Overview of preparation for gastrointestinal procedures in adults

This topic addresses preparation requirements for upper gastrointestinal endoscopy and colonoscopy, which are common gastrointestinal procedures.

Before referring a patient for a gastrointestinal procedure, consider:

• the indication for referral for colonoscopy or endoscopy (see Indications for upper gastrointestinal endoscopy in patients with symptoms suspected to be due to gastro-oesophageal reflux for indications for upper gastrointestinal endoscopy)
• the potential adverse effects associated with bowel preparation
• whether the result of the procedure will alter management (including whether surgical intervention is appropriate for the patient)
• the potential harms associated with the procedure (eg splenic rupture, perforation, post-polypectomy bleeding, complications of sedation)
• the effect of the procedure on the patient’s existing medical conditions (including interruption of regular medications).

Patients preparing for a diagnostic or therapeutic gastrointestinal procedure should be given written information and instructions, and a verbal explanation of the procedure (including the indication and potential harms and benefits). This enables them to give informed consent, which must be obtained before the patient takes the bowel preparation.

Consumer information about colonoscopy is available from the Gastroenterological Society of Australia website. The Australian Commission on Safety and Quality in Healthcare website also contains consumer information about colonoscopy, including a culturally appropriate resource for Aboriginal and Torres Strait Islander communities.