What to expect before, during and after a colonoscopy

So you’ve scheduled your colonoscopy. Now what?
Knowing what to expect beforehand can help you adequately prepare and successfully complete the procedure. 
Before your colonoscopy
One of the most critical steps in preparing for your colonoscopy is cleansing your colon. Your colon must be cleansed of all stool to ensure that the doctor has excellent visibility and can detect even very small abnormalities, if present. This cleansing is commonly known as a bowel prep. A bowel prep involves drinking a solution and, in some cases, also taking pills that will help you to evacuate your stool. Specific instructions for the type of bowel prep you need to take, how to take it, and what diet to adhere to before and during the bowel prep will be provided by your doctor’s office. It’s most commonly mailed from the office of the doctor who’ll be performing your procedure.
It may also be important for you to review your medications with your doctor before your colonoscopy. If you take blood thinner medications, ask the doctor who prescribed it if it will be safe to stop it before your colonoscopy. If you take medication for management of diabetes, ask the doctor who prescribed it if you need to make adjustments in taking the medication before your colonoscopy.
Last, but not least, make sure that you arrange to have a companion to bring you and take you home from your colonoscopy. During the colonoscopy, you’ll be given medicine to help you relax that will affect your judgement and reflexes. You’ll need a responsible adult to drive you home. If you take public or medical transportation, you’ll need an adult other than the driver to ride with you for your safety.
During your colonoscopy
On the day of your exam, you typically need to arrive 45 minutes before your procedure.  
Keep in mind that you’ll be sedated for this procedure, unless you request otherwise, and there are two forms of sedation: conscious sedation, which is a twilight kind of sleep, versus the monitored anesthesia care in which an anesthesiologist will be present to administer medications to help get you to sleep. The determination on which type of sedation is best for you is made by your doctor before the procedure is scheduled.
During the procedure, a thin, flexible tube with a camera and light on the end called a colonoscope is inserted through the rectum and throughout the entire colon. The tube is about the diameter of an index finger, and is lubricated to allow for easy insertion. Your doctor will then gently pump air or CO2 and sterilized water or saline through the colonoscope so that the entire lining can be viewed.
If your doctor finds any abnormal areas, a biopsy may be done. If there are any polyps present, they may be removed as well. Polyps are tissue growths that are generally benign, but can develop into cancer if they are allowed to grow.
After your colonoscopy
Following your colonoscopy, you’ll be moved into a recovery area until you are awake and coherent. You may feel bloated and have gas cramps, and it’s encouraged that you try to pass the gas, as it will relieve the bloating and cramps. 
If your doctor took any biopsies or removed any polyps, your doctors’ office will contact you when results are available.
The risks of a colonoscopy are few and very rare. This procedure is typically very well tolerated. However, with any medical procedure, there is a risk of complication. You should call your doctor immediately if you experience severe abdominal pain, vomiting, fever or rectal bleeding.
Darrell Gray II is a gastroenterologist specializing in the evaluation, management and prevention of diseases involving the digestive tract at The Ohio State University Wexner Medical Center.

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