How to make your colonoscopy prep a little easier

Whether you’re 45 and going for your first screening colonoscopy or having symptoms you’d like to get checked out, you might have questions about what happens during the procedure and how you can prepare. 

A colonoscopy is a procedure during which a gastroenterologist, or GI doctor, uses a flexible tube affixed with a camera called a colonoscope to examine your rectum and colon, or large intestine. If the doctor finds a polyp or other growth, they can remove it and check it for cancer. Because approximately 5-10% of polyps become cancerous, colonoscopies actually prevent cancer by removing premalignant polyps. If the doctor doesn’t find anything, you don’t have to schedule another colonoscopy for 10 years as long as you don’t develop any worrying symptoms. 

C. Mobin Khan, MD, a BJC Medical Group gastroenterologist at Progress West Hospital, says that the biggest concerns about colonoscopies he hears from patients before the procedure are about the prep — changes you’ll have to make to your diet and a laxative you’ll need to take to clear your bowels before the colonoscopy so your GI doctor can get a clear picture. Patients are also concerned with whether they'll feel pain during or after the colonoscopy. 

The answer to the latter is simple: You won’t feel anything during or after the procedure because you’ll be sedated. The procedure takes about 30 to 60 minutes. Because you’re sedated, you’ll need a family member or friend to drive you home. 

Colonoscopy prep is a little more involved and typically conjures images of having to guzzle a gallon of liquid laxative the night before your procedure. However, there are several different types of preps now, including smaller liquid laxatives, pills and tablets. The gold standard is called split prep, in which you’ll take half of the prep the night before your colonoscopy and the other half the morning of your procedure. When scheduling a colonoscopy, remember that you’ll have to take the second part of the prep at least three hours before the colonoscopy in order to give your stomach enough time to empty for sedation. 

The most important thing you can do to prepare for your colonoscopy, Dr. Khan says, is to read the instructions a week before your procedure. A good tip is to set a calendar notification to remind you. “The most common thing we see is that people open the instructions the day before the colonoscopy. That’s too late because you have to alter your diet and eat low-fiber foods,” Dr. Khan says. If you don’t clear your colon well enough, the doctor won’t be able to get a good view — and you’ll have to repeat the prep and procedure.

To make your prep a little easier, try these tips: 

• If you’re taking a liquid prep, refrigerating it might make it a little more palatable. Drinking it with a straw also helps.

• Nausea is a common symptom of colonoscopy prep, but you can ask your doctor for anti-nausea medication to mitigate that side effect.

• Stay hydrated. In the past, you were advised not to eat or drink after midnight before your colonoscopy. Now, you can drink the evening before and have clear liquids up to three hours before your test.

• Clear your schedule. Your only plans while you prep should be to stay close to home.

• Pat, don’t wipe, to avoid irritation.

You might be wondering when your bowels will return to normal after taking the prep. Every person is different, but Dr. Khan advises his patients to avoid returning to work the same day they have a colonoscopy. You also shouldn’t drive because the sedation can impair your decision-making ability. 

Although colonoscopy prep is a little involved, it is easier than in the past. If you’re still nervous, Dr. Khan says, “one of the most common comments we receive after someone has their colonoscopy is ‘I should have done it sooner’ because it’s so relaxing. Patients wake up more refreshed after the colonoscopy because of the sedation and the hydration they get during the procedure.”

Talk to your doctor to see if scheduling a colonoscopy is right for you.

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