An upper endoscopy and a colonoscopy are common procedures often performed together to examine the entire gastrointestinal tract. An endoscopy views the esophagus, stomach, and upper small intestine via the mouth, while a colonoscopy examines the large intestine through the rectum. Both minimally invasive diagnostic tests require sedation, so recovery involves managing the temporary effects of medication and allowing the digestive system to rest. The recovery timeline is short, with most people returning to their routines within 24 hours.
Immediate Physical Sensations
The most noticeable initial effect is the grogginess and sleepiness resulting from the intravenous sedation. Even though you may feel awake shortly after the procedure, the medication, such as propofol, impairs judgment and reaction time for the rest of the day. This feeling of a “sleep hangover” means coordination will be compromised, and decision-making abilities will be temporarily dulled.
Following the upper endoscopy, you can expect a mild sore throat or a scratchy sensation in the back of your mouth. This irritation is caused by the passage of the endoscope tube and typically resolves within a few hours to a day. Cold liquids or soft foods can help soothe the discomfort during this time.
Abdominal bloating and cramping are common sensations after a colonoscopy. These feelings occur because air or carbon dioxide gas is gently pumped into the colon to expand the space, allowing the physician a clear view of the lining. Your body will naturally expel this excess gas through flatulence over the next few hours, and moving around gently can help accelerate this process.
Food and Drink Guidelines
Begin reintroducing food and drink slowly to avoid irritating the digestive tracts. Do not attempt to eat or drink anything until the numbness from the throat spray has fully worn off and you can swallow comfortably, which usually takes about one hour. Start by sipping water, clear broth, or electrolyte beverages to rehydrate the body after the bowel preparation and fasting.
Once liquids are tolerated, transition to soft, bland, and easily digestible foods for the remainder of the day. Good choices include applesauce, plain yogurt, scrambled eggs, white toast, and mashed potatoes, as these options are low in fiber and easy on the stomach. For the first 24 hours, avoid anything that could aggravate the gastrointestinal lining, such as spicy foods, high-fat or fried items, and tough meats. Alcohol must be strictly avoided for at least 24 hours because it intensifies the lingering effects of the sedation medication.
Returning to Normal Life
The most significant restriction is the strict 24-hour prohibition on activities requiring full mental alertness. This safety measure is due to the residual effects of the sedation, even if you feel completely normal. You must not drive, operate heavy machinery, or sign any legal documents until a full 24 hours have passed since the procedure.
Most people can return to work and resume their normal daily activities the day after the procedure. Light physical activity, such as walking, can help relieve any lingering gas or bloating. Strenuous exercise, heavy lifting, or intense workouts should be avoided for 24 to 48 hours, especially if polyps were removed.
Medication management, particularly for blood thinners, requires specific instructions from your physician. If you take an anticoagulant like warfarin, it is often restarted the evening of the procedure, provided no significant bleeding occurred. Direct oral anticoagulants (DOACs) are often resumed the day after the procedure, but timing depends on the procedure’s invasiveness and your personal risk profile. For diabetes management, your doctor will advise when to restart normal medication and insulin doses, accounting for the day of fasting and light eating.
Signs Requiring Medical Attention
While mild discomfort is expected, certain symptoms can indicate a complication and require immediate medical attention. Severe, persistent abdominal pain that does not improve with passing gas or pain medication is a sign to contact your doctor immediately. This pain may be accompanied by a hard or distended abdomen.
Any significant rectal bleeding that continues or increases after you return home should be reported promptly. A small amount of blood is common if a biopsy was taken or a polyp was removed, but passing more than a few tablespoons of bright red blood or developing black, tarry stools is abnormal.
Fever (over 100.4°F) or chills can be a sign of infection and should not be ignored. Other concerning symptoms include persistent vomiting, chest pain, or difficulty breathing. If any of these serious signs occur, contact your doctor or seek emergency medical care immediately.