How to Prepare for a Colonoscopy Exam

Colorectal cancer otherwise known as colon cancer is a concern at any age but after age 50 it is even more important for appropriate screening. Because 93% of all colon cancers are found in adults over age 50, if you or loved one is in this age group then colon cancer screening should be done on a regular basis. As you age, your risk of developing colon cancer increases. Most of the time, a cancer of the colorectal area begins with a type of abnormal growth, called a polyp. A colonoscopy, or screening test, is done to see if your colon and rectal area has any polyps so that they could be removed before they have the chance to turn into cancer. So getting screened is not only important—it could be life saving!

Some patients report that the colonoscopy exam itself was “no problem”, yet say the hardest part of the colonosopy may be in getting ready or preparing for the test. One of the most challenging parts of a colonosopy preparation is the part where it is necessary to clean out the bowels. You see, in order for the physician to be able to detect any possible polyps, the field of view needs to be visible and free of any stool. So, patients must do what’s called a bowel “prep”.

There are several types of Bowel preparations for a colonoscopy exam. What you should know however, is that many patients who are experienced in having colonoscopies or other procedures that require a bowel prep have provided with some bowel preparation tips that can make the whole process for you much easier. Here are some hints on preparing for a colonosopy.

1. Ask your physician in advance what type of bowel preparation he/she uses. If it is GoLytely or another type of bowel prep, you may want to ask if you could do a Dulcolax/Miralax prep instead. The reason being is that so many patients have said that the GoLytely should be named “Go Violently” and it can cause nausea and vomiting in some people which can be very unpleasant if you’re having to spend time in the bathroom emptying your bowels and are having nausea and/or vomiting at the same time.

The Dulcolax/Miralax combination of preparing for a colonoscpy is the #1 choice of patients we interviewed for this article.

Two Days before your procedure if you are using the Miralax/Dulcolax prep for a bowel prep you will need to purchase the following items:

Purchase a 238g bottle of Miralax and 2 32 oz of clear Powerade. (Not red or green, so most will choice the yellow colored drink). You may also choose Gatorade, but some patients prefer the Powerade.

Purchase 4 Dulcolax tablets (5mg each) at this time as well

Optional purchases: you may want to purchase some preparation H or Vaseline, Desitin, or other ointment and apply this right before you begin drinking your bowel cleansing liquids or begin taking any laxatives. The key here is to “pre-treat the area” around your bottom so that it does not get red and irritated during the many bathroom trips you will be making

You may also want to stock up on the materials you will need for a clear liquid diet

Clear liquids include:

Fruit juices, (apple or white grape juice) (no fruit pieces, just clear liquid only)
Broth – Make sure it is clear broths. Some store bought broth is actually filled with vegetables that have been pureed, so make sure it is clear broth only
Coffee or tea (without milk or creamer)
Powerade, Gatorade or other sports drinks (No Reds or Greens)Carbonated beverages
Jello-not green or red
Popsickles – no green or red

If you can find flushable toddler wipes, it is a good idea to have these on hand. They are generally much easier on the bottom then regular toilet paper, and you can take a bag with you to the hospital or surgery center on the day of your exam in the event that you need them. Zip lock bags work great for transporting baby wipes. Each time you empty your bowels, wipe and then apply your ointment.

It is also helpful to wear a comfortable shirt with no panties on the day of your prep so that you can get to the bathroom quickly if you need to do so. Plan on spending a lot of time in the bathroom on the day of your prep. Perhaps have books or reading material available.

Note: Your doctor will have specific instructions on when to start reducing your fiber intake and perhaps asking you to stop taking certain supplements or over the counter medications, but here are some other hints for the days preceding your colonoscopy exam.

2. Start reducing your food intake a few days (generally 2-3 days before your exam is scheduled. This does not mean you cannot eat, but try to eat soups or easily digestible items. Basically, keep in mind that anything you eat now will have to come out, so it’s in your best interest to start reducing your roughage and/or cutting down on meats and other harder to digest materials, and staying with easily digestible items and avoiding things like red meat, or other green or red items. Avoid any foods that are constipating.

3. Begin increasing your fluid intake because the preparation that will cause you to pass large amounts of stool, will also contain water and it is easy to get dehydrated if you are not adequately hydrated before you begin the prep.

4. The night before you are to start your bowel preparation you will have no solid foods after midnight. Now, keep in mind that this day (the day before your prep) is not a good time to fill yourself up or eat more. You should be reducing your food intake, and again only having foods that are easily digested. The day before your exam, you will generally begin your preparation in full force.

Here is a sample colonoscopy preparation day: (THE DAY BEFORE YOUR PROCEDURE) (Note: your instructions may vary as each doctor may use a slightly different variation)

No solid foods after midnight the day before the prep
Reduce the amount of food you eat and stick with easily digestible items for several days before your exam
Don’t eat any green or red items a few days before your exam
Warm tea with honey settles the stomach

a: Drink plenty of clear liquids all day, no food is permitted
b. You may have coffee, tea, carbonated beverages, jello, no reds or greens and no food particles, popsickles, no reds or greens, clear broth, you can see through, no red liquids at all
c. At 3:00 pm – Take 2 Dulcolax Tablets by mouth with a full glass of water
d. Mix 1/2 of the bottle of Miralax in one Powerade bottle, and mix the other 1/2 of the Miralax into the 2nd Powerade bottle. Shake well, and refrigerate the bottles.
e. At 5:00pm begin drinking 8 ounces of the mixed Miralax and Powerade Mixture. Repeat every 15 minutes unit you have finished both bottles (which is approximately 64 oz of liquid)
f. (Some Doctors will ask you to take 2 additional Dulcolax tablets with a glass of water at 8:00 pm) Some of the patients interviewed did not have to do this last step if their bowel movements were already clear or mostly yellow fluid. But check with your doctor on what you should be doing to properly prepare for your exam.
g. Stop all fluids at midnight before your procedure and do not consume any liquids if your procedure is in the morning. Ask your doctor for instructions if your procedure is scheduled later in the day.

These are the bowel preparation tips that were reported to be easiest to tolerate for most patients. Remember, your doctor may tailor these instructions to fit your specific case, so it is important to follow the instructions provided to you by your own physician.

If you are obese or severely overweight your doctor may also have some different instructions for you to follow. You will be going to the bathroom very frequently. If your stool is clear, watery and or yellow and watery, you will know your bowel is clean.

Safety tips: if you are elderly or have a problem with blood pressure you need to be careful now to stand up too fast from a lying down or sitting position as it can make you unsteady on your feet. Have someone with you during your bowel preparation and call your doctor if you have any problems during your bowel preparaton procedure.