Colonoscopy Perth

What to know before having a colonoscopy

When bowel symptoms need a proper look

A colonoscopy is not something most people look forward to. I understand that. Many people feel awkward about it, or worried about the bowel prep, or they just do not like the idea of the test. That is all very normal.

As a general surgeon in Perth, I see people for colonoscopy when there is bleeding, unexplained weight loss, bowel habit change, abdominal pain, low iron, a positive bowel screening test, or a family history of bowel cancer. Sometimes the symptoms are small. Sometimes they have been going on for a while because people feel embarrassed to talk about them.

Please do not feel embarrassed. I have this conversation every day. My job is to make it simple, respectful and clear.

What is a colonoscopy?

A colonoscopy is a test where I use a long, thin, flexible camera to look inside the large bowel. This includes the rectum and colon. The camera lets me see the lining of the bowel on a screen.

During the same procedure, I can also take small samples, called biopsies. If I find polyps, many can be removed at the same time. Polyps are small growths in the bowel. Most are not cancer, but some can change over time, so removing them can be important.

A colonoscopy is commonly used to look for bowel polyps, bowel cancer, inflammation, bleeding, and other bowel conditions.

Why might you need a colonoscopy?

You may be referred for a colonoscopy if you have:

  • Blood in the stool or bleeding from the back passage
  • A change in bowel habits
  • Ongoing diarrhoea or constipation
  • Unexplained abdominal pain
  • Unexplained weight loss
  • Low iron or anaemia
  • A positive bowel cancer screening test
  • A personal or family history of bowel polyps or bowel cancer
  • Inflammatory bowel disease that needs checking

Not every bowel symptom means something serious. Many people have haemorrhoids, irritable bowel symptoms, food-related changes or other common problems. But we should not guess when the symptoms need checking.

Bowel cancer screening and colonoscopy

In Australia, bowel cancer screening is usually done with a stool test first for people at average risk. If that test is positive, a colonoscopy may be recommended. Colonoscopy is also used for people at higher risk, for example if there is a strong family history or previous polyps.

A positive screening test does not mean you have bowel cancer. It means blood has been found and we need to find out why.

The bowel prep

I will be honest. For many people, the bowel prep is the hardest part.

Before the colonoscopy, you need to clear the bowel so I can see properly. This usually means changing your diet for a short time and taking bowel preparation medicine that makes you go to the toilet often.

It is not glamorous. But it matters. If the bowel is not clean enough, small polyps can be missed, or the test may need to be repeated. Before you start bowel prep, you should be given clear information about the preparation, the procedure, sedation, risks, benefits and other options.

What happens on the day?

On the day of your colonoscopy, you will usually change into a hospital gown and be taken into the procedure room. Most people lie on their left side with their knees slightly bent.  

You are given sedation through a small needle in your hand or arm, so you are sleepy and comfortable. Most people remember very little afterwards, but this can vary from person to person.

For a colonoscopy, the camera is gently passed through the back passage into the large bowel. It then moves around the colon, which is the large bowel that sits around the outside of the abdomen.

The camera is long and flexible. It has a light and a tiny camera at the end, so I can see the bowel lining on a screen. A small amount of air or carbon dioxide is used to open the bowel slightly, because the bowel is normally soft and folded down. This helps me see properly. 

The camera can usually be moved all the way around the large bowel to the start of the colon, near where the small bowel joins it. It does not travel up into the stomach. The stomach is checked with a different test called a gastroscopy, where the camera goes through the mouth.

During the colonoscopy, I look carefully for polyps, inflammation, bleeding, narrowing, or anything unusual. If I see a small polyp, I may be able to remove it during the same procedure. If an area needs testing, I can take a tiny sample.

Risks of colonoscopy

Colonoscopy is common and generally safe, but it is still a medical procedure, so there are risks.

These can include bleeding, especially after polyp removal, reaction to sedation, infection, missed lesions, abdominal discomfort, bloating, and rarely a perforation in the bowel wall. If a perforation happens, further treatment or surgery may be needed.

Before your colonoscopy, I will talk you through the risks that apply to your situation. The risk is not the same for everyone. It can depend on your age, medical history, medications, bowel condition, and whether polyps need to be removed.

After the colonoscopy

After the procedure, you rest in recovery while the sedation wears off. You may feel bloated or pass wind, which is normal because of the air used during the procedure. You will need someone to take you home, and you should not drive that day. 

In most cases, I can tell you on the day what I saw during the colonoscopy. For example, I can explain whether the bowel looked normal, whether there were haemorrhoids, inflammation, diverticular disease, polyps, or any area that needed a biopsy.

If I removed a polyp or took a biopsy, those samples are sent to the laboratory. The final results usually take a few days. So on the day, I can explain the procedure findings, but some answers may need to wait until the pathology report is back.

Before you leave, you will usually be given instructions about eating, drinking, medications, driving, and what symptoms to watch for. If you have strong abdominal pain, heavy bleeding, fever, or feel very unwell after going home, you should seek urgent medical advice.

Once the results are available, I will explain what they mean and what happens next. Sometimes no further treatment is needed. Sometimes you may need follow-up, another colonoscopy in the future, or referral for another type of care.

Seeing a general surgeon for colonoscopy in Perth

If you have bowel symptoms, a positive screening test, or a family history that worries you, it is worth getting proper advice.

At Perth Obesity Solutions, I will take time to understand what has been happening, review your referral and results, and explain whether colonoscopy is the right next step. My approach is simple: no shame, no rushed explanation, and no making things more complicated than they need to be.

Gallbladder disease can be painful and disruptive, but once the cause is clear, we can talk through the treatment options and what may be appropriate for you.