You may have heard stories from friends, family or co-workers that have left you petrified and dreading the colonoscopy preparation process, but it will probably not be as bad as you have heard (…or it just might). You are just simply cleaning out your colon of fecal matter. To do this you drink a lot of colon cleansing liquid, wait a little bit, then sit on the toilet and let everything you just drank make its exit. It is not pleasant and it is not glamorous, but it is a necessity for a successful colonoscopy.
We will try and walk you through what you can expect plus provide some useful tips that will make the process go a little smoother. These are just general guides, you should always follow the directions given to you by your physician as closely as possible. Every doctor, clinic, hospital may have their own ways in which they prefer their patients to prep for colonoscopy exams. This can include differences in the types of liquid used (laxatives or prep solutions), and the timeline laid out for completing everything. Always follow your doctor’s instructions.
Why is Colonoscopy Prep So Important?
In order for the physician to get a clear view of the interior lining of the colon it must be free of waste material. This is crucial for the colonoscope (flexible tube with the camera attached) to spot any lesions, colon polyps or other areas of concern. If anything is found during the exam, a sample can be taken with the scope for further examination. The presence of fecal matter could interfere and cause the doctor to miss something important.
Why Is It Dreaded?
There are two main reasons most patients dislike having to go through colonoscopy preparation. First is the bowel clearing mixtures, both the amount needed to be consumed and the taste (for those taking prep mixtures) are a lot to handle. Second, what goes in must come out. Flushing out the colon and all that liquid requires frequent trips and a lot of time spent on the toilet.
Also, not being able to eat solid foods for at least a day, an empty gurgling stomach, and feeling a little weak all add to the unpleasantness of the entire process. Some patients have higher tolerance levels than others and have no problems with everything involved, but no one truly enjoys prepping for their colonoscopy.
What Can I Expect?
Usually it will be recommended to stop solid food intake the day before you are prep mixtures are to be taken. Clear liquids are preferred and anything with any type of dark red or blue dyes should be avoided. Even though you will eventually get rather hungry, this is probably the easiest step in the process. This is done in preparation for ingesting the mixtures below.
Total Bowel Clearing Mixtures
There are a few main ways that patients are prescribed to flush out their colon. Some are easier to put up with and swallow than others. They all share one thing in common however, a large amount of liquid is required for them to work effectively and safely.
Some patients are given a Miralax regimen. This is a strong laxative powder that is tasteless and mixes well into liquid. This is often used in conjunction with laxative tablets such as Dulcolax to get things moving. Patients on this program are spared the foul taste often associated with the other prep mixtures as they can mix the Miralax with ready made drinks such as Gatorade, ginger ale, apple juice or other clear liquids. They are not spared in the amount they have to drink though. Patients usually have the easiest time with this method.
Some physicians and clinics may prefer to prescribe their patients dedicated colonoscopy prep mixtures. Also known as Polyethylene Glycol (PEG) mixtures, some of the more popular brands include Golytely, SuPrep and MoviPrep. These are a little thicker than they look inside the bottle and often are not exactly the best tasting. Doses are usually split up with anywhere from ½ gallon up to 2 gallons being consumed in total depending on the mixture.
Oral Sodium Phosphate solutions may also be used to clean the bowels. Brand names include EZ-Prep, Accu-Prep and Phospho-soda. These are usually diluted in liquid. Special care must be taken to stay hydrated.
Oral Sodium Phosphate tablets are another option. Brand names include OsmoPrep and Visicol. This lets the patient take pills with a clear liquid of their choosing. Adequate fluid consumption is very important with these not only to avoid dehydration, but to avoid kidney damage. Drinking plenty of liquid is a must.
Patients may also be prescribed a combination of the above methods. As always, following your doctors instructions as closely as possible is always advised.
The Final Step
After your the mixtures start working it will be time for them to make their exit. Frequent trips, or less trips if you camp out in there, may be needed to make sure everything gets expelled. You just have to wait it out until it is over. At least you get to sit down for this part.
Colonoscopy Prep Tips
While you might not be able to avoid all of the discomforts associated with this process, there are a few tips and tricks that others have found useful to lessen some of the more unpleasant aspects of preparation.
Mentally prepare yourself: Know ahead of time what to expect so that there will be fewer surprises. Stay positive and try not to psyche yourself out. Remember why you are putting yourself through this and the positive outcome that it can have for your health.
Adjust your diet earlier than recommended: Solid food intake is usually advised to be stopped one day before taking the mixtures, however starting earlier, if possible, may be more helpful. The less material that is inside your colon, the less that needs to come out at the time of your prep. Eating lighter meals containing less meat 2 to 4 days before you start can prove beneficial when the prep mixtures start to kick in. Eating more soup or peanut butter and jelly sandwiches can lessen the load in your colon. This of course, comes with the drawback of feeling weak or slow so this might not be ideal for everyone.
Chill the prep mixtures: Those who are prescribed the standard mixtures might find the taste easier to handle by drinking them cold. Put them in the fridge when you bring them home or chill them in the freezer for an hour.
Drink your mixtures through a straw: This may aid in getting the liquid passed most of the taste buds of the tongue and straight to the back of your throat. Holding your nose while doing this may also help. Although it may take longer to finish drinking, it may be a solution for those that are having problems with the taste of their mixtures.
Use hard candy or gummy bears to get the taste out of your mouth: Again, the awful taste of the mixtures is something quite commonly experienced, so after drinking your dose it will help to suck on some hard candy or chew on some gummy bears. Lighter colored flavors like lemon or pineapple are preferable.
Add Crystal Lite to the mixture: It would be a good idea to try the prep mixture first without adding any flavoring. Some people find it is not all that bad and adding a flavor pack to it might not be necessary. If the taste of your solution doesn’t agree with your palette you can try adding a pack of Crystal Lite.
Stock the bathroom with distractions: You might be in there awhile, so having a magazine, book, ipad, or some music can help take your mind off some of the discomfort you may experience. Something to pass the time and distract you from what you may be experiencing can make everything go a little smoother (no pun intended).
Use scented candles: Some people seem to find the use of these to be relaxing and soothing. Even if you don’t buy into this, they will definitely make the the bathroom smell a lot nicer while you are in there.
Stay near the bathroom: This one seems kind of obvious, but you never know when the “magic” will kick in. Being near the toilet will help cut down on any unwanted accidents.
Use soft toilet paper, baby wipes, soothing ointments: Skin irritation and soreness is likely to occur depending how much and how often you have to go to the bathroom. Your back end will thank you.
Stay hydrated: This tip may seem like torture at first glance but you should drink even more. The huge amount of the prep mixtures that you are ingesting are designed to flush out your colon and be expelled soon afterwards. This can rob your body of vital fluids and lead to dehydration. Sipping on ginger ale, Gatorade or water in between doses can help avoid this.
Below is an informative video further outlining some of the aspects of preparing for your colonoscopy.