What to Do After a Colonoscopy

Post-procedure care can reduce risk of complications

Stomach Ache
Getty Images/Paul Bradbury

More often than not, people will characterize a colonoscopy as an irritating and yucky procedure that they are forced to go through almost as a punishment. At the same time, many will either forget or entirely ignore the fact that it's an invasive procedure that demands a period of watchfulness and recovery, particularly if it involves a biopsy or the removal of a polyp.

These long-standing attitudes are at the heart of why one in every 125 colonoscopies results in a complication.

While medical error certainly plays a part, failure to adhere to post-treatment recommendations and/or dismissing symptoms are "minor" remain key factors.

Understanding Colonoscopy

A colonoscopy entails the insertion of a flexible scope through the anal canal into the rectum and colon. A colonoscope allows visualization of the colon structure as well as the removal of any suspicious growths that may suggest a developing malignancy.

Colonoscopy is considered the gold standard tool for visualizing the colon, far better than either flexible sigmoidoscopy or barium enema. While computerized tomography (CT) scans are emerging as an effective means to detect colorectal cancer; they aren't nearly as good at detecting flat lesions or polyps.

While most people who undergo the procedure will elect to be anesthetized, a skilled clinician can perform one without sedation if the person would rather avoid the after-effects of anesthesia.

(Currently, only one percent of colonoscopies are performed without sedation.)

In the United States, it is recommended that all persons 50 years of age or older receive a colonoscopy every 10 years to screen for colorectal cancer. The frequency may be increased for persons at higher risk or those who have been previously treated for colon cancer.

First 24 Hours Following the Procedure

Once the colonoscopic procedure has been completed, it is recommended that you be driven home by a friend or family member. If you have nausea, your doctor may prescribe medications to help alleviate symptoms.

During the first 24 hours, you should adhere to the following guidelines:

  • Refrain from driving or operating heavy machinery until at least day after your procedure.
  • Take any pain medications or stool softeners as prescribed.
  • Drink plenty of liquids, including prune juice which can help soften stools.
  • Avoid alcohol for the first 24 hours.
  • Eat high-fiber foods or use an over-the-counter fiber supplement, if needed.
  • Rest and avoid any heavy lifting or strenuous activity.

If you are taking a daily aspirin to prevent heart troubles, you do not need to stop. Lower-dose aspirin is considered perfectly safe.

Symptoms to Watch For

Call your doctor or clinic if you experience any of the following symptoms in the first 24 hours following your procedure:

  • You have chills or fever.
  • You experience rectal bleeding of more than a tablespoon.
  • You experience swelling at the site where the IV needle was inserted.
  • You experience severe abdominal pain or bloating (mild pain or bloating can be expected).
  • You are vomiting.
  • You are experiencing irregular heartbeats (arrhythmia).

After the First 24 Hours

If polyps were removed during your colonoscopy, you will likely need to alter your activities for next seven days. This includes not running, not lifting anything over five pounds, avoiding unnecessary travel, and stopping any blood thinners you may be taking, In short, be careful and treat your body gingerly.

If you experience any of the following symptoms during the first week, call your doctor immediately or go to your nearest emergency room:

  • You are unable to have a bowel movement or to urinate.
  • You suddenly have trouble breathing.
  • Your stools are black or bloody.
  • Your vomit has blood or bile in it.
  • Your abdomen becomes tender and hard.
  • Any symptoms you have are getting worse.

Sources:

Ranasinghe, I.; Parzynski, C.; Searfoss. R. "Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits." Gastroenterology. January 2016; 150(1):103-113

Mayo Clinic. "Colonoscopy: What to Expect." Rochester, Minnesota; updated June 12, 2014.

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