Surviving Your Colonoscopy Prep
Ask anyone who’s done it: The colonoscopy is not the hard part. It’s the getting ready that’s so tough to stomach—literally. A colonoscopy requires what’s basically the cleanse of your life beforehand: no solid food for days, the gallon of polyethylene glycol you have to drink—and, of course, the drop-everything bathroom runs. But you can do it—just like the millions of people who’ve gone before you—and we’re here to help with insider ways to make the process easier to endure.
Prep Starts Earlier Than You Might Think
One misconception is that colonoscopy prep starts the day before the procedure, but for things to go as smoothly as possible, you should start lowering your fiber intake about a week out, says John Kisiel, M.D., a gastroenterologist at Mayo Clinic in Rochester, MN. Pay special attention to foods with insoluble fiber, he says, “including things like dietary roughage found in fruits and vegetables, as well as grains.” Insoluble fiber takes longer to clear out of the colon, and the idea is to go into the procedure with a clean slate.
A Liquid Diet Doesn’t Mean a Starvation Diet
It’s true, you can’t eat solid foods, but you aren’t stuck with just water. Lots of things count as clear liquids and are more filling. You can drink coffee or tea (without creamer or dairy), pulp-free fruit juices, sports drinks, broth, gelatin, ginger ale, and cola, and even suck on juice-based popsicles, Dr. Kisiel says. “As long as you can hold it up to a light and see through it, you're probably good to go.” Just avoid anything colored (red, blue, purple, etc.), which can stain the colon and confuse the exam.
Doctor Your Prep Solution
The worst part of prepping may be the foul-tasting formula you’re required to chug to things get moving. Luckily, no rule says you have to drink it as it. Mixing it with Crystal Light powder, lemon juice, or clear Gatorade can make it much more palatable, Dr. Kisiel says. Colonoscopy veterans also say it’s easier to drink the solution chilled and through a straw placed near the back of your mouth (that gets it past your taste buds, which are more concentrated on the front of your tongue). Honestly, whatever works.
Split It Up
Instead of having to guzzle a gallon of liquid in a single sitting, split it into two doses. “Take half of the prep the night before the procedure and finish the second half about two hours before the colonoscopy,” Dr. Kisiel says. Not only does this cut the volume of liquid you have to take at once but that same-day prep helps get rid of any bile, which can interfere with visualization during the procedure, Dr. Kisiel says. And there’s another reason: One study published in the American Journal of Gastroenterology found that a split dose resulted in less intense bowel movements with a shorter duration. You can thank us later.
Opt for an OTC Solution
If you’ve struggled to take a bowel prep before, or find brand name products prohibitively expensive, ask your gastroenterologist about preparation cocktails that can be crafted from OTC ingredients you might already have at home, Dr. Kisiel says. For example, some people report success taking a powder bowel prep solution and mixing it with a clear sports drink like Gatorade. But, before you become a master mixologist, make sure you talk to your doctor first.
If drinking the prep solution still seems daunting, there may be a pill form of prep on the horizon. The FDA recently approved a new tablet called SUTAB, which will be available by prescription to patients in the U.S. beginning January 1, 2021. However, in order to effectively cleanse your system, you have to take 24 tablets: 12 tablets the night before the colonoscopy and the additional 12 the morning of. So, it’s really a matter of picking your
poison prep style.
Baby Your Booty
Let’s face it, cleaning out your colon means going to the bathroom—on repeat. To lessen irritation, Dr. Kisiel recommends applying a barrier cream (a diaper cream would work), trying medicated wipes, avoiding vigorous wiping, and warm baths. Also, says Jeff D. Scott, M.D., a gastroenterologist with Digestive Disease Specialists, Inc. in Oklahoma City, “I don’t recommend using any lotions with scents or other additives—these typically contain alcohol, which can cause burning and is ultimately drying. Buy the softest toilet tissue you can find or use aloe wipes, which are the gentlest option.”
- Low-Residue Diets: Gastrointestinal Endoscopy (2020). “Low-residual diet versus clear-liquid diet for bowel preparation before colonoscopy: meta-analysis and trial sequential analysis or randomized controlled trials.” giejournal.org/article/S0016-5107(20)34269-3/fulltext
- Benefits of Split Dose Colonoscopy Preps: American Journal of Gastroenterology. (2016). “Impact of Single- vs. Split-Dose Low-Volume Bowel Preparations on Bowel Movement Kinetics, Patient Inconvenience, and Polyp Detection: A Prospective Trial.” pubmed.ncbi.nlm.nih.gov/27377521/
- Effectiveness of Bowel Prep Tablets: American Journal of Gastroenterology. (2020). “A Safety and Efficacy Comparison of a New Sulfate-Based Tablet Bowel Preparation Versus a PEG and Ascorbate Comparator in Adult Subjects Undergoing Colonoscopy.” journals.lww.com/ajg/Abstract/9000/A_Safety_and_Efficacy_Comparison_of_a_New.99021.aspx