A Complete Guide to Colonoscopy Prep: What to Expect and Tips

Understanding Colonoscopy Prep

A colonoscopy is a routine screening test used to check for colorectal cancers and other abnormalities in the large intestine (colon) and rectum. It is commonly recommended for individuals over the age of 50, and for younger people who have a higher risk of colorectal cancers.

In preparation for a colonoscopy, patients are required to follow a strict diet and use laxatives or enemas to completely clean out the colon. This cleansing process is referred to as bowel prep or colonoscopy prep.

Colonoscopy prep is vital for ensuring the gastroenterologist can clearly view the lining of the entire colon. Any remaining stool or debris can obscure small polyps or other abnormalities. An inadequately cleansed colon requires the test to be repeated again in a few months time.

Goals of Colonoscopy Prep

The goals of preparation for a colonoscopy include:

• Emptying the colon of all stool
• Cleaning the colon by removing any residual debris or fluid
• Preventing any new stool from entering the gastrointestinal tract

To achieve these goals, patients are required to follow a restricted diet, use laxatives, and drink only clear liquids leading up to the colonoscopy. This allows the gastrointestinal tract to be flushed completely clean.

Timing of Colonoscopy Prep

The preparation process begins 1-2 days before the scheduled colonoscopy. The timing depends on the specific bowel prep prescription provided by your gastroenterologist.

Below are some general prep guidelines:

• 1-2 days before: Begin restricted low-fiber diet
• Day before: Begin clear liquid diet. Take first dose of laxative in the afternoon or evening.
• Day of colonoscopy: Take second dose of laxative early in the morning to finish cleansing

Restricted Diet Before Colonoscopy

In the days leading up to the colonoscopy, patients are told to avoid:

• High-fiber foods: Whole grains, beans, vegetables, nuts, seeds
• Dairy products: Milk, cheese
• Fatty and fried foods
• Raw fruits with skins or seeds
• Popcorn, baked goods with seeds/nuts
• Alcohol

Instead, choose options like:

• White bread, white rice, pasta, crackers
• Fish, chicken, eggs
• Tender, peeled fruits like bananas
• Clear juices without pulp
• Plain yogurt
• Milk, cheese
• Caffeinated beverages

These types of foods help reduce residue and stimulate bowel movements.

Clear Liquid Diet Before Colonoscopy

On the day before your colonoscopy, only clear liquids are allowed. Options include:

• Water
• Fruit juices without pulp
• Clear sports drinks like Gatorade
• Black coffee or tea
• Clear broths
• Plain gelatin
• Popsicles

Avoid liquids that are red, blue, or purple, as they can look similar to blood during the colonoscopy.

Stay hydrated by drinking at least 8 ounces of clear liquid every hour you are awake on the day before your colonoscopy.

Laxatives for Colon Cleansing

Taking laxatives is key to cleansing the colon prior to this procedure. There are a few different types of laxatives that may be used:

• PEG solutions: Polyethylene glycol electrolyte solutions like Miralax or Glycolax. These are dissolved in water and drunk over a few hours.
• Magnesium citrate: This loosens stool and draws water into the colon to induce bowel movements when taken orally.
• Bisacodyl tablets: These stimulate the intestines to contract and pass stool.
• Enemas: Phosphate enemas like Fleet are used to flush out the rectum.

Patients may need to take laxatives in split doses over a day or two depending on the prescription instructions provided by the gastroenterologist.

What to Expect During Colonoscopy Prep

Undergoing the colon cleansing process before a colonoscopy is often the most challenging part of the procedure for patients. Here is an overview of what you may experience:

First Day of Prep

On the first day of the prep process, you will start a restricted low-fiber diet. You may notice some mild abdominal bloating or gas pains from changing your diet.

Diarrhea often starts within 2-4 hours after taking the first dose of laxative in the late afternoon or early evening. Stay near a toilet, as diarrhea can be sudden and intense.

Some common side effects after taking laxatives include:

• Cramping
• Bloating
• Nausea
• Vomiting

Use baby wipes and apply Vaseline or diaper rash ointment to protect your rectum from irritation. Change soiled underwear and clothing right away.

Second Day of Prep

The day before your colonoscopy will involve drinking clear liquids and taking a second dose of laxatives to finish cleansing your colon. Stick close to a bathroom all day, as intense diarrhea will continue. Use wet wipes and ointment to manage skin irritation.

Other common symptoms include:

• Fatigue
• Hunger or weakness from calorie restriction
• Headache
• Dizziness or muscle cramps from fluid loss

Drink at least 8 ounces of allowed clear liquids every hour you are awake to maintain hydration. Call your doctor if you experience severe reactions to the bowel prep.

Morning of Colonoscopy

Your goal is to arrive for your colonoscopy with an empty colon and only clear fluids in your system. Avoid any liquids with red or purple dyes.

Use the bathroom one final time right before leaving for your appointment to completely empty your bowels.

Bring an extra pair of underwear and baby wipes in case you have an accident on the way.

What Your Bowel Movements Should Look Like

Here’s a helpful picture guide of what successful colon cleansing looks like before a colonoscopy:

Two Days Before

After starting a restricted diet, bowel movements become less frequent and smaller.

Day Before

Shortly after the first laxative dose, stools become loose and frequent. Look for a pale yellow liquid without any solid pieces.

Morning Of

The morning bathroom trip should pass watery, pale yellow liquid again. Your stool should look nearly clear by the final bathroom trip before leaving home.

Tips to Improve Colonoscopy Prep

While required, colonoscopy prep is challenging. Here are some tips to help make the process easier:

Stay near a bathroom

When the laxatives start working, you may need to use the toilet frequently. Avoid going out in public to minimize accidents.

Wear a diaper or pad

For added security, you can wear an adult diaper or pad to contain unexpected leakage on the way to the toilet.

Use wet wipes

Gently clean yourself after each bowel movement to prevent irritation and rashes on your bottom.

Apply protective ointment

Coat the skin around your anus with petroleum jelly or diaper rash cream to create a moisture barrier.

Stay hydrated

Drink the recommended amount of clear liquids to prevent dehydration from diarrhea and vomiting.

Set reminders to drink

Set a timer or reminders to drink 8 oz of clear liquids hourly while awake on laxative days.

Soothe nausea

Eat some crackers, breath mints, or chew gum to alleviate nausea between bathroom trips.

Rest and relax

The frequent bowel movements can be exhausting. Rest between bathroom trips and treat yourself gently.

Stay positive

Keep focused on why the colonoscopy is necessary, and remind yourself the prep is temporary.

When to Call Your Doctor

Contact your gastroenterologist if you experience:

• Chest pain or heartbeat changes
• Difficulty breathing
• Fainting or weakness
• Rash, hives, or itching
• Blood in stool
• Inability to complete prep

Also let the colonoscopy staff know if you still have solid stool or have not fully completed the bowel prep before the procedure.

The Value of Colonoscopy Screenings

While unpleasant, properly cleansing the colon is vital for an effective, high-quality colonoscopy. Finding and removing polyps early is the best way to prevent colorectal cancer.

Colonoscopies save lives by detecting issues before they become cancer. Over 75% of colorectal tumors are found in people without a family history of these cancers.

The preparation is temporary discomfort, but the colonoscopy can provide you with many healthy years ahead. Focus on the big picture, and remind yourself why the test matters.

With the right preparation guidance and coping tips, you can get through the colonoscopy prep smoothly. Stay positive as you take the necessary steps to complete the bowel cleansing.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.