate, and treat conditions of the upper gastrointestinal tract. Common reasons for undergoing gastroscopy include evaluation of heartburn, abdominal pain, gastrointestinal bleeding, and swallowing difficulties.

What are the risks of gastroscopy?

Gastroscopy is a generally safe procedure that is commonly performed and complications are rare. Your doctor will discuss the risks and benefits with you and answer any question or concerns that you may have.

Common side-effects

Temporary side-effects following gastroscopy include a sense of abdominal bloating related to the use of air to inflate your bowel. You may also feel nauseated or sleepy due to the effects of the anaesthetic medications. You may also experience a sore throat, which relates to the passage of the endoscope.

Complications

Perforation. Perforation is a hole or tear in the bowel wall, which may require an operation.

Bleeding. Most bleeding is minor and requires no treatment but very rarely bleeding will require a repeat endoscopy, blood transfusion, hospitalisation, or surgery.

Aspiration. If your stomach is not empty, it is possible that you can vomit and aspirate the contents into your lungs. This can require hospitalisation if severe.

Oral or dental injury. A protective mouth guard is used to reduce this risk.

Failed procedure. Occasionally gastroscopy may be unsuccessful and needs to be repeated.

Infection. The endoscope is a reusable instrument that is stringently disinfected, however there is a very small risk of infection being introduced during the procedure.

Death. Death is extremely rare, although is a remote possibility with any interventional procedure.

What will I need to do before my procedure?

You will need to fast, with nothing to eat or drink for at least 6 hours prior to the procedure. This will ensure that your stomach is empty and that good views are obtained. What do I do with my usual medications prior to the procedure?

Please inform your specialist if you are taking blood thinning or diabetic medications. You will be given specific instructions on the use of these medications prior to your procedure.

Your other regular medications should be continued unless your specialist provides you with specific instructions otherwise. Medications required on the morning of the procedure can be taken with a sip of water.

What happens on the day of the procedure?

You will be given an appointment time to come into hospital.  Prior to your procedure you will be seen by both nursing staff and your anaesthetic doctor, who will ask for further information regarding your past medical history, medications and any allergies that you may have. You will be asked to sign a consent form for the procedure if you have not already done so. You will also have a chance to see your Gastroenterologist prior to the procedure to discuss any questions that may have arisen.

What happens during the procedure?

We will make every effort to ensure that you are as comfortable as possible during your procedure. You will be asked to change into a hospital gown and then brought into the procedure room for your upper endoscopy. You will be given a small drink to clear any bubbles from your stomach. A small drip needle will be inserted by your anesthetist, through which sedation will be given to make you comfortable during the test. Your vitals signs (oxygen levels, blood pressure, and pulse) will be closely monitored whilst you are undergoing the procedure. Your specialist will examine your upper gastrointestinal tract, and if necessary perform biopsies or other interventions.

How long does a gastroscopy take?

An upper endoscopy usually takes 10-15 minutes.

What happens after the procedure?

You will be taken to the recovery area, where you will be closely observed by nursing staff as you recover from your anaesthetic. Once awake, you will be given something to eat and drink.  Your specialist will speak with you to inform you of your results and of the need for a follow-up test or appointment.

Going home after my gastroscopy?

You will be ready to go home from hospital around 2 hours after your procedure.

Due to the sedative medications given, you must not drive a car, operate heavy machinery or sign any important documents for 24 hours after the procedure.  Therefore, please arrange for someone to pick you up in order for you to go home.  You will also need a responsible adult to stay in the house with you the night after the procedure.

If you experience any abdominal pain, chest pain or concerning symptoms after your procedure then you should seek medical attention immediately.

 Further information about gastroscopy?

Further information on endoscopy can be found through our information sheets or the Gastroenterological Society of Australia website:

http://www.gesa.org.au/resources/patients/health-information-fact-sheets/

Flexible sigmoidoscopy

Flexible sigmoidoscopy is a safe and effective way to visually examine the lining of your lower gastrointestinal tract (the rectum and bottom part of your colon).

A thin, flexible tube with a video camera and light at its end is used to perform a flexible sigmoidoscopy. Using various controls on the instrument, your specialist is able to guide the camera and carefully examine the lining of your bowel. The test is shorter in duration than a full colonoscopy, as only the rectum and distal part of the colon are examined.

Depending on the findings and the indication for the colonoscopy, biopsies (small tissue samples) may be taken, polyps (small growths) may be removed and in some instances, therapy may be delivered.

What is the reason for having a flexible sigmoidoscopy?

