Colonoscopy with polyp removal.

A colonoscopy shows the entire large bowel from the inside. It is used for screening from the age of 50 and to investigate symptoms. Polyps, which can develop into bowel cancer over the years, can usually be removed during the same examination.

  • Screening from 50
  • Polyps usually removed straight away
  • Two clinics in Wertheim

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  • From 50screening entitlement for women and men
  • 10years between colonoscopies after a normal result
  • 15–45minutes, depending on the bowel and the number of polyps
  • Eveningbefore and the morning of: bowel-cleansing solution

Screening according to the rules of the Federal Joint Committee (G-BA); all other figures are approximate. Details are clarified in the consent discussion.

The colonoscopy

The entire large bowel in view.

During a colonoscopy, a flexible endoscope is inserted through the anus and advanced to the junction with the small intestine. As it is slowly withdrawn, the bowel wall is examined section by section. To smooth out the folds, the instrument introduces air or carbon dioxide.

Bowel cancer usually develops over many years from initially benign growths in the bowel lining, known as polyps. Such precursors rarely cause symptoms. A colonoscopy can detect them, and they can usually be removed during the examination itself. This is why colonoscopy can not only detect bowel cancer early but also help prevent it from developing.

Since 1 April 2025, the same rules have applied to women and men in the German statutory early detection programme: from the age of 50, there is an entitlement to two screening colonoscopies at least ten years apart. Those who decide against it can take a test for invisible blood in the stool every two years; if it is abnormal, a colonoscopy follows to investigate. The statutory health insurers send written invitations at the ages of 50, 55, 60 and 65.

Colonoscopy also has its place regardless of age: when blood is noticed in or on the stool, bowel habits change for no apparent reason, abdominal pain or diarrhoea persists or anaemia remains unexplained. In chronic inflammatory bowel disease, it is also used for regular monitoring.

The examination

Find, remove, classify.

Find

Polyps, inflammation, diverticula – small pouches in the bowel wall – or the source of bleeding become directly visible, including flat changes that cause no symptoms.

Remove

Very small polyps can be removed with forceps, larger ones with a fine wire snare. Large, flat lesions sometimes need a special technique and a second appointment.

Classify

All removed tissue goes to the laboratory. The report shows whether it was a harmless growth or a precancerous lesion and whether it has been removed completely.

The procedure

Well prepared for your colonoscopy.

Cleansing the bowel is the most demanding part of the examination – and crucial to ensuring that even small findings are not missed.

  1. Informed consent

    The discussion beforehand covers the procedure, sedation and possible complications. If you take blood-thinning medication, you will be told whether and for how long to pause it – it is only stopped after consulting a doctor.

  2. Light diet

    In the days before, easily digestible food is on the menu. Grains and seeds, wholemeal bread, muesli, raw vegetables and salad are left out.

  3. Bowel preparation

    On the day before, only clear drinks are allowed from a set time. A drinking solution, usually split between the evening before and the morning, flushes out the bowel until only clear, yellowish fluid comes out.

  4. Colonoscopy

    While you lie on your side, with sedation if you wish, the colonoscope is advanced to the caecum, the beginning of the large bowel. Abnormal areas are photographed and documented.

  5. Recovery

    You are monitored until the sedation has worn off. Eating is usually possible again straight away; any feeling of bloating disappears once the air escapes.

  6. Results

    You receive the first results straight afterwards. The laboratory report on the polyps follows a few days later and determines the interval until the next colonoscopy.

Statutory and private insurance

Screening and investigation on statutory insurance.

Statutory health insurance

Early detection from 50, investigation of symptoms.

German statutory health insurance covers screening colonoscopy from the age of 50 according to the rules of the Federal Joint Committee (G-BA). For symptoms, after an abnormal stool test or as a check-up after polyps have been removed, colonoscopy is also covered by statutory insurance, including removal and laboratory examination of the polyps.

In Wertheim, patients with statutory insurance come to the Bürgerspital – of the two clinics, the one with a public healthcare mandate.

Private insurance or self-pay

Reimbursement according to your policy.

Private health insurers cover screening and diagnostic colonoscopies according to the terms of their policies.

In Wertheim, privately insured and self-pay patients can choose between the Bürgerspital and the Main-Tauber-Klinik, a private clinic at the same site.

Specialists

Your doctors at a glance.

In Wertheim, colonoscopies and polyp removal are the responsibility of gastroenterology; bowel cancer screening is a focus of the Department of Internal Medicine.

  • Mamoon Al HamedSpecialist in Internal Medicine & GastroenterologyWertheim
  • Mohammad Al RashdanSpecialist in Internal Medicine & GastroenterologyWertheim
  • Dr. med. Barbara John, FEBGHSpecialist in Internal Medicine & GastroenterologyWertheim

Locations

Where treatment takes place.

Each clinic shows on its own website how the treatment works there.

Frequently asked questions

Good to know.

Colonoscopy or stool test – which is better?

Both are part of statutory early detection from the age of 50. The stool test is simple, looks for hidden blood and is repeated every two years. Only a colonoscopy can remove precancerous lesions straight away; however, it requires bowel preparation and carries slightly higher risks. Which method suits you is a personal decision.

What applies if bowel cancer runs in the family?

Anyone with a parent, sibling or child with bowel cancer has an increased risk themselves. The guideline then recommends the first colonoscopy ten years before the age at which the relative developed the disease, at the latest at 40. The right time is clarified in a consultation with your doctor.

Why is bowel preparation so important?

Only in a clean bowel can small and flat polyps be seen; if residue remains, the examination may need to be repeated. Many people find the solution easier to drink when it is well chilled. On the preparation day, it makes sense to stay at home and near a toilet.

Will I feel anything during the examination?

With sedation – an injection that sends you to sleep – most people sleep and notice little. Without it, advancing the instrument and inflating the bowel with air can cause pressure and cramps. Sedation can also make the examination more thorough, because the relaxed bowel can be assessed more completely.

What complications are possible with a colonoscopy?

The most common is bleeding after a polyp has been removed; it is usually stopped during the colonoscopy itself and only rarely occurs days later. A perforation of the bowel wall is rare but may require surgery. There are also possible side effects of the sedative on breathing and circulation, which the team watches for during monitoring. Severe abdominal pain, fever or blood in the stool after the examination require immediate medical attention.

When is the next colonoscopy due?

After a normal result, in ten years. If polyps were removed, the interval depends on their number, size and the laboratory report – according to the current guideline usually three to ten years, earlier with many or large polyps.

May I drive myself home after the colonoscopy?

Not after sedation. Depending on the medication used, you should not drive, operate machinery or make important decisions for 12 to 24 hours; someone should collect you.

Further reading

More on the topic.

In-depth articles from the group's clinics.

Consultation

Personal consultation.

Describe your request – the right clinic will get back to you.

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