Getting a colonoscopy is bad enough. But the prep work can be brutal. Here are some insider tips on how to get through the “moment before” the actual procedure.
A colonoscopy is a medical examination of the interior lining of the colon where colon cancer starts. A long, narrow, flexible tube equipped with a small high-definition (HD) video camera at the end is inserted and snaked along the colonic passage to evaluate its condition.
For those my Dear Readers who haven’t yet experienced the joy (NOT!) of undergoing a colonic inspection to look for cancer or other abnormalities in the digestive tract, all I can say is: you probably will someday, junior.
The updated 2018 American Cancer Society (ACS) guidelines for regular colorectal screening lowered the age for adults at average risk to start from 50 to 45.
Colonoscopies are used to detect colorectal cancer (CRC), the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. Blacks, American Indians, and Alaska Natives have the highest incidence and mortality rates.
These anal tests for precancerous or cancerous colon polyps (growths on the inside of the colon’s lining) are very effective, identifying 94 percent of all colorectal cancer cases as well as colitis, inflammatory bowel disease, and diverticulosis.
The colonoscopy (-scopy comes from the camera or scope) itself is painless because an anesthesiologist will pump numbing agents in a process called monitored anesthesia. Medicine delivered through an intravenous (IV) tube keep the patient relaxed and unaware that the procedure is going on.
But getting ready to lie on the examining table for a video tour of your colon and rectum by following a doctor’s orders can be both daunting and very uncomfortable.
Some people will say that colonoscopy prep has improved over the past yadda-yadda-yadda years but the fact remains that the goal is to clear the bowels of fecal matter so the camera can get a clear view of what’s going on inside there.
Cleansing the digestive tract is usually done with what is called a split prep. The night before the procedure, the patient drinks half of a prescribed laxative (a substance that promotes emptying of the bowels – bowel movements – and eases constipation) that causes diarrhea for a couple of hours. The second half of the purgative is taken the next morning before the exam.
You read that right. This procedure will make you sh*t. A lot. Hopefully, all of it.
Knowing this, there are ways to ease the potentially explosive effects of the prescription-grade laxative:
- Three days before the colonoscopy, eat only low-fiber foods
- Stop taking fiber supplements or anti-diarrheal medication
- Two days before, continue eating only low-fiber foods
- One day before, begin a clear-liquid diet
Drinking at least 8 glasses of liquid the day before a colonoscopy (in addition to the prescribed laxative drink) will prevent dehydration.
Pre-cleansing the digestive tract in the days up to a colonoscopy will reduce the amount of fecal matter present in the colon naturally. When you drink the first half of the high-strength laxative the evening before and finish with the second half-dose the next morning, less “stuff” should come out.
The laxative drink has to be mixed according to the instructions provided. Most patients are directed to start drinking the laxative between 4 pm and 7 pm. It takes about 2 hours to quickly toss off (rather than sip) 8 ounces of the muscle-relaxer every 10 to 15 minutes.
All told, 6 hours isn’t uncommon to complete the laxative drink and finish bowel movements. The left-over laxative is kept chilled in a refrigerator before finishing the remaining half-dose the following morning, taken with the same schedule.
Some people may have to rise and shine earlier than usual to complete the laxative course which often needs to be completed 4-5 hours before heading for the examining table. Many colonoscopies require that the patient stop drinking any other beverages at least 2 hours before table time. This may involve higher math. (Let’s hope not.)
Many examination facilities won’t let you drive home or even take a taxi or Uber. A designated driver may need to sign a form and take you home after your colonoscopy, staying with you for at least two hours to make sure you’re okay.
Avoid drinking alcohol, driving a car or signing legal documents until the day after your procedure.
May these insider tips help you have an “uneventful” colonoscopy. The good news – if we can call it that – is that this procedure normally is recommended only once every 10 years.