What Happens During a Colonoscopy and Do I Need One?

A colonoscopy is a procedure that allows a gastroenterologist or colorectal surgeon to examine the inside of your large bowel using a thin flexible camera called a colonoscope. It detects polyps, bowel cancer, and inflammatory conditions.

Australians aged 45 to 74 should complete regular bowel screening, even if they have no symptoms. Your Nuvo Health GP can assess your risk and arrange appropriate screening or specialist referral.

Why Bowel Screening Matters in Australia

Bowel cancer is Australia’s second deadliest cancer, yet it is one of the most treatable when found early.

The National Bowel Cancer Screening Program now recommends bowel screening from age 45. Australians aged 45 to 49 can request a free at-home faecal immunochemical test (FIT), while people aged 50 to 74 automatically receive a kit in the mail every two years.

If that test returns a positive result, or if you have symptoms or a family history that places you at higher risk, your GP will likely recommend a colonoscopy for a more thorough examination.

Who May Need a Colonoscopy?

Your GP may recommend a colonoscopy if you have any of the following risk factors, symptoms, or screening results:

Age 45 and over — bowel cancer screening is now recommended from age 45, as risk increases with age
Positive FIT result — a positive at-home bowel screening test requires follow-up
Family history — a first-degree relative diagnosed with bowel cancer, particularly before age 55
Personal history of polyps — previous adenomatous polyps require surveillance colonoscopies
Inflammatory bowel disease (IBD) — Crohn’s disease or ulcerative colitis increases risk after 8 to 10 years
Persistent symptoms — rectal bleeding, unexplained changes in bowel habits lasting more than two weeks, unexplained weight loss, persistent abdominal pain, or iron deficiency without an obvious cause

How to Prepare for a Colonoscopy (Bowel Prep)

Low-fibre diet (3 to 5 days before): Switch to white bread, plain chicken, eggs, clear broth. Avoid seeds, nuts, raw vegetables, and wholegrain foods.

Clear fluids only (the day before): Water, clear apple juice, black tea or coffee (no milk), clear broth, sports drinks (no red or purple colours).

Bowel prep solution (evening before and morning of): Drink a prescribed bowel prep solution in two doses (split prep). Stay near a toilet.

Fasting (morning of): Stop all fluids at the time specified by your specialist, usually 2 to 4 hours before.

Tell your GP and specialist about all medications you take. Blood thinners, diabetes medications, and iron supplements may need to be paused or adjusted.

What Happens During the Procedure

Arrival and check-in: Admitted, changed into a gown, IV cannula inserted.

Sedation: You will receive sedation administered by an anaesthetist. Most patients have little or no memory of the procedure.

The procedure: The colonoscope is advanced through the entire large bowel. Takes approximately 20 to 45 minutes.

Polyp removal: If polyps are found, they are usually removed during the same procedure.

Recovery: Rest in recovery for 30 to 60 minutes. You need someone to drive you home; you cannot drive for 24 hours after sedation.

Getting a Referral From Your Nuvo Health GP

A colonoscopy requires a GP referral. Nuvo Health has a gastroenterologist, Dr Suhirdan Vivekanandarajah, and colorectal surgeon, Dr Penelope De Lacavalerie, both available at Sydney Specialist Suites in Rozelle. Your GP can also refer you to a public hospital or another private specialist. Book at any of our 22 medical centres across Sydney.

Medicare and Cost

Public hospital (public patient): Generally no out-of-pocket cost, but wait times can be several months

Private hospital with insurance: Gap fee typically $100 to $500

Private hospital without insurance: Total $1,500 to $3,500 including hospital, specialist, and anaesthetist fees

Frequently Asked Questions

How long does a colonoscopy take?

The procedure takes 20 to 45 minutes. Including arrival, prep, sedation, and recovery, plan for approximately 3 to 4 hours at the facility.

Will I be awake during a colonoscopy?

You receive sedation; most patients have no memory of the procedure. General anaesthesia is not usually required.

How often do I need a colonoscopy?

If normal and average risk, your specialist may recommend repeating in 5 to 10 years. If polyps are found, surveillance may be every 1 to 3 years.

Is a colonoscopy painful?

Most patients tolerate colonoscopy very well with sedation and remember little or none of the procedure. Some bloating or mild cramping afterwards is common but usually settles quickly.

Is the bowel prep the worst part?

Many patients find the prep more unpleasant than the procedure itself. Thorough prep is essential; an inadequate prep may mean repeating the procedure.

Can I choose between a public or private colonoscopy?

Yes. Public is free but wait times can be 3 to 12 months. Private can be booked within 2 to 4 weeks but involves out-of-pocket costs.

What should I eat after a colonoscopy?

Start with light foods such as toast, soup, crackers, and rice. Resume normal diet within 24 hours. Avoid alcohol for 24 hours.

Do I need a colonoscopy if my FIT test was negative?

Continue completing the free FIT tests every two years. If you develop symptoms or have strong family history, your GP may still recommend a colonoscopy.

At what age should I start bowel screening?

Free FIT tests from age 45. If a first-degree relative was diagnosed before 55, screening may begin at 40 or 10 years before the youngest family diagnosis.

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