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Got a positive bowel screening result? What happens next
Getting a letter that says your bowel screening test was positive can be unsettling, whether the result is yours or belongs to someone you're looking after. This page walks through what usually happens next, one step at a time: what the result means, who to see first, how a colonoscopy referral works, and where the prep instructions and the food come in. It can't tell you what your result means for you. Your GP and the clinic doing your procedure can.
What a positive result means
A positive result means traces of blood were found in your sample. It is not a cancer diagnosis. There are lots of reasons you could have blood in your poo, and most of these are not related to cancer. See your GP to find out what is causing it.
Source: Australian Government Department of Health — Understanding your bowel screening test results
About the free screening program
The National Bowel Cancer Screening Program offers eligible Australians aged 45 to 74 a free test to do at home every 2 years. If you are 50 to 74, the kit is mailed to you. If you are 45 to 49, you can request your first free kit, and anyone aged 45 to 74 can ask their doctor about getting a kit.
Source: Department of Health — How bowel screening with the program works
Your next step: see your GP
If you get a positive result, see your GP as soon as possible to find out what is causing the bleeding. Your GP will usually refer you to a specialist for a colonoscopy or other tests. Follow the instructions from your GP and the clinic doing your procedure.
It helps to take your result letter with you to the appointment.
Source: Department of Health — Understanding your bowel screening test results
Direct-access colonoscopy
Many endoscopists in Australia offer direct-access colonoscopy for people with a positive screening result. This means your GP can refer you straight to the endoscopist for the procedure, often without a separate specialist appointment first. Your GP and the endoscopy service decide whether direct access suits you.
Further information: Cancer Council Australia: clinical practice guidelines for colorectal cancer
Your clinic's prep sheet comes next
Once your colonoscopy is booked, the clinic doing it will give you written preparation instructions. That's the sheet to follow, because it's written for you and your procedure. If anything's unclear, like your medicines, the bowel prep product, timing or what you can eat and drink, or the sheet doesn't cover it, call the clinic and ask.
Stick it on the fridge or keep a photo of it on your phone, so everyone cooking that week is working from the same list.
Where the prep diet fits in
Your prep sheet will tell you which food phases apply to you and when each one starts. These pages cover each phase:
The low-fibre days
In the low-fibre days before a colonoscopy, avoid foods with seeds, nuts, grains and peels and skins of fruit and vegetables. These can block the suction channel of the colonoscope.
The 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline recommends a low-fibre diet on the day before colonoscopy (strong recommendation, moderate quality evidence). Your treating clinic’s specific written instructions still come first for your own preparation timing and food lists.
Source: ESGE 2019 bowel preparation guideline
For meal ideas, see what to eat before a colonoscopy and low-residue snacks, then check each one against your own sheet.
The clear-fluid phase
During the clear-fluid phase, a clear fluid is a translucent liquid with no solid bits (pulp-free). A practical check used in BowlPrep education is: could you, or your colonoscopist, see through it well enough to spot a tiny lesion on the bowel wall? If not, it is not clear enough for that phase. This is generic education — follow your clinic’s written list and hours. BowlPrep does not publish a national colour or cola chart.
For recipes that fit your clinic's list, see clear-fluid recipes.
Help with food during prep week
If you'd like proper meals for the low-fibre days, Sophie Hansen's 20-recipe BowlPrep cookbook was written for exactly that week. Read what it is and isn't.
Questions people ask
What does a positive bowel screening result mean?
A positive result means traces of blood were found in your sample. It is not a cancer diagnosis. There are lots of reasons you could have blood in your poo, and most of these are not related to cancer. See your GP to find out what is causing it.
Who gets a free bowel screening kit in Australia?
The National Bowel Cancer Screening Program offers eligible Australians aged 45 to 74 a free test to do at home every 2 years. If you are 50 to 74, the kit is mailed to you. If you are 45 to 49, you can request your first free kit, and anyone aged 45 to 74 can ask their doctor about getting a kit.
What should I do after a positive bowel screening test?
If you get a positive result, see your GP as soon as possible to find out what is causing the bleeding. Your GP will usually refer you to a specialist for a colonoscopy or other tests. Follow the instructions from your GP and the clinic doing your procedure.
What is direct-access colonoscopy?
Many endoscopists in Australia offer direct-access colonoscopy for people with a positive screening result. This means your GP can refer you straight to the endoscopist for the procedure, often without a separate specialist appointment first. Your GP and the endoscopy service decide whether direct access suits you.
What should I avoid eating in the low-fibre days before a colonoscopy?
In the low-fibre days before a colonoscopy, avoid foods with seeds, nuts, grains and peels and skins of fruit and vegetables. These can block the suction channel of the colonoscope. The 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline recommends a low-fibre diet on the day before colonoscopy (strong recommendation, moderate quality evidence). Your treating clinic’s specific written instructions still come first for your own preparation timing and food lists. This is generic advice and does not override any specific instructions from your doctor or clinic.
What counts as a clear fluid before a colonoscopy?
During the clear-fluid phase, a clear fluid is a translucent liquid with no solid bits (pulp-free). A practical check used in BowlPrep education is: could you, or your colonoscopist, see through it well enough to spot a tiny lesion on the bowel wall? If not, it is not clear enough for that phase. This is generic education — follow your clinic’s written list and hours. BowlPrep does not publish a national colour or cola chart. This is generic advice and does not override any specific instructions from your doctor or clinic.
Further reading: Bowel Cancer Australia