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Colonoscopy Prep Tips & Screening Timeline

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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. Dean Abramson, MD, 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, MoviPrep or Clenpiq). Take comfort in knowing that many products have improved in taste over the years. The Miralax and Gatorade combination isn’t often used due to its poor cleansing results.
  • 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. Unless you work the night shift, there’s no need to take time off the day before the procedure. However, it’s recommended to take the entire day off (including the evening) the day of the procedure. Due to the sedation, you’ll feel sleepy afterward, and there’s no driving or operating heavy machinery.

1 Week Before Your Colonoscopy Procedure 

The week before your procedure, head to the grocery store for low-fiber foods. A good, general rule is a diet of white-colored foods the week (or at least three days) leading up to your colonoscopy.

Low-fiber foods to add:
  • Rice
  • Pasta
  • Potatoes
  • White bread
  • Pretzels
High-fiber foods to eliminate:
  • Nuts
  • Seeds
  • Fresh fruit
  • Beans
  • Raw vegetables

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 is 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 or purple, which could imitate blood in the colon. Don’t drink any beverages with red or purple colors for 24 hours leading up to your screening.
  • Don’t eat solid foods. You shouldn’t eat in the 24-hours before your screening. If you get hungry, stick with popsicles, JELL-O or chicken broth. Again, avoid anything purple or red in color.

Tips for Consuming the Colonoscopy Prep 

  • Take your time. If you feel ill, take a 30-minute break from drinking the prep mixture.
  • Between glasses. Chew gum or suck on hard candies.
  • 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 personal hygiene wipes instead of toilet paper for comfort. However, beware, sometimes the wipes can sting.
  • Some bleeding is normal. It is 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 provider 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 screening.

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 provider.
  • 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 will be able to give you an idea of the results right after your colonoscopy is complete. If a biopsy occurred or polyps removed, you’ll get full results a couple of days later.

If no polys are found, you likely won’t need to repeat your preventive colonoscopy screening for another 10 years. 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?

Colonoscopies are the best screening tool to detect colon polyps and to both find and prevent colon cancer. However, there are other screenings available. You’ve probably heard of the mail-in stool tests. These are designed to be convenient and comfortable while detecting DNA abnormalities or blood in your stool. These will miss 8% to 20% of cancers and at least 40% of polyps. Before deciding which screening to use, check with your insurance carrier. In some cases, insurance may only cover one preventive colon cancer screening. For example, if your mail-in test is abnormal, a follow-up colonoscopy is required, and you might get stuck with the bill. Overall, talk to your doctor to select a screening that’s appropriate for you.