Colonoscopy Prep: How To Prepare For the Procedure

You’ve heard the stories, and I’ve heard them too—colonoscopy prep is the worst! It’s hell, I was told, flat-out. You have to starve yourself for a day, the colonoscopy prep drink is disgusting, and the trips to the bathroom last all night. They have to knock you out to do your colonoscopy, and, to top it all off, you need someone to take you to and from the hospital, a witness to your discomfort.

No wonder people like myself put off scheduling a colonoscopy, even though they know this quick procedure could save their lives. A colonoscopy is the best way to screen for colon and rectal cancer and remove any suspicious polyps at the same time. As my family doctor once shared with me, the only patients of hers who died of colon cancer were those who didn’t get a timely colonoscopy.

Well. Who can argue with that?

Still, I put scheduling my first colonoscopy off. For years. I dreaded the thought of the discomfort of colonoscopy prep, of being under anesthesia, and needing someone to drive me home after the procedure.

Finally, after a ridiculously long interval, I made an appointment for my first colonoscopy. I arranged for a good friend to drive me home, and I used Uber for the ride to the surgery center, which satisfied my fear of being a burden to my friend.

Experiencing My First Colonoscopy

My colonoscopy prep really wasn’t that bad. I’ve been through worse bouts of discomfort. If you’ve had the flu or a bad digestive tract bug, you likely felt worse than when you’re prepping for a colonoscopy. And unlike the flu and the bug, you know, more or less, what’s coming, which makes your colonoscopy preparation more tolerable.

As for the 45-minute procedure itself, I remember nothing, thanks to the propofol anesthesia. One second the nurse in the procedure room was adjusting my pillow, and the next I was opening my eyes in my recovery room.

In the spirit of helping you NOT delay getting your first colonoscopy like I did, here are some suggestions that you may not receive from your doctor but may make your personal colonoscopy prep experience more tolerable.

Your Prep Box/Basket

Your colonoscopy prep list may end up being different, but I stand by mine on the basis of comfort and practicality.

• Liquid diet supplies. The day before your colonoscopy, you’ll be on all liquids. I chose apple juice, green tea, peach gelatin, and a few gummy bears along the way. (If you like your caffeine, your doctor may allow coffee, some sodas or tea for part of the day.) Review your doctor’s instructions for more liquid diet suggestions.
• Your colonoscopy prep drink ingredients. Follow your doctor’s instructions. Usually, this will involve two rounds of prep. I was told to combine Miralax with an energy drink like Gatorade or Powerade that wasn’t red or purple. I mixed Miralax in with Gatorade Frost. A 510-gram bottle of Miralax is about 3 cups of powder, so I mixed 1 1/2 cups in with 32 ounces of Gatorade for each prep.
• 1 2-quart pitcher. It’s much easier to mix up your colonoscopy prep drink in a pitcher than trying to combine your Gatorade and Miralax in the drink bottle.
• 1 12- or 16-ounce glass tumbler. Be sure it’s one you really like, as you’ll be drinking from it for the next several hours. Measure out 1 cup of water, put it in the tumbler, and take a piece of masking or painter’s tape and mark the top of the water line. Use the tape guide to pour out your prep drink in 1-cup servings.
• A drinking straw. This makes consuming the prep drink much easier. Plus, it helps you regulate your drinking speed—you may find that you need to drink your second round more slowly.
• 1 scented candle for the bathroom and matches
• 1 large, cozy blanket. Your colonoscopy prep starts in the late afternoon/early evening, lasts until late in the evening and puts your body through a bit of a strain. A little extra warmth will be comforting.
• Comfortable clothes, including elastic-waist pants or sweats and underwear. Set aside an extra set of the same. Don’t ask why, just trust me.
• Extra toilet paper. Bathroom wipes are optional, but a nice suggestion. Your evening should be all about comfort.
• 1 season or series of binge-worthy television or movie series, preferably one you’ve seen before. Yes, you could watch something new, but you can’t think, oh, I’ll watch 30 more seconds to see what happens before hitting pause because you won’t have 30 seconds after the urge to void. I rewatched a season of Downton Abbey, since I know everyone’s story line and I’ve memorized nearly all of Maggie Smith’s one-line zingers.
• Drinks to keep yourself hydrated and that cut through the colonoscopy prep drink, especially for the second round: e.g., chicken stock, warmed; sparkling water, ginger ale, apple juice (no red or purple dyes, which can interfere with the results). I enjoyed chicken stock during the first round, then La Croix water for the second round.

Two Weeks Before Your Colonoscopy

• Read your doctor’s instructions about which medications and supplements to stop before your colonoscopy, such as herbal supplements, vitamins, aspirin, ibuprofen, weight loss medications, etc.

A Few Days Before Your Colonoscopy

• Buy your colonoscopy prep supplies listed on your physician’s instruction sheet and gather any comfort measures listed above. Place your drinks, including what you plan to use for colonoscopy prep, in the refrigerator. Make gelatin, if that’s one of your choices.
• Following a low-residue diet a few days before your colonoscopy is said to make the final preparation time a little easier. Just avoid “bulky,” fiber-containing foods, like beans, nuts, popcorn, whole-grain foods, and fatty meats. Instead, think “clean” eating (pun intended), such as chicken, fish, eggs, white rice, soups, potatoes without the skin, pasta and smoothies.
• Smaller meals a few days before may also help, so skip the appetizers, snacks, and desserts.

The Day Before Your Colonoscopy

• This is the all-liquid day. Take your “workday” drinks to your office cubicle and hope no one eats lunch at their desk.
• Reread your doctor’s instructions as to when to start your colonoscopy prep drink. You’ll want to be home when you begin the laxative cocktail.
• Set up your comfy nest: Blanket, pillow, movies, etc.
• Prepare the bathroom with toilet paper, wipes, clean clothes, etc.
• Prepare your first colonoscopy prep drink and keep the batch chilled. Drinking 8 ounces every 15 to 30 minutes, you may start to experience movement before or shortly after your fourth glass.
• Heed your doctor’s instructions to pause before starting the second round of prep.
• Rest assured that you will be able to get some sleep.

The Day Of Your Colonoscopy

• Do not eat or drink anything at home.
• Follow your doctor’s instructions regarding your routine medications.
• Report to the surgery center on time.

After Your Colonoscopy

• Pay attention to your doctor’s comments about his or her findings. This will be easier than you think, thanks to the anesthesia wearing off quickly.
• Thank your friend or family member for taking you home.
• You may be a little nauseated, which will be the reason you tell your friend to slow down, even though she’s driving only 39 mph.
• Stay home. Don’t drive, don’t make any major life decisions, and don’t shop online. One nurse told me a friend of hers bought an entire living room suite after her colonoscopy. She reportedly still liked it when it arrived a couple weeks later.
• Again, read your doctor’s instruction sheet. You’ll want to start slowly in getting back to a regular diet, avoiding fiber-rich foods and dairy products right away (Okay, I didn’t. I put milk in my hot tea soon after I got home, with no issues.)

My colonoscopy results were good—one little polyp, which ended up being not cancerous, and some evidence of diverticulosis, which apparently means I need to have more fiber in my diet. Because of my results, I’ll go back in seven years for my next colonoscopy, instead of the usual 10-year intervals, but now I know next time it will be nothing I can’t handle easily.