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.
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).
There are many reasons to get your colonoscopy. When colon cancer is caught early through this screening tool, 83-90% survive five years or more. In addition, getting a colonoscopy can help manage heart disease risks. Due to the chronic inflammation, bowel disease may play an essential role in atherogenesis (plaque forming in the arteries). Colonoscopies help diagnosis and manage bowel disease and those with irritable bowel disease (IBD), Crohn’s or Ulcerative Colitis are at higher risk for heart disease.
If you’ve been putting off that first colonoscopy screening, I hope you’ll find my recommendations here supportive. I’m sharing my colonoscopy experience here to encourage you to schedule yours. Keep in mind that prep instructions may vary slightly – follow your doctor’s specific advice!
Your doctor will give you specific dietary advice, depending on the time of day your exam is. Mine was scheduled for 10 am, so required a Clear Liquid Diet the entire day before. 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 in the afternoon. Follow the specific instructions given to you regarding timeline.
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.
Squirt (pun intended), homemade vegetable broth (consume the broth, don’t eat the veggies), white grape juice, sports drink
Here are some ideas:
- Broth. You can buy plain vegetable broth, but it’s super easy to make your own broth. 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 sodas, nor sports drinks unless you’re very 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. Fill a big water bottle for the day and sip on that. I enjoy putting an herbal tea bag into it for a weak iced tea.
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. 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.
Prep type and instructions may vary. Always follow your doctor’s recommendations!
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 a bit 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. 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). If you have a bidet, you’re the lucky ones.
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.
The Colonoscopy
photo credit: healthline.com
After you’re done pooping, you head to the hospital for the easy part – 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. My first experience with anesthesia made me a little anxious, 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, 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 healthy 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.
Having had 4 colonoscopies in last 13 years ( polyps first two times) and a family history, I couldn’t agree more with your assessment. Prep is definitely no fun but procedure itself is a breeze! Get screened! The alternative is worse!
Absolutely. Thanks for sharing your story!
What happens id you dont know and you est some red dragonfruit the day/morning before colonoscopy
I’m 30 and am having my first one tomorrow (have a lot of GI issues pretty much my whole life). Friends and family scared me about the prep. Other than a painful tush, it was really nothing to complain about.
My Doctor had me do dulcolax and miralax. So maybe it’s gentler than some older techniques. After living with chronic diarrhea this was a walk in the park. It was the poop minus stomach pain. Hoping all goes well with the sedation tomorrow but so far it has been unremarkable and not as scary as people make it seem! Definitely good to get checked out and I feel the worry about the prep is worse than the actual prep.