Colonoscopy
A colonoscopy is an examination of the colon and part of the small intestine to detect and treat changes in the patient’s medical condition.
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What you need to know before examination?
A colonoscopy is an endoscopic lower gastrointestinal examination to examine the large intestine mucosa and the final section of the small intestine in detail.
Colonoscopy provides an endoscopic examination of the large intestine mucosa and the final section of the small intestine. Due to modern high-resolution equipment and additional technical options (magnification, light modification, artificial intelligence), inflammation, precancerous and cancerous lesions can be detected and identified during the examination. During the procedure, tissue samples can be taken for histological analysis and/or polyps can be removed. Larger polyps require more complex procedures, sometimes in a hospital.
Thorough bowel cleansing is essential for good mucosal visibility and detailed examination. This requires dietary adjustment (avoiding foods with seeds, husks, whole-grain products) several days before the examination. On the last day before the examination, only clear liquids and prescribed bowel cleansing agent (e.g. Moviprep) should be consumed. Certain medications (blood-thinning medications, diabetes medications) also need to be adjusted before the examination.
More about colonoscopy
A colonoscopy is an endoscopic examination of the inside of the large intestine (colon) using a flexible instrument – the colonoscope. The colonoscope is equipped with a camera and a light source at the end, which allows a detailed view of the intestinal mucosa, assessing its structure and appearance as well as any abnormalities. Besides a thorough examination, it is also possible to treat certain lesions – polyps are in most cases removed immediately.
The test can be uncomfortable; it is routinely performed without sedation in most cases without difficulty, but can also be performed under analgesia or deep sedation.
Course and duration of examination
The colonoscopy is performed in a lying position on the left side. The doctor introduces the endoscope through the anus and the whole colon to the cecum and the back of the small intestine. During the examination, CO₂ gas is blown into the bowel, which can cause a feeling of bloating and cramps that are relieved when the gas is expelled. Exceptionally, pain may occur, which can be significantly alleviated with cooperation and appropriate action. If the pain is too severe, the examination can be stopped and then a sedated examination can be planned. The procedure takes about 20 to 60 minutes, depending on the complexity of the examination and additional procedures, such as polyp removal.
Preparation for examination
A thorough bowel cleansing is essential for a successful colonoscopy. Seven days before, do not eat wholemeal bread, fruit with small seeds, raw vegetables, or foods with peelings, skins or seeds. Three days before, exclude raw vegetables, fresh fruit, nuts and seeds. The day before the examination, eat only an easily digestible meal, drink only clear liquids (non-fat soups, clear juice, tea without milk) and drink 2 litres of slightly warmed, aerated Donat (a natural mineral water from Rogaška Slatina with a high content of magnesium).
On the day of the examination follow the instructions regarding Moviprep. If you have an appointment in the morning, drink the first litre the night before and the second one in the morning (5 hours before the examination). If you have an appointment in the afternoon, start drinking the first one 8 hours and the second one 4–5 hours before the examination. Take your usual medication with minimal water at least one hour before taking laxatives. After the second litre of laxative, the defecated fluid should be almost clear, with no significant admixture of faeces.
Frequently asked questions
Most patients only feel tension and bloated from the CO₂ inhalation. Exceptionally, pain may occur due to the shape of the distended bowel, adhesions or muscle tension. If the pain is too severe, the procedure can be interrupted and sedation can be given.
How and when do I arrange a sedated colonoscopy?
If you want to have a sedated colonoscopy, you should make prior arrangements with the ordering service, preferably at the time of the appointment or as soon as possible. Sedation is a procedure that requires extra time and staff, so it cannot be done at any time. If you decide to have sedation afterwards, the date of the test may be changed. More about sedation options and forms of sedation at
A colonoscopy usually takes between 20 and 60 minutes, depending on the complexity and any additional procedures (e.g. polyp removal).
A well-cleaned bowel is the key to a clear examination. Avoid foods with seeds, nuts and wholemeal products for seven days before the examination. Stop eating raw vegetables and fruit with seeds three days before the examination. Drink only clear liquids on the last day before the examination. Use a laxative (e.g. Moviprep) as directed to achieve a completely clean intestine.
Yes, adjustments of certain medications are needed before the test. Consult your personal doctor about how the preparation and test affects your known chronic diseases and regular medication. Blood-thinning and diabetes medications should be adjusted accordingly, and iron replacement medications should be stopped several days before the test.
If you are taking diabetes medication, doses should be reduced or stopped as appropriate during extended periods of time without food during blood sugar check-ups.
If you are taking blood-thinning medications, we can perform an endoscopic examination, but it is not always possible to take tissue samples. Aspirin 100 therapy should be discontinued 3–5 days before the test. If Aspirin 100 mg is part of the treatment after a heart attack, stent insertion or high risk of vascular complications, aspirin should not be discontinued. For anticoagulant therapy (Pradaxa, Xarelto, Eliquis, Roteas, Marevan medications), consult your doctor or an anticoagulant clinic to see if and how you can discontinue treatment. Before the test, we need to know exactly which blood-thinners you are taking and at what dose, and when you took your last pill before the test. If you are receiving Marevan and treatment has been interrupted, you will also need a fresh PT and INR, as well as an anticoagulant clinic test result.
Your doctor will inform you about the results and findings after the procedure. You will receive a written test result. The removed polyps and samples are sent to the histopathology laboratory for examination. You will receive your histology and final opinion within 2–3 weeks and your doctor can view it in the CRPP system.
You may feel slight cramps or bloating after the examination.
These symptoms usually disappear after a few hours, and it is recommended to consume enough warm fluids. After the test, eat light cooked food, avoid cold, fatty, heavy foods, foods that cause constipation or bloating. If polyps are removed, you will receive further instructions and recommendations to prevent complications.
If you have received sedation, you will be observed for a while after the examination until the effect of the medication wears off. Before discharge, you will receive additional instructions to prevent complications related to sedation. You need an escort to take you home, a reliable person to drive you home, as you are not allowed to drive after taking sedatives.
If a larger and more complex polypectomy has been performed, rest for a few days after the procedure, with a light liquid diet. Occasionally, emergency hospitalisation is necessary. You will receive all the necessary instructions after the examination
Colonoscopy is generally a safe procedure, but as with any medical procedure, there are some risks. Some possible complications:
Bleeding: Occasionally, slight bleeding may occur, especially if polyps have been removed or biopsies have been performed.
Perforation: Very rarely, perforation (puncturing of the intestinal wall) can occur and requires immediate medical attention.
Infection: By following safe endoscopy standards, the possibility of infection is very rare, but it can occur, especially in persons with weakened immune systems.
In case of severe abdominal pain, fever, major bleeding or other unusual symptoms, you should be examined immediately.
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