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Tips for Making Your Colonoscopy Prep Smooth (and Bearable)

When it comes to preventing colon and rectal cancers, there is no question that a colonoscopy is the best screening for colorectal cancer.

However, many people agree, it can be quite intimidating. Reading this may even have you clenching up a little. But colonoscopies are not just important—they can save your life.

Why should I get a colonoscopy?

While colorectal cancer is more common in older adults, colorectal cancers are increasing in young adults as well. That’s why a colonoscopy to screen for colon cancer is strongly recommended for those age 45 and over.

“Colorectal cancer is one of the leading causes of cancer-related death in both men and women,” said Dr. William Cirocco, MD, a colorectal surgeon at Banner MD Anderson Cancer Center. “The good news is that with early detection through regular screenings, we can improve the chances of successful treatment and survival.”

In a colonoscopy, your health care provider uses a thin, flexible tube with a tiny light and camera to look for colon cancer and polyps, which grow in the lining of the colon and can turn into cancer. To have a successful colonoscopy, the colon (large instestine) needs to be flushed out so they can get a good look inside and remove any polyps before they turn into cancer.

“If bowel preparations are poor, the doctor won’t be able to adequately see the inside of your colon to complete the exam or the procedure will be canceled or rescheduled,” Dr. Cirocco said. “While bowel prep isn’t everyone’s favorite part, it’s a key part of your colonoscopy.”

If your health care provider has given you the thumbs up for your first colonoscopy or it’s time yet again for another, take heart. Times have changed (for the better!), and so has the most dreaded part—the prep.

Here are five tips to make your next colonoscopy smooth and bearable.

Cut back on fiber

Days before your colonoscopy, you’ll want to follow a low fiber diet—avoiding beans and nuts, foods with seeds (like kiwi and sesame seed bread), most vegetables and anything else that has a lot of fiber. This may be confusing, because fiber is great for your colon, but it can leave residue behind and disrupt the cleansing process.

Switch to clear liquids

The day before or 24 hours prior to your procedure, switch to a clear liquid diet. This means no food. Many people assume “clear liquid” literally means no color in it, but in this case, it means there’s no pulp or anything floating around in it. You’ll need to drink clear fluids to help you stay hydrated and flush the prep.

Here’s a list of what to stock up on beforehand:

  • Clear broth (herb-infused broth can help with savory cravings)
  • Coffee or tea (straight, no cream or sugar)
  • Sparkling or carbonated water
  • Sports drinks*
  • Frozen ices*
  • Gelatins*

*Avoid drinking anything red, blue or purple, such as colors found in products like Jell-O, Gatorade or Kool-Aid, which could imitate blood in the colon. If you love these products, aim for flavors like lemon, lime, orange or white grape.

Don’t fear the prep … you’ve got options!

In the past, you had to drink about a gallon of this terrible-tasting laxative fluid in one sitting. Thankfully, the lax situation (drinking the prep) has gotten much better in recent years—both in process and taste.

“There are multiple commercial versions of bowel preparation for a colonoscopy, depending on the preference of the gastroenterologist, from a single prep to a so-called ‘split prep’ depending on the timing of the colonoscopy,” Dr. Cirocco said.  “These prep solutions are usually consumed the day prior to procedure, or split dosing, where half of it is consumed the night before and the other half early in the morning of the procedure.”

To “spice” up the process, you can put the prep in the fridge and drink chilled, add some flavor like Crystal Light, drink it with a fancy straw and suck on some hard candy, such as peppermints, LIFE SAVERS or Jolly Rancher (no red, blue or purple) in between sips. And remember, slow and steady – no chugging.

Make yourself at home in the bathroom

You may be wondering, “Just how long am I going to be in the bathroom for?!”

“The prep process can take an hour or two to several hours, depending on your individual response,” Dr. Cirocco said.

This may sound ominous (queue the “Dun Dun Duuuuun” music), but it won’t be as scary as that horrific scene in the movie Dumb and Dumber. However, plan ahead that you may be in the bathroom a while, so you’ll want to make sure your porcelain throne is good to go for when you need to go.

Here are some additional tips that could be helpful:

  • Wear comfortable clothes—something you can get on and off quickly.
  • Stock up on soft toilet paper. And blot, rather than aggressively wipe, to reduce irritation.
  • Use skin-soothing products such as baby wipes or baby rash ointment because wiping can be irritating. Medicated pads and lidocaine cream can also help reduce anal discomfort.
  • Have entertainment on hand. You could be in the bathroom longer than you think. This is great time to binge a show, read a book or catch up on your favorite podcasts.

Talk to your doctor about your medications

You can take most prescription and non-prescription medications right up to the day of the colonoscopy, but some medications may need to be adjusted. If you take blood thinners, insulin or other prescription medications, consult your health care provider about how to proceed with these in preparation for your colonoscopy.

Now that the hard part is over with, what can you expect on that day? Here are a few things to know during and after your screening.

  • You’ll be given a short-acting anesthetic via IV, so you won’t feel any pain during the procedure and probably won’t remember much about the screening either. Colonoscopy procedures themselves are pretty quick, “usually 30 to 45 minutes depending on what’s found and the need for further procedures, such as a polypectomy, which is a simple surgical procedure where we remove any polyps.” Dr. Cirocco said.
  • After the colonoscopy, you’ll go to a recovery room as you come out of the anesthesia, usually 30 to 45 minutes. You will need to have a friend or loved one drive you home to rest and sleep off the side-effects of the sedation. You should be back to normal and back to work the next day.
  • Several days later, your health care provider will contact you with the results. If polyps were found, you may have to be re-checked more regularly on a schedule determined by your health care provider. If no problems are detected during the test (and you don’t have a family history of colon cancer), you may not require another colonoscopy for 10 years.

The bottom line about colonoscopy prep

Now that you know the ins-and-outs of prepping for your colonoscopy, it’s not totally unpleasant or unbearable. Besides, early detection for cancer can make a significant difference in recovery and potentially save your life.

To learn more about colorectal cancers and prevention, check out:

Cancer Colorectal Cancer Women's Health Men's Health