Endoscopy and colonoscopy

Both unit and individual endoscopist performance is audited regularly. Professor Bloom is an accredited bowel cancer screening colonoscopist, and has carried out more than 8,000 endoscopies with exceptional success rate. Before your endoscopy or colonoscopy, we’ll discuss the procedure with you and come up with a sedation plan you’re comfortable with. You can opt for no sedation, minimal sedation, or deep sedation.

Endoscopy is a general term to describe a camera examination of the upper or lower part of your digestive system. It’s a quick and painless procedure, normally lasting between 15 and 30 minutes. It’s also safe – complications from upper GI endoscopy are extremely rare.

Upper gastrointestinal (GI) endoscopy looks at the oesophagus, stomach and duodenum. A high-quality digital image is displayed on a screen and recorded (a copy of the images is then available for you to have). If necessary, we can take tissue samples for laboratory analysis at the same time.

Preparation for endoscopy is quite straightforward. You’ll need to avoid solid food for six hours before the procedure, and liquids for about two hours. If necessary, you’ll also be advised on whether you should temporarily stop any medication.

Sedation involves local anaesthetic spray to numb the throat. If required, intravenous medication is given which helps to reduce anxiety, as well as providing sedation and amnesia for the procedure. It’s important to note that an endoscopy is not a painful procedure and normally lasts between 15 and 30 minutes. After a recovery period of about an hour, patients are able to go home. 

If you decide to have a sedative, you’ll need someone to accompany you home, so please ensure you have someone available. After discharge you’ll need to rest for a few hours.

Endoscopy of the lower gastrointestinal tract can be either flexible sigmoidoscopy, or colonoscopy. A flexible sigmoidoscopy is usually carried out with minimal preparation (an enema administered in the department just before the procedure) and no sedation. It’s a very safe procedure that allows your specialist to examine the rectum and lower colon.

Colonoscopy uses the same instrument, but is a more complete examination of the whole of the large bowel (colon) as well as the last part of the small bowel. This does involve some preparation at home, including taking a laxative the day before the procedure.

Diagnostic colonoscopy carries about a 1 in 1000 risk of damage to the bowel. There is also a chance of some bleeding if a procedure, such as polyp removal, is carried out at the same time.

Again, Professor Bloom will talk to you before your procedure about any changes needed you might need to make with your medication, and discuss your preference for sedation (which is quite common for colonoscopy).

As computing power has increased, so virtual colonoscopy has come into play. Using CT scans, we build a 3D internal model of your body. For patients either unable or unwilling to have regular colonoscopies, this is a very welcome development, although it doesn’t allow for either a biopsy or polyp removal.

This applies to both of these newer methods and it may be that using a standard approach may work best for your diagnosis. Rest assured, you’ll have every chance to discuss all options with us so we can determine the best possible pathway for you.

Professor Bloom explains more about capsule endoscopy and the benefits it brings for both patient and doctor.