Netcare Greenacres Hospital
SASSO - South African Society for Obesity and Metabolism
Centre of Excellence


Indications for Colonoscopy

  • Abdominal pain
  • Blood per rectum
  • Change in bowel habits
  • Screening in high risk patients

  • Ulcerative colitis
  • Crohn's disease
  • Malignancy
  • Abdominal mass
  • Irritable bowel syndrome (IBS)
  • Family history of colo-rectal malignancy
  • What is a colonoscopy?
    It is an out-patient procedure, meaning that you will not need to stay over in hospital for the procedure. The whole procedure takes more or less 30 minutes.

    This is a non-surgical technique (that means no incisions!) for diagnosing problems in the lower gastro intestinal tract, the colon.

    This is the passage of thin, flexible fibre optic tube with an advanced digital camera installed in the tip. Passage of this tube through the whole of the "colon" (large bowel) for visualisation and the take of specimens and the snaring of "polyps" (growths). A colonoscopy is a safe and highly effective diagnostic technique and since your cooperation is essential for a successful examination, it is important that you understand what is to be done and why.

    Firstly the preparation of the colon: it is very important that the colon is cleared of any solids during the examination in order to optimise visualisation.

    Two days before the procedure, solid food and foods containing seeds, should be avoided, food colourants especially-red complicate visualisation.

    One day before procedure (Bowel Preperation):

    1. A normal breakfast. (+- 8h00am)
    2. Bowel Preparation:
      • “PICO PREP”:
      • Mix 1 sachet Pico-prep in a glass of hot water, let it cool down before drinking.
      • Drink 1 sachet Pico-prep per hour, every hour x4.
      • 1 sachet @ 9h00am;
      • 1 sachet @ 10h00am;
      • 1 sachet @ 11h00am &
      • 1 sachet @ 12h00pm.
    3. “Foods” allowed:
      • Water and cool drinks
      • Fruit juices
      • Tea and coffee
      • Soup and jelly
      • Mashed pumpkin and potatoes
      • Yoghurt

    Drink 6-8 glasses fluids throughout the day to prevent dehydration.

    FROM 22H00 - NIL PER MOUTH!!

    You need to be at hospital admissions no later than 6h30 on the Monday morning

    You should wear loose, comfortable, casual clothing that is easily removed. Avoid girdles, pantyhose and tight fitting garments.

    You will then be admitted in the Day Hospital of the Netcare facility. When it is you turn, you will be taken into the colonoscopy room, and the anesthetist will administer a small intravenous line. That should be the only pain that you will experience during this whole process. Also, a blood pressure cuff will be placed around your arm and on the finger tip, a monitor to monitor you pulse rate and breathing function. After that, the anesthetist will give you the sedative, and you will not remember anything about the procedure. You will only wake up after the procedure has been finished.

    The procedure itself
    Dr van Niekerk will examine the rectal opening before he inserts the colonoscope. The whole of the colon may be visualised, and there are some circumstances that prohibit him from visualising the whole of the colon. It might be due to diverticulosis, previous abdominal surgery, or then if the bowel is not prepared correctly.

    Abnormal tissue will be visualised and seeing that Dr van Niekerk makes use of a digital camera recording system, photos will be taken of these abnormalities and will be available for you afterwards. Furthermore, biopsies can be taken of these abnormalities and sent off to the pathology lab where the results should be available within 48 hours.

    Post procedure
    As we do the procedure under deep sedation, there are a few things to bear in mind:

    Firstly, no fluids or foods are to be taken within 6 hours prior to the procedure.

    Secondly, you will not be allowed to drive after the procedure, so bring someone to drive you home.

    Thirdly, after the procedure, you will be debriefed by Dr van Niekerk on his findings, but the effects of the anaesthesia may last for a few hours and it would be preferable if a family member can escort you during this debriefing, just to make sure that nothing falls between the lines.

    Abdomen may feel bloated as air is inflated into the bowel to optimise visualisation. There also might be a little bit of bleeding rectally due to the procedure, but fortunately all these side effects pass within the first 24 hours.

    Risks involved in a colonoscopy
    Every medical procedure involve some degree of risk. Complications rarely occur in patients undergoing a colonoscopy. Severe complications like perforation of the colon is a possibility.

    Secondly, the issue about AIDS, any fears of contracting AIDS through a colonoscopy is unfounded, as our instruments are thoroughly cleaned in-between each patient.

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