The American Cancer Society estimates over 95,000 new cases of colon cancer will be diagnosed this year. Besides skin cancer, colon and rectal cancers are the third most common cancer. The Center for Disease Control recommends that screening for colon cancer via the colonoscopy begins at age 50, and is done every 10 years until age 75. When colon cancer is caught early through this screening tool, 83-90% survive five years or more.
About 1 in 3 adults do not heed this advice, and do not get tested at age 50. I admit that I waited two years. I’m sure I procrastinated for the same reasons many people do – for no good reason. Mostly, I dreaded the Prep, and Clear Liquid diet (I love solid foods).
In addition, it’s Heart Month, and those with irritable bowel disease (IBD), Crohn’s or Ulcerative Colitis are at higher risk for heart disease. So there are many reasons to get your colonoscopy.
I thought I’d share my recent Colonoscopy experience here, encouraging you to schedule yours. Maybe you’ll find my advice supportive if you’ve been putting off that first colonoscopy screening.
Clear Liquid Diet
Your doctor will give you specific dietary advice, depending on the time of day your exam is. Mine was scheduled for 10 am, so the day before required a Clear Liquid Diet. If your appointment is later in the day, you may be permitted to eat a light breakfast the day before, and then begin Clear Liquid diet. Some examples of clear liquids include black coffee, plain tea, clear juices (apple, white grape, white cranberry), non-red sports drinks, non-red gelatin, plain broth, clear soda, water.
Here are some ideas:
- Broth. It’s super easy to make your own broth, and since you won’t be eating for about 36 hours, it’ll give you something to do. Pour 3-4 cups of water into a pot, add chopped carrots, celery, 2 tablespoons soup-starter (or two boullion cubes), 1/4 teaspoon ground white pepper, 1/4 teaspoon onion powder. Bring mixture to boil and simmer for at least an hour. Strain out vegetables and enjoy (I saved the veggies and added them to a smoothie 2 days later)
- Soda or Sports Drinks. Normally I don’t recommend regular intake of these beverages unless you’re active. Pre-colonoscopy is a perfect time to enjoy your favorite bubbly soda, or pour a sports drink over ice. Since you’re only consuming Clear liquids today, the sugar and calories from these drinks are useful.
- Gelatin Dessert. Again, more excuses to enjoy sugar. The reason your doctor recommends avoiding everything “red” is because most reds that go in, come out red. And the red color may be confused with bleeding.
Now Comes the Fun Part
The first few hours of the clear liquid diet may be a little rough. You might find yourself thinking about food. But after a few hours, you’ll get over it and enjoy your broth and flavored gelatin. What will really cure your hunger pangs? The “Prep”.
There are several types of colonoscopy preparations on the market. The goal of each: To make you poop. A lot. Everything that’s in your colon, must come out. As a pure liquid.
No matter which variety of “prep” your doctor prescribes, I can pretty much guarantee that it is going to be a little unpleasant. Some may use the word “Nasty!” I was prescribed Suprep – which is delivered in two doses. You pour one bottle into a cup, then fill that cup with cold water until you have 16 ounces of fluid. Down the hatch!
Prep One: Let the Fun Begin!
I made the mistake of trying to drink this first cup down a little bit too fast. You know, get it over with. I don’t recommend this. I won’t mislead you – it tastes like a salt bath. Drinking it quickly made me gag even more, especially since you must follow this drink with 32 ounces of water within the hour. Some find it helpful to add sweet lemonade to the prep mix.
Once I got all this fluid down, I was pretty nauseous. I was close to vomiting, but I knew I was doing a good thing for my health – colonoscopies save lives. Everyone needs to know that they don’t have colon cancer, and if they do detect it – treatment can start in a timely manner making your prognosis better.
In the meantime, I was queasy, and waiting for the bowel movement to begin.
Everyone Poops – Let’s Get this Party Started!
When my children were little we read books every day. One of them was called “Everyone Poops”. The theme of this book was to encourage toddlers in diapers to not fear pooping outside of their pants. My son once asked me at about age 3: “What exactly is poop?” The book presents the biology of poop and illustrates the feces of all sorts of mammals, sketching out what their poop resembles.
Let me tell you now – colonoscopy-prepped-poop does not resemble any of those illustrations. It’s a full on geyser coming out of your *ss! And there’s a lot of wiping so be sure to have extra-soft toilet tissue on hand (One of the nurse’s at the hospital joked about “the ring of fire” which you may indeed feel by the following morning).
And this is just Prep One…
I took Prep One at 4:30 pm, the afternoon before my morning test. Perhaps it’s my maintenance of a high fiber diet, or perhaps I have slower motility, but it took about 2 hours for the Prep to take effect, but once it was working, it continued to work. Stay near the bathroom. By 10:00pm, I had cleared out most of my colon and needed to get some sleep.
Don’t plan on getting much sleep though, because you’ll likely be up in the middle of the night for a couple of bathroom breaks. My husband claimed to be awoken my the grumbling of my gut.
Hang in there, because a few hours before the actual exam, you’ll be gracing yourself with Prep Two.
Prep Two: Are you Still Pooping the Morning of Your Colonoscopy?
Following your doctor’s orders, you will need to take the second prep about 5 hours before your exam. For me, this meant I set my alarm clock for 5:00am. But, I woke up at 4:00am, and was awake so just figured I’d get it over with, and then hopefully be able to take an hour nap before I woke up at 7:00am.
Prep Two did not go down any easier than Prep One. I did, however, change my strategy, and took small sips, with plain water in between. While I nearly chugged Prep One, I drank Prep Two gradually over 20 minutes, and that made me less nauseous. In my case, I got through two thirds of the solution before it took effect. Rather than finish it, I just drank the recommended water, and let nature take its course. Nature did its job.
After you’re done pooping, you head to the hospital for the exam itself. The nurse’s will check you in and get you comfy. They will ask if your bowel movements now look like urine (nice huh?). It’s routine to be given either a sedative or general anesthesia for the procedure. I have had a colonoscopy in the past without anesthesia (it’s not horrible), but this time I had anesthesia. It was my first experience with anesthesia, and I was anxious about it for no good reason. The anesthesiologist told me to have a sweet dream, and I remember taking two breaths, and then 3 seconds later I heard, “Ok Rosanne, all done, you did great.” Of course it was actually 15 minutes later, but it seemed like 3 seconds.
Your Life is Worth It
The nastiness of this beverage preparation, and the physical discomforts that go along with emptying your entire colon, are a small price to pay for your life. Checking the inside of your colon is the only way to detect colon cancer.
Colon cancer typically shows no symptoms until the disease is progressed. The earlier the detection, the better the outcome.
Poop the Facts
If you are approaching your 50th birthday, make the call now, and get checked! Don’t delay. Don’t worry about the Prep or the exam. It’s easy peasy, and when it’s done, the gravitational pull of your inverse geyser will be just a vague memory…
Diarrhea After Colonoscopy
While not common, some people with IBD may have lingering diarrhea after the colonoscopy. Talk to your doctor if you have this experience.