Lower Endoscopy
During a lower endoscopy, a gastroenterologist uses a scope to view your rectum and part of your colon. This procedure can help diagnose lower digestive tract conditions, like inflammatory bowel disease, or locate the cause of bleeding from your rectum.
A lower endoscopy is a procedure to examine your lower gastrointestinal tract (GI tract). A gastroenterologist uses an endoscope (a thin tube with a camera at the end) to view the inside of your anus, rectum and colon.
Your provider may recommend one if you have symptoms like:
- Diarrhea or constipation
- Changes to your pooping habits
- Cramping or lower abdominal pain
- Bleeding from your rectum or blood in your poop
It can help diagnose conditions like:
- Colitis or proctitis
- Inflammatory bowel disease
- Diverticulitis
- Ulcers in your rectum
- Colorectal polyps
- Gastrointestinal bleeding
- Colorectal cancer
It also monitors conditions like ulcerative colitis to see if the disease is getting worse.
A lower endoscopy is the counterpart to an upper endoscopy, which looks at the area from your throat to the top of your small intestine.
You’ll need to have an empty colon. The bowel preparation differs, depending on what your provider is examining. You may need to prepare with:
- Food and drink: Prep could involve using laxatives or drinking a clear liquid diet. Your healthcare provider will give you the exact instructions.
- Medications: You may need to stop taking certain medications before the procedure. Be sure to let your provider know about all the medications you take.
Ask any questions you have about the prep work for the procedure.
What you can expect depends on what procedure you have. The general steps are:
- You lie on an exam table.
- You get medication to relax you or to put you to sleep.
- Your provider inserts an endoscope into your anus.
- The endoscope sends video images to a monitor. Your provider can see your GI tract and find potential problems. They can take pictures of things they see and save them to your medical record.
- They may pass small tools through the endoscope to remove polyps or take a biopsy.
- They pull the scope out once they finish the exam.
- If you had anesthesia or sedation, you’ll have time to rest and recover afterward.
It shouldn’t be painful. If you’re awake, you may feel pressure when your provider inserts the endoscope. If you’re asleep for the procedure, you won’t feel anything. You may feel discomfort after you wake up, but this will only last a few hours.
It depends on the reason for the procedure and how clean your bowels are. Exams that only look at your rectum take about 15 minutes. But procedures that look at your entire colon can take an hour.
The main benefits are that it can diagnose or treat a wide range of lower GI conditions.
Lower endoscopies are safe, but all procedures carry some risks. These include:
- Perforating (or tearing) your bowel.
- Bleeding.
- Infection.
- Complications from anesthesia.
For some lower endoscopies, you can go home right after the exam. If you were asleep for the procedure, you may need time to recover before someone drives you home.
You should be able to eat and return to your regular activities the same day. But you may have gas pains or cramping for a few hours. In some cases, your healthcare provider may recommend limiting physical activity or avoiding certain foods for the rest of the day.
Depending on the reason for the procedure, your provider may be able to give you information about what they saw right away. Other times, they send samples of tissue from your GI tract to a laboratory. These results take longer to get.
Call your healthcare provider if you have any of the following symptoms:
- Severe or worsening abdominal pain.
- Rectal bleeding (more than a tiny amount).
- A fever.
- Nausea or vomiting.
References
- National Institute of Diabetes and Digestive and Kidney Diseases (U.S.). About the Lower GI Tract (https://www.niddk.nih.gov/health-information/digestive-diseases/anatomic-problems-lower-gi-tract/about-lower-gi-tract). Last reviewed 8/2019. Accessed 1/26/2026.
- Sivananthan A, Glover B, Ayaru L, Patel K, Darzi A, Patel N. The evolution of lower gastrointestinal endoscopy: where are we now? (https://pmc.ncbi.nlm.nih.gov/articles/PMC7754801/) Ther Adv Gastrointest 2020 Dec 20;13:2631774520979591. Accessed 11/26/2026.
- Tumino E, Visaggi P, Bolognesi V, Ceccarelli L, Lambiase C, et al. Robotic Colonoscopy and Beyond: Insights into Modern Lower Gastrointestinal Endoscopy (https://pubmed.ncbi.nlm.nih.gov/37510196/). Diagnostics (Basel). 2023 Jul 23;13(14):2452. Accessed 1/26/2026.
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