bowel screening test preparation

Overview

Bowel screening test preparation means getting ready for a test that checks for early signs of bowel cancer. The most common test is the faecal immunochemical test (FIT), which looks for hidden blood in a small stool sample. Preparation usually involves collecting a sample at home and following simple instructions to make sure the result is accurate.

Bowel screening is offered regularly in many countries, for example to people aged 60 to 74 in the UK. It is a common and simple way to check for bowel cancer in people who have no symptoms.

Bowel screening is for adults – usually people aged 50 and older. In some places, screening starts earlier if you have a strong family history of bowel cancer. It does not apply to children.

Symptoms

Common symptoms

• Most people who take part in bowel screening have no symptoms at all – the test is for early detection.
• Some people may have symptoms like a change in bowel habits, blood in stool, or tummy pain, which are reasons to talk to a doctor.

Symptoms in children

• Bowel screening is not for children. Children with bowel symptoms should be seen by a doctor.

Symptoms in older adults

• Older adults may need help following the instructions if they have vision or memory problems. A family member or carer can assist.

Causes

Main causes

• Preparation is needed to make sure the test result is accurate – for example, by collecting the sample correctly and not mixing it with toilet water.
• If you are having a colonoscopy (a tube camera test), preparation includes a special diet and laxatives to clear the bowel completely.

Risk factors

• Not following the preparation instructions can lead to a poor sample that cannot be tested, or an incomplete colonoscopy.
• Having certain medical conditions (like diabetes or kidney disease) may mean you need special advice before a colonoscopy preparation.

When to see a doctor

See a doctor urgently if:

• You have symptoms like those listed under 'emergency' – call your local emergency number.
• You cannot pass stool or have severe belly pain after starting a colonoscopy preparation.

Book a routine appointment if:

• You are unsure how to do the FIT test – ask your pharmacist or GP practice.
• You have a medical condition and are due for a colonoscopy – speak to your doctor about how to prepare safely.
• You have questions about whether to take your regular medicines before the test.

Diagnosis

Bowel screening is done using a simple home test (FIT) that checks for hidden blood in your stool. If the result is abnormal, your doctor will arrange a follow-up test, usually a colonoscopy, to look inside your bowel more closely.

Tests that may be done

• Faecal immunochemical test (FIT) – collect a small sample of stool at home and send it to a lab.
• Colonoscopy – a thin, flexible tube with a camera is passed through the back passage to examine the whole bowel.
• Flexible sigmoidoscopy – a shorter tube checks only the lower part of the bowel.

What to expect at your appointment

For the FIT test: you will receive a kit in the post with clear instructions. You use a small stick to take a tiny bit of stool from the toilet paper or a collection sheet, put it in the tube, and post it back. It takes a few minutes. For a colonoscopy: you will need to follow a special diet for a day or two and take laxatives to empty your bowel. The procedure itself is usually done with sedation (medicine to help you relax) and takes about 30 minutes. You will be told what to do step by step.

Treatment

If a bowel screening test finds something abnormal, the next step is usually a colonoscopy to see what is going on. If polyps (small growths) are found, they can often be removed during the colonoscopy. If cancer is found, treatment depends on the stage and may include surgery, radiotherapy, chemotherapy, or other therapies. Your doctor will explain all the options.

Self-care at home

• Follow the preparation instructions carefully to avoid needing a repeat test.
• Drink plenty of water as advised, especially before a colonoscopy.
• Ask for help if you have trouble understanding the instructions.

Medical treatments

If a problem is found, your doctor will discuss the best approach for you. Treatment may involve removal of polyps during colonoscopy, surgery to remove part of the bowel, radiation therapy, or drug treatments (such as chemotherapy). The choice depends on the size, location, and stage of the problem. Always follow your doctor’s advice and ask questions if you are unsure.

When is surgery considered?

Surgery may be needed if a large polyp cannot be removed during colonoscopy, or if bowel cancer is found. The type of surgery depends on where the cancer is and how advanced it is. Your surgical team will explain what to expect.

Living with this condition

After a normal screening result, you can continue your usual routine. If you have had a colonoscopy and polyps were removed, you may need to repeat screening in a few years. If you are diagnosed with bowel cancer, your care team will support you through treatment and recovery. Most people return to their normal daily activities after treatment, though it may take time.

Lifestyle tips

• Eat a diet rich in fibre – whole grains, fruits, vegetables, and beans.
• Stay active – aim for at least 30 minutes of exercise most days.
• Limit red and processed meat, and avoid smoking and too much alcohol.

Diet and exercise

A healthy diet and regular exercise help keep your bowel healthy and may lower your risk of bowel cancer. After a screening that finds polyps, your doctor may recommend follow-up tests every few years. Staying active and eating well can also help you recover after treatment.

Mental health and emotional wellbeing

Waiting for screening results or dealing with a cancer diagnosis can be stressful. It is normal to feel anxious. Talk to your doctor or a counsellor if you need support. Many people find it helps to share their feelings with family or friends.

Prevention

Bowel screening itself does not prevent cancer, but it can find early changes (polyps) that can be removed before they become cancer. A healthy lifestyle – including a fibre-rich diet, regular exercise, and not smoking – may help reduce your risk of bowel cancer.

Screening programmes

Regular bowel screening is offered to people at average risk (often starting around age 50–60). If you have a family history of bowel cancer, you may be offered screening earlier or more often. Talk to your doctor about when to start and how often to be screened.

Complications

If left untreated

• If an abnormal screening result is ignored, a bowel problem that could have been treated early may get worse.
• Polyps that are not removed might develop into bowel cancer over time.
• If bowel cancer is left untreated, it can spread to other parts of the body and become harder to treat.

Long-term outlook

Most people who take part in bowel screening get a normal result and do not have bowel cancer. Even if something is found, early detection gives the best chance of successful treatment. Bowel cancer is treatable, especially when caught early. The outlook has improved greatly in recent years thanks to better screening and treatment.

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