Lower GI endoscopy is also called a colonoscopy. Colonoscopy is a visual examination of the lining of the large intestine. It uses a tool called a fiber optic endoscope. An endoscope is long, thin and flexible. It can pass through the entire length of the large intestine. The fibers transmit light and a video image. The examiner can also pass surgical tools through the endoscope.

Colonoscopy is used to evaluate the following conditions:
* inflammation or ulcerative disease,
* unexplained rectal bleeding or blood in the stool,
* intestinal narrowing or blockage, and
* to screen for polyps and cancer.

The large intestine must be thoroughly clean to be clearly visible. The person goes on a liquid diet for 48 hours before the test. He or she uses a laxative the night before. On the morning of the test he or she takes an enema. The test can be done as an outpatient procedure. It usually lasts 30 to 60 minutes. The examiner often gives the person a mild sedative to help relax them.

At the start of the test the person lies on his side. The endoscope is well lubricated for easy insertion through the rectum. The person may feel the urge to defecate, but it is rarely painful. The examiner often pumps air into the intestine to get a better view. It is normal for this air to escape as flatulence during the test and for a while after the test. The examiner may ask the person to change positions. This helps the endoscope go around corners. The examiner can view the entire lining on a TV monitor. He or she can photograph or record the test for comparison with future tests.

The examiner can take biopsies or remove polyps. Polyps are small outgrowths from the lining of the intestine. They are fairly common as we age. Although they are not cancer, they have the potential to become cancer. If the examiner removes any polyps, the person may briefly have blood in the stool. A repeat colonoscopy is recommended in 3 years to look for missed or new polyps. If none are found in follow up, repeat tests are recommended every 5 years. The American Cancer Society recommends a limited colonoscopy every 3 to 5 years for all persons after age 50.

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