Why might I recommend it?
I can also take biopsies to investigate inflammation and other conditions. Reasons for the test may include bowel symptoms, a positive FIT result, low iron or follow-up after previous polyps.
Watch your colonoscopy
A short guide to what you can expect. 2:20 · English narration and captions
Captions are included in the film. Your own preparation instructions, consent discussion and discharge advice take priority.
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Read the film transcript
0:00 Looking at your large bowel
Colonoscopy is generally very safe. It gives a close-up view of your large bowel. Samples can be taken and many polyps can be removed during the examination.
0:11 Preparation gives a clearer view
Preparation clears poo so the lining can be seen clearly. Follow your own preparation and medicine instructions. Call your endoscopy team if you cannot complete them.
0:23 Before the examination
The team checks your preparation, health and medicines, discusses sedation and individual risks, and answers your questions before you give consent.
0:33 Getting you comfortable
You usually lie on your left side with your knees bent. Monitoring is set up before any sedation. You may be helped to change position during the examination.
0:45 Following the bowel
The scope passes through your bottom to the beginning of the colon, when possible. Sometimes the end of the small bowel is also checked.
0:58 The view on the screen
The camera sends close-up pictures to a screen so the lining and folds can be examined carefully.
1:06 Careful inspection
The lining is examined carefully as the scope comes back. Good preparation helps reveal small or flat changes, although no examination finds every abnormality.
1:17 Samples and polyp removal
Instruments pass through the scope to take biopsies or remove polyps, usually without being felt. Large or complex polyps may need another procedure.
1:28 A small clip, if needed
Sometimes, small clips are placed after removing a polyp to help prevent bleeding. They usually fall off and pass naturally in your poo, without needing a procedure to remove them.
1:40 Recovery and going home
You rest in recovery. After sedation, an adult must collect you. Follow your discharge instructions about medicines, activity and driving, even if you feel awake.
1:52 What happens to the results?
Afterwards, you’ll hear the initial findings and what happens next. Tissue results come later. Your endoscopy or histology report documents the recommended treatment and follow-up.
2:04 If you feel unwell at home
Seek urgent advice for severe or increasing tummy pain, fever, heavy or ongoing bleeding, or persistent vomiting. Use your discharge contact details. Call 111 for collapse or severe breathing difficulty.
Where does the camera go?
Modern high-definition video endoscopes give a clear, close-up view of the digestive lining on a monitor.
Optional: into the end of the small bowel, when needed.
Front view, not to scale. Your right is on the left of the picture. The camera stays inside the digestive tract. Its exact position varies.
The route through the digestive tract
The camera may pass into the terminal ileum when needed. It does not enter the appendix or examine the whole small bowel.
Rectum
The camera enters through the anus and passes into the rectum. This is the last part of the large bowel before the anal canal.
Sigmoid colon
This curved section joins the descending colon to the rectum. Its length and bends vary between people. The camera stays inside the bowel.
Descending colon
This section runs down the left side of your abdomen. In this front view, your left is shown on the right of the picture.
Transverse colon
This section crosses the abdomen between the descending and ascending colon. Its position and the shape of its bends vary.
Ascending colon
This section runs up the right side of your abdomen. In this front view, your right is shown on the left of the picture.
Caecum
The caecum is the pouch at the beginning of the large bowel. Reaching it helps confirm that the camera has passed through the full length of the colon. I also examine the lining carefully as I withdraw the camera. The appendix opens into this pouch, but I do not pass the camera into the appendix.
Terminal ileum (when needed)
The end of the small bowel joins the caecum through the ileocaecal valve. When appropriate, I may pass through this valve to examine a short section. This is not required for every colonoscopy and does not examine the whole small bowel.
Read the anatomy and route as text
The camera may pass into the terminal ileum when needed. It does not enter the appendix or examine the whole small bowel.
1. Rectum
The camera enters through the anus and passes into the rectum. This is the last part of the large bowel before the anal canal.
2. Sigmoid colon
This curved section joins the descending colon to the rectum. Its length and bends vary between people. The camera stays inside the bowel.
3. Descending colon
This section runs down the left side of your abdomen. In this front view, your left is shown on the right of the picture.
4. Transverse colon
This section crosses the abdomen between the descending and ascending colon. Its position and the shape of its bends vary.
5. Ascending colon
This section runs up the right side of your abdomen. In this front view, your right is shown on the left of the picture.
6. Caecum
The caecum is the pouch at the beginning of the large bowel. Reaching it helps confirm that the camera has passed through the full length of the colon. I also examine the lining carefully as I withdraw the camera. The appendix opens into this pouch, but I do not pass the camera into the appendix.
7. Terminal ileum (when needed)
The end of the small bowel joins the caecum through the ileocaecal valve. When appropriate, I may pass through this valve to examine a short section. This is not required for every colonoscopy and does not examine the whole small bowel.
Your appointment,
step by step.
Good preparation helps me see the lining
Follow the diet, laxative and medicine instructions for your own appointment. The correct plan depends on your appointment time, bowel preparation product and your health.
