“Ooh, I love the way this colonoscopy prep tastes. Bring it on!” said no one, ever.
Let me reassure you. It’s so common to dread it. In fact, it’s the procedure before the procedure that causes most people—myself included—the most angst. It’s hard to find an equivalent of unpleasantness. (All I can think of is going to the dentist times a zillion.)
But it’s a necessary evil. A squeaky-clean colon is the best way to detect colon polyps and colon cancer early, when it’s easiest to treat. Any debris or particle left behind could hide something serious lurking beneath the surface. Read 10 Things Every Woman Should Know About Colon Cancer.
Squeaky-clean is important, because if you don’t follow the instructions and clean out your colon as directed, the doctor can’t get a full view—and you may be sent home to repeat the prep. All over again (my worst nightmare).
If the prep your health care professional gives you is different from the one your friend got, it’s because there are many over-the-counter and prescription preps out there. Every health care professional has their favorite that they swear is easiest or best to use. Or they may choose a specific one for you if you have a special health consideration (like constipation or inflammatory bowel disease).
Among the available options: Miralax, GoLytely, MoviPrep, Prepopik, Suprep. Some require you to drink as much as a gallon, while others require just 10 ounces (for the lower-volume preps, you’ll need to make up the difference in the amount of additional water you drink to get it moving through your system).
For people who have difficulty drinking liquid solutions, some health care professionals prescribe oral sodium phosphate tablets (Visicol, OsmoPrep), which must be taken with clear fluid. They may be better tolerated but carry a warning from the U.S. Food and Drug Administration because they can cause dehydration, electrolyte imbalances and kidney damage in some people, as can oral phosphate sodium liquid solutions (Fleet Phospho-soda EZ-Prep, Fleet Accu-prep).
I’ve been having colonoscopies since I was 50 (although the updated guidelines say you should begin at 45) and have used more than one of these. It seems that each time I go, my doctor raves about a newer prep that her patients like and insist it is “so much easier to take.” Um, no. I’ve never met a bowel prep I could attach the word “like” or “easy” to.
And yet. There are ways to make the best of a bad situation.
To that end, I’ve scoured the Internet to find tips and tricks for making “the cleanout” a bit more tolerable. Some tips are from reputable organizations, like the Mayo and Cleveland Clinics, while others are from patients, including colon cancer survivors. (Always check with your health care professional before following any of this advice.)
A Few Days Before
- Don’t eat foods with small seeds (like cucumber, kiwi or bread with sesame seeds). These can get in the way of the cleansing process.
- If you’re constipated ahead of prep time, let your health care professional know. You may be instructed to drink a laxative like magnesium citrate so that you won’t be constipated on the day you start the cleansing process.
- Switch to a low-fiber diet a week before your exam, suggests the Colon Cancer Alliance.
- Start your soft diet a couple of days earlier than recommended.
- The day before the prep, you can only have clear liquids or foods like Popsicles, Jello, clear coffee or tea and chicken broth. One patient says she strains out the chicken and noodles from chicken noodle soup, which results in a better-tasting broth.
- Avoid any fluids containing red, blue or purple food coloring, which can mimic the color of blood in the colon.
Powering Through the Prep
- Start the prep a few hours earlier than recommended so your sleep is not disrupted.
- Chill the prep and drink it through a straw.
- Suck on a hard candy after drinking the solution.
- Drink plenty of clear liquids; staying well hydrated helps to flush the prep through your system.
- Drink Gatorade, Powerade or Pedialyte (for people with diabetes) in addition to water for hydration; avoid red, blue or purple drinks.
- Some doctors advise a split-dose prep, meaning you’ll take half the prep the evening before and the other half the morning of the procedure. A recent study found that this, as compared to the conventional method, resulted in less intense bowel movements with a shorter duration; improved bowel preparation; and was less inconvenient.
- If you use GoLytely, mix it with orange or lemon-flavored Crystal Light.
- Miralax mixed with Gatorade is easier to deal with, some people report. Chase it with cold water.
- One doctor tells her patients it’s OK to eat gummy bears (minus the red and purple ones) during the prep, since they dissolve to a clear liquid at body temperature.
During the Prep
- Stock up on baby wipes.
- Treat yourself to three-ply, extra-soft toilet paper (make sure it’s unscented to avoid irritation).
- Use Preparation H, petroleum jelly or diaper rash ointment to ease soreness.
- Make sure your phone is fully charged and you have a good book or two to read while on the toilet to help pass the time.
The Finish Line—You Did It!
- The end of the colonoscopy. Bliss. Like waking up from a great nap.
- You can eat or drink whatever you want, but ease back in slowly.
- That first sip or bite will be heavenly, no matter what the food.
- You have permission to expel gas as often and as loudly as you’d like.