A combined colonoscopy and endoscopy lets a doctor examine your upper and lower gastrointestinal tract, all in one procedure.

Doctors use a combined colonoscopy and endoscopy to help diagnose the cause of gastrointestinal symptoms that you might be experiencing, such as abdominal pain, persistent heartburn, or unusual bowel movements.

Colonoscopies and endoscopies are typically safe procedures with a very small risk of complications.

Keep reading to learn when a combined colonoscopy and endoscopy might be used, and what you can expect before, during, and after the procedure.

Doctors use a combined endoscopy and colonoscopy to examine the lining of your esophagus, stomach, upper small intestine, and large bowel. The procedure helps doctors investigate the cause of specific symptoms you may be experiencing.

For example, an endoscopy can help determine the cause of:

A colonoscopy can help your doctor determine the cause of:

During a combined colonoscopy and endoscopy, doctors can identify many underlying conditions, including:

Before the procedure

Your healthcare team will typically give you a printed handout with the steps you need to follow prior to your procedure. This may include information about stopping specific medications, such as proton pump inhibitors (PPIs) or constipating agents, about a week before the combined procedure.

The day before you undergo a combined endoscopy and colonoscopy, you may need to take an oral laxative (called a “bowel prep“) to clear your bowels. This makes it easier for the doctors to see the lining of your intestines.

In addition, you may not be allowed to eat or drink anything for 8 hours prior to the procedure.

Be sure to let your doctor know if you have a known allergy or reaction to anesthesia or sedatives.

During the procedure

After you arrive at the clinic or hospital, a member of the healthcare team will ask you to fill out an assessment form. Your doctor or a nurse will review your assessment form with you, and they may take your blood pressure and pulse. They may also ask you to change into a clinic-provided gown and shorts.

You’ll then meet the endoscopist before the procedure starts. You’ll have the opportunity to discuss what is going to happen during the colonoscopy and endoscopy. You can also ask them any questions you may have.

During the procedure, you’ll be given a light sedative through a needle in your arm so you won’t feel any discomfort. Your healthcare team will stay with you throughout the entire process. They will monitor your pulse, blood pressure, and oxygen levels to ensure your safety.

During the endoscopy

During the endoscopy, the doctor will pass an endoscope down your throat, through your esophagus, stomach, and duodenum. The endoscope has a tiny camera mounted on its structure that allows your doctor to view the inside of your gastrointestinal tract. The endoscope can also blow air into your GI tract, which makes the area easier to assess.

During the exam, your doctor may also collect a sample of tissue for testing (biopsy), stop any bleeding that they find, or complete other procedures, such as removing an obstruction.

During the colonoscopy

After completing the endoscopy, your doctor will insert a colonoscope through your anus and rectum to check your large intestine. The colonoscope will blow air into your intestine, making it easier to see.

Some types of colonoscopy use a stream of water instead of blowing air into the intestine, which may be a more comfortable option for a person undergoing the procedure.

Once the coloscope reaches the opening of your small intestine, the doctor will start examining the large intestine again while retracting the coloscope.

As with the endoscopy, your doctor has the option to remove polyps or other tissues that they may want to biopsy.

After the procedure

If you’re having your procedure done at an outpatient clinic, it may take a couple of hours after the procedure before you can go home. This time allows the anesthesia to wear off.

You may not be able to drive for 24 hours, so it’s a good idea to plan on having someone drive you to and from the clinic.

The entire procedure can last between 45 to 90 minutes. An endoscopy usually lasts about 15 to 30 minutes while a colonoscopy may last between 30 to 60 minutes.

After a combined colonoscopy and endoscopy you may experience symptoms including:

  • a light blood discharge from your rectum if the doctor removed polyps during the examination
  • abdominal pain caused by the air pumped in during the procedure
  • nausea for a couple of hours after the end of the exam
  • sore throat for a couple of days after the test

After the combined colonoscopy and endoscopy your doctor may give you the result of your test. However, it may take a few days to get the result of a biopsy.

The potential risks and side effects of a combined colonoscopy and endoscopy are rare but can include:

  • abdominal pain
  • bleeding
  • perforation
  • reaction to sedatives causing heart or breathing problems
  • death (this risk is rare)

You should seek medical care if you experience any of the following symptoms after you have attended a combined colonoscopy and endoscopy:

  • bloody vomit
  • throat pain or difficulty swallowing
  • bloody diarrhea or bowel movements
  • blood discharge from your rectum that does not get better
  • severe abdominal pain that gets worse
  • chest pain
  • dizziness or weakness

The average cost for a combined colonoscopy and endoscopy in the United States varies by state, city, and clinic. According to MDsave, costs range from $2,346 to $10,221 depending on where you have the procedure done.

Generally, it’s less expensive to undergo a combined colonoscopy and endoscopy on the same day during the same procedure, rather than booking two different sessions.

In most cases, a combined colonoscopy and endoscopy would be covered by medical insurance policies when recommended by a doctor. Contact your insurance company if you’re unsure.

A combined colonoscopy and endoscopy can help doctors diagnose the cause of symptoms you might be experiencing, such as abdominal pain, persistent heartburn, or atypical bowel movements. The procedure allows doctors to examine the interior of your gastrointestinal tract.

The risks of a combined colonoscopy are rare but can include perforation or internal bleeding. However, your healthcare team will constantly monitor you during the procedure to ensure your safety and to make you as comfortable as possible.