Tell our endoscopy team about blood thinners, diabetes and weight-loss medicines. Your instructions should say whether each medicine needs to be withheld, the last dose and when to restart if withheld. Call the team if the instructions are missing or unclear.
Arrange transport and support at home if you plan to have sedation. Contact the service if you cannot complete the preparation or keep fluids down.
Looking carefully and treating what can be treated
You usually start lying on your side. A flexible tube with a camera at its tip passes through your bottom into the large bowel. You may be asked to change position, and a nurse may apply gentle pressure to your abdomen to help the camera move around bends.
You may feel bloating or brief cramping. Sedation and careful technique help most people remain comfortable. Small biopsies and removal of small polyps are usually not felt.
A large or complex polyp may need a separate procedure.
Recovery and a clear follow-up recommendation
You will be monitored after the procedure. Mild bloating or cramping can occur. Follow the discharge instructions about medicines, activity and travel, particularly if a polyp was removed.
If you have sedation, arrange for a responsible adult to collect you. Follow the service’s restrictions on driving, work, alcohol, important decisions and support at home, even if you feel awake.
I can explain what I have seen. Tissue samples need laboratory examination. Your recommended follow-up will be documented in your endoscopy report and/or histology report once those results are available.
Read all three stages
Before: Good preparation helps me see the lining
Follow the diet, laxative and medicine instructions for your own appointment. The correct plan depends on your appointment time, bowel preparation product and your health.
Tell our endoscopy team about blood thinners, diabetes and weight-loss medicines. Your instructions should say whether each medicine needs to be withheld, the last dose and when to restart if withheld. Call the team if the instructions are missing or unclear.
Arrange transport and support at home if you plan to have sedation. Contact the service if you cannot complete the preparation or keep fluids down.
On the day: Looking carefully and treating what can be treated
You usually start lying on your side. A flexible tube with a camera at its tip passes through your bottom into the large bowel. You may be asked to change position, and a nurse may apply gentle pressure to your abdomen to help the camera move around bends.
You may feel bloating or brief cramping. Sedation and careful technique help most people remain comfortable. Small biopsies and removal of small polyps are usually not felt.
A large or complex polyp may need a separate procedure.
Afterwards: Recovery and a clear follow-up recommendation
You will be monitored after the procedure. Mild bloating or cramping can occur. Follow the discharge instructions about medicines, activity and travel, particularly if a polyp was removed.
If you have sedation, arrange for a responsible adult to collect you. Follow the service’s restrictions on driving, work, alcohol, important decisions and support at home, even if you feel awake.
I can explain what I have seen. Tissue samples need laboratory examination. Your recommended follow-up will be documented in your endoscopy report and/or histology report once those results are available.
Your own preparation instructions come first
Follow the plan from the service where you are booked. It should cover food, fluids, medicines and transport. If you are unsure, call our endoscopy team.
Bowel preparation options and practical tips
Finding a polyp and removing it
Small instruments pass through a channel inside the colonoscope. A thin wire loop called a snare can remove many polyps from inside the bowel, without a cut through the skin.
The technique depends on the polyp’s size, shape and position. Tissue is usually sent to the laboratory. The small wound left after removal usually heals quickly; larger removal sites can take longer.
How do I take a biopsy from inside the bowel?
Small instruments pass through a working channel inside the scope. A biopsy usually takes a tiny sample from the surface lining for laboratory examination. I do not cut through the whole bowel wall to take a routine biopsy.
Simplified side view. The wall is not shown at its actual thickness.
I examine the surface lining. Biopsies can be useful even when the lining looks normal.
How safe is the examination?
Colonoscopy is generally very safe. Serious complications are uncommon, and perforation (a hole in the bowel wall) is very rare. Bleeding can occur after polyp removal, particularly with larger polyps or blood-thinning medicines. I will discuss your individual risks. Good preparation and careful inspection help find lesions, although no examination detects every abnormality.
When to get help afterwards
Follow your discharge advice. Seek urgent medical assessment for heavy or ongoing bleeding, black tarry stools, severe or worsening abdominal pain, fever, persistent vomiting, or feeling faint or very unwell.
Call 111 if you collapse, have severe breathing difficulty, have heavy bleeding with faintness, or are too unwell to travel safely.
Common questions
Why do I need bowel preparation?
Poo left in the bowel can hide the lining and make small or flat polyps harder to see. Good preparation helps me examine the bowel carefully.
Use the instructions for your own appointment. If you cannot finish the preparation or keep fluids down, call our endoscopy team.
Why do some people need 3, 4 or 6 litres of bowel preparation?
The amount depends on the product and how easily your bowel clears. Standard PEG preparations such as Glycoprep commonly use 3 or 4 litres of prepared solution. A larger or extended course, sometimes 6 litres, may be prescribed for selected people with a previous poor clean-out or marked constipation. Medicines that slow the bowel can also affect the plan.
More is not automatically better. The timing, completing the prescribed course and following the diet instructions are also important. I take account of your previous preparation, tolerance, kidney or heart disease and any fluid restriction before changing the plan. Do not increase the volume or add laxatives yourself.
Check whether the number on your sheet means litres of preparation solution or total fluid including the extra clear drinks. These are different. Lower-volume products also need additional clear fluids. Follow the exact product, sachet number and mixing instructions for your appointment; do not reduce the water to make a stronger drink.