Flexible sigmoidoscopy can be performed for a variety of reasons, both to diagnose, evaluate, and treat conditions of the lower gastrointestinal tract. Common reasons for undergoing colonoscopy include a change in your bowel habit, rectal bleeding, and screening for polyps or bowel cancer.

What are the risks of flexible sigmoidoscopy?

Flexible sigmoidoscopy is a generally safe procedure that is commonly performed and complications are rare.  Your doctor will discuss the risks and benefits with you and answer any question or concerns that you may have.

Common side-effects

Temporary side-effects following flexible sigmoidoscopy include a sense of abdominal bloating related to the use of air to inflate your bowel. You may also feel nauseated or sleepy due to the effects of the anaesthetic medications.

Complications

Perforation. 1:1000 cases. Perforation is a hole or tear in the bowel wall that may require an operation to repair.

Bleeding. Bleeding can arise at a polypectomy or biopsy site. Most bleeding is minor and requires no treatment but occasionally bleeding will require a repeat colonoscopy, blood transfusion, hospitalization, or surgery.

Infection. The colonoscope is a reusable instrument that is stringently disinfected, however there is a very small risk of infection being introduced during the procedure.

Failure of procedure. The flexible sigmoidoscopy may be unsuccessful (e.g. technical issues or bowel preparation) and may need to be repeated.

Reaction to anaesthetic drugs. Rarely patients may have a reaction to the sedation.

Aspiration. Although uncommon, it is possible that whilst sedated you can vomit and aspirate the contents into your lungs.

Missed lesions. There is a chance that important lesions, in particular bowel cancers and polyps, may be missed at flexible sigmoidoscopy. The risk of missing a lesion is between 2% and 8%.

Death. Death is extremely rare, although is a remote possibility with any interventional procedure.

How do I prepare for the procedure?

Unlike colonoscopy, there is no bowel preparation required the day prior to your flexible sigmoidoscopy. An enema will be given to you after you arrive at the hospital on the day of your procedure to clear the rectum and distal part of the colon of faeces.

You will be asked to fast with nothing to eat or drink for at least 6 hours prior to your procedure.

What do I do with my usual medications prior to the procedure?

Please inform your specialist if you are taking blood thinning or diabetic medications. You will be given specific instructions on the use of these medications prior to your procedure.

Your other regular medications should be continued unless your specialist provides you with specific instructions otherwise. Medications required on the morning of the procedure can be taken with a sip of water.

What happens on the day of the procedure?

You will be given an appointment time to come into hospital.  Prior to your procedure you will be seen by both nursing staff and your anaesthetic doctor, who will ask for further information regarding your past medical history, medications and any allergies that you may have. You will be asked to sign a consent form for the procedure if you have not already done so. You will also have a chance to see your Gastroenterologist prior to the procedure to discuss any questions that may have arisen.

Whilst in hospital, around an hour prior to your flexible sigmoidoscopy, you will be given an enema to clear the rectum and distal colon of faeces.

What happens during the procedure?

We will make every effort to ensure that you are as comfortable as possible during your procedure. You will be asked to change into a hospital gown and then brought into the procedure room for your flexible sigmoidoscopy. A small drip needle will be inserted by your anesthetist, through which sedation will be given to make you comfortable during the test. Your vital signs (oxygen levels, blood pressure, and pulse) will be closely monitored whilst you are undergoing the procedure. Your specialist will examine your lower bowel, and if necessary perform biopsies or removal of polyps.

How long does a flexible sigmoidoscopy take?

The time taken for flexible sigmoidoscopy varies, but is most often between 15 and 30 minutes. Flexible sigmoidoscopy is usually a day procedure so you will not need to stay in hospital overnight.

What happens after the flexible sigmoidoscopy?

You will be taken to the recovery area, where you will be closely observed by nursing staff as you recover from your anaesthetic. Once awake, you will be given something to eat and drink.  Your specialist will speak with you to inform you of your results and of the need for a follow-up test or appointment.

Going home after my flexible sigmoidoscopy?

You will be ready to go home from hospital around 2 hours after your procedure.

Due to the sedative medications given, you must not drive a car, operate heavy machinery or sign any important documents for 24 hours after the procedure.  Therefore, please arrange for someone to pick you up in order for you to go home.  You will also need a responsible adult to stay in the house with you the night after the procedure.

Most patients do not have any problems after flexible sigmoidoscopy, however if you experience any abdominal pain, rectal bleeding, fever or chills, or other concerning symptoms, then it is important that you seek medical attention immediately.

Further information about flexible sigmoidoscopy?

Further information on flexible sigmoidoscopy can be found through our information sheets or the Gastroenterological Society of Australia website:

http://www.gesa.org.au/resources/patients/health-information-fact-sheets/