Colonoscopy Prep Tips & Screening Timeline

45-year-old woman with red hair looking at the camera; Colonoscopy Prep Tips & Screening Timeline

The thought of getting a colonoscopy might make you feel squeamish. The screening is recommended beginning at the age of 45. However, if you have a family history of colon cancer, talk to your doctor to see if you should start screening earlier. Lauri Harsh, DO, UnityPoint Health, outlines the colonoscopy timeline so you know what to expect. Plus, learn a few tricks so your colonoscopy prep experience is as comfortable as possible.

What Do Colonoscopies Look For? 

During a colonoscopy screening, your doctor looks for both colon cancer and colon polyps, which grow in the lining of the colon. Most polyps found during a colonoscopy can be removed during the screening process. Polyps don’t usually cause any problems or symptoms until they turn into colon cancer. By removing colon polyps found during a colonoscopy, your chances of developing colon cancer are reduced.

6 Months Before Turning 45 – Schedule Your Appointment 

  • First, learn to laugh about it. While colon cancer is serious business, having a sense of humor can help you better deal with the awkward, but lifesaving, procedure.
  • It’s an infrequent screening. Remind yourself this screening isn’t something you have to do often. For most people, it’s once every 10 years after the age of 45 — depending on your cancer risk.
  • Don’t dread the prep. Your provider will work with you to determine the best prep option for you. Often, a standard 4-liter (about one gallon) prescription (like Nulytely and Golytely) is used as the laxative to clean out the intestines before your screening. There are also some lower volume alternatives (like Suprep or Clenpiq). Take comfort in knowing that many products have improved in taste over the years. 
  • The prep is split in two. Studies show better results and more tolerability if the prep in a split-dose regiment. A split-dose prep means you’ll take half the night before the screening, and the other half four-to-five hours before the procedure itself.
  • Think about time off. Depending on the prep, you may need to take time off work the day before your procedure. You'll need to plan to take the entire day off on your procedure day, including the nightshift for work. Due to the sedation, you’ll feel sleepy afterward, and there’s no driving or operating heavy machinery the day of your procedure.

1 Week Before Your Colonoscopy Procedure 

The week before your procedure, try to eat a little lighter and stay away from corn, red meat and seeds. Instead, load up your grocery cart with things like soup, pasta, fish and chicken. Be sure to drink plenty of water to help with regular stools, too. This makes the prep work faster and more smoothly. 

1 Day Before Your Colonoscopy: Prep Mixture 

  • Follow the colonoscopy prep instructions. Follow your prep instructions closely, so you don’t have to do it twice. The commonly used polyethylene glycol (PEG)/electrolyte solutions (like Nulytely and Golytely) must only be mixed with water.
  • Chill your prep mixture. Prepare a colonoscopy prep mixture that's lightly chilled, but not ice-cold. Drinking a large volume of ice-cold liquid can make you feel very ill.
  • Drink extra liquids. Stick with drinking clear liquids during the prep process. Sparkling or carbonated water is OK. Avoid drinking anything red, purple or black in color, which imitates blood in the colon. 
  • Don’t eat solid foods. You shouldn’t eat food within the 24-hours before your colonoscopy. If you get hungry, stick with popsicles, JELL-O or chicken broth. Again, avoid anything red, purple or black. 

Tips for Consuming the Colonoscopy Prep 

  • Take your time. If you feel ill, take a 30-minute break from drinking the prep mixture. The goal isn't to drink it as quickly as possible, it's to keep the liquid in your body so it can cleanse your colon. 
  • Between glasses. Chew gum or suck on hard candies. Brush your teeth and tongue after every glass of prep, which helps if you're experiencing any nausea. 
  • Settle in with good entertainment. The goal is clean out 6 feet of colon, so you can plan on spending a good deal of time in the bathroom. Have good reading material handy to pass the time.
  • Combat a sore bottom. An ointment can go a long way to help a sore bottom. Consider taking a lukewarm bath or shower and then apply the soothing ointment, like A&D ointment or Vaseline during your colonoscopy prep. Also, try using baby wipes instead of toilet paper for comfort. However, beware, sometimes the wipes can sting.
  • Some bleeding is normal. It's normal to bleed a little during your colonoscopy prep. Colonoscopy preps may cause any hemorrhoids already present to bleed. If you noticed significant blood or blood clots, call your doctor for advice.

It’s Colonoscopy Time! 

Don’t be nervous about the actual procedure. Once you arrive for your appointment, you’re almost done. You’ll be given intravenous (IV) sedation to keep you comfortable, so you'll have little memory of the actual exam.

1 Hour After Your Colonoscopy 

  • Expect gas. After your screening you might experience gas or bloating. This is short-lived, lasting an hour or so. Lying on your belly will help the gas to pass.
  • Avoid greasy/spicy foods. When your colonoscopy is complete, you’re able to eat a normal diet again. However, it’s a good idea to ease into high-fiber foods and avoid greasy and spicy foods for the first day or so.
  • Add Yogurt. Adding yogurt to your diet for a couple of days will help repopulate the healthy bacteria in your digestive tract.
  • Blood in Stool. If you had a biopsy or a polyp removed, you might experience some blood in your stool. It should only last a few days, at most. If you notice significant bleeding or blood clots, talk to your doctor.
  • Give yourself a pat on the back! You’ve taken an essential step in maintaining good health and reducing your chances of developing colon cancer.

2-3 Days After Your Colonoscopy: Results 

The doctor can give you an idea of the results right after your colonoscopy is complete. If a biopsy occurred or polyps removed, you’ll get a call from your care team within one week with your full results.

If no polys are found, you likely won’t need to repeat your preventive colonoscopy screening for another 10 years. However, this depends on your family history of colon cancer and colon polyps, so the timeframe can change.

If precancerous polyps are found, you’ll likely need to be re-checked more regularly on a schedule determined by your doctor. 

Are there Other Colon Cancer Screenings to Consider?

The colonoscopy exam is still the gold standard test for prevention of colon cancer today. There are multiple stool studies available, but only very specific patient populations should use them. These stool studies can miss 8 - 20% of colon cancers and at least 40% of polyps. In no way should the stool studies be used in place of having a colonoscopy exam. Overall, talk to your doctor to select a screening that’s appropriate for you.

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