How clear should my bowel motions be after preparation?
Near the end of preparation, aim for watery, see-through output with no solid pieces. It is often pale yellow, like weak tea, and does not have to be colourless. Thick brown liquid, cloudy output you cannot see through, or pieces of poo suggest more stool remains.
Appearance is a useful guide, but it cannot confirm that the whole colon is clean. Finish the prescribed course even if the output clears early, unless the team tells you to stop. Keep the final drinking cut-off and do not take extra laxatives yourself.
Call the endoscopy service on your appointment letter if you cannot finish, keep vomiting, have little or no bowel output, or still pass thick brown liquid or solids after the prescribed course. Contact the service before it closes if you are already struggling.
If you are booked at Endoscopy Auckland and feel well but preparation is incomplete while the service is closed, attend at the booked time and tell the team. Keep the drinking cut-off. The team will assess whether the examination can proceed. For another service, follow its own instructions.
Will you remove any polyps at the same time?
Many polyps can be removed during colonoscopy using small instruments passed through a channel in the scope. A thin wire loop called a snare is often used.
A large or complex polyp may need a separate procedure.
How long will the procedure and visit take?
Gastroscopy and colonoscopy are usually day procedures, so most people go home on the same day. You will be given a morning or afternoon appointment slot. This is a session time, rather than a guaranteed procedure start time.
The examination itself may be relatively short, but the full visit also includes admission, preparation, consent, recovery and discharge. It can take longer if biopsies, polyp removal or other treatment is needed.
There can sometimes be a wait before the procedure, particularly if an earlier case takes longer or urgent work is added to the list. Please allow enough time for the whole visit. You will usually go home soon after you have recovered and the team has completed your discharge instructions.
If you have sedation, a responsible adult will need to take you home and you must follow the restrictions provided by the endoscopy service.
Will I be asleep?
This depends on the sedation chosen. With moderate sedation you are usually relaxed and drowsy, but may still respond to instructions and remember some of the procedure. Deeper sedation reduces awareness further.
We will discuss the options that suit your health, the procedure and your preferences. Some people choose to have their test without intravenous sedation. Deeper sedation needs to be arranged with the service.
What are my options for sedation?
Approval for endoscopy does not always include every sedation option or the anaesthetist fee. Please discuss your preference with our team before booking and confirm cover with your insurer.
Southern Cross has additional eligibility criteria for deeper sedation from 1 April 2026. Ask our team which options are suitable for you and confirm your own policy and any anaesthetist fee with your insurer. The linked guide explains the options in more detail.
Can I drive home after sedation?
If you have sedation, arrange for a responsible adult to collect you. Sedation can affect judgement and coordination even when you feel awake.
Follow your discharge instructions about driving, alcohol, work, machinery, important decisions and support at home. Confirm these arrangements with the endoscopy service before your appointment. Faster waking after propofol does not mean you can drive yourself home.
How soon can I travel after gastroscopy or colonoscopy?
Gastroscopy and colonoscopy are generally very safe. Serious complications are uncommon, and the risk is lower after a diagnostic examination, including routine small biopsies, than after treatment such as removal of a large polyp.
Tell our team about travel plans before booking. As a practical precaution, allow two weeks between colonoscopy and overseas, long-haul or remote travel unless the team confirms a shorter interval is suitable. Polyps may be found and removed on the day. Delayed bleeding is one reason to stay within reach of medical care: it can occur several days after removal and up to two weeks later.
After an uncomplicated diagnostic gastroscopy or colonoscopy, a two-week restriction is not usually needed once the findings are known. Allow at least 24 hours before flying after colonoscopy. After sedation, do not drive or travel independently for 24 hours, and arrange the support specified in your discharge instructions. Confirm your flight and any long journey with the team, especially after polyp removal, dilatation or other treatment.
Seek urgent medical assessment for heavy or ongoing bleeding, black tarry poo, severe or worsening tummy or chest pain, fever or faintness. Do not set off on a trip with these symptoms. Call 111 for collapse, heavy bleeding with faintness, severe breathing difficulty or if you cannot travel safely.
When will I receive my results?
I can explain what I have seen after the procedure. Tissue samples need laboratory examination, so some answers come later. Our team will explain how you will receive those results and the expected timeframe.
Your recommended follow-up will be documented in the endoscopy report and/or histology report once the tissue results are available. If an expected result has not arrived, call our team.
Can a negative FIT replace colonoscopy?
FIT looks for blood from the lower digestive tract in a poo sample. It has not been validated as a screening test for upper gastrointestinal problems such as oesophageal or stomach disease. Some precancerous polyps do not bleed, and a negative result cannot exclude every cause of bowel symptoms.
A negative FIT does not replace a colonoscopy that has been recommended for symptoms, polyp follow-up or another clinical concern.
Understanding your histology report
Three things to remember
- Use the preparation and medicine plan for your own appointment.
- Arrange transport home and follow the discharge advice if you have sedation.
- Your recommended follow-up is documented in the endoscopy report and/or histology report once tissue results are available.