Doctors urge everyone between the ages of 55 and 75 to be screened for colon cancer by colonoscopy once every ten years. Yet only about 60% of people follow this advice, and the main reason cited by those opting out is dread of the colonoscopy preparation. But let’s get our priorities straight here, people! Colon cancer is the second leading cause of cancer death in the United States, and even survivors of the disease have a diminished quality of life. When you think about this, wouldn’t you rather be on the safe side? Of course you would!
So let’s look at how to prepare for your colonoscopy like a champion. The doctor performing the procedure will give you a short list of instructions. These often include not taking any aspirin or ibuprofen for several days before the test, to reduce chances of internal bleeding. For the doctor performing the exam, it’s all about visibility. The basic colonoscope has a light and camera on the leading end and an eyepiece for the doctor on the other. The modern version of this connects to a computer, displaying the view on its monitor for the doctor and recording the pictures. The doctor is looking for abnormalities such as polyps – small growths that are on their way to becoming cancerous – and areas of inflammation or bleeding. To get a clear view of the inner wall of the colon, it has to be empty and clean.
So, rule one for colonoscopy preparation is: no solid foods the day before the procedure. However, it’s not a total fast and you may drink any type of clear liquid. Apple juice is okay, but orange juice is not. Coffee or tea is okay, but not with milk or creamer – you can still sweeten it with sugar or a substitute. Chicken and beef broth are both fine, but not soup. You can also have jello, though it’s best to avoid red, purple or blue varieties because little pieces of it can look like small areas of bleeding or inflammation to the doctor. When taking a closer look, an experienced doctor isn’t likely to be misled but it will end up taking a bit more time, which increases the chances of a complication. You want to be empty and clean with no complications.
Nobody enjoys feeling hungry, but consuming those clear liquids will help fight that feeling. You can also have a supply of hard candies to slowly suck on. The sugar they contain will partially satisfy your hunger. Having a good book, a set of puzzles or a couple movies on hand to occupy your mind can help you get through the day.
The other major part of colonoscopy preparation is taking a laxative – and not just any type will do. You need one that not only stimulates a bowel movement, but also washes everything else out with it. For this, a special drink is prepared – but sorry, no booze here, even the clear variety! Instead, you will drink a solution of a compound called polyethylene glycol, or PEG. Then you’ll drink some more of it… and then even more. In fact, you’ll drink an entire gallon of this wonderful solution, and discover that it’s wonderful at cleaning you out but not so wonderful tasting. It’s not that it’s horrible, but it’s a bit salty and otherwise bland. To make it more palatable, add various flavorings such as a packet or two of Kool-Aid or Crystal Light drink, and keep it chilled. You have a few hours to consume all of it, so you don’t have to “chug” a gallon all at once. Those who have done this will tell you the first glass really isn’t too bad – but one becomes tired of it well before it’s all gone. Another trick to help with this is to drink it through a straw, with the straw far back in your mouth. You won’t taste it as much that way.
Remember, this is a gallon of laxative you are drinking – and what goes in must come out. So do yourself a favor and take the day of preparation off work, and clear your schedule of all commitments. Treat yourself to a leisurely day at home, specifically not too far from your bathroom, and be prepared to have a lot of diarrhea. Sorry, there’s no getting around it! By the end of this it will be mostly clear, and this is exactly what you – and your doctor – want. You might think all that liquid would cause you to urinate excessively during this time as well, but this seldom happens, due to salts in the solution and the way osmosis works in your digestive tract.
What if you cheat and don’t drink very much of your PEG? Most likely, the doctor will get started with the procedure and then find that the view isn’t good enough – and you’ll be sent home only to do it all again (except better) the next week! Best to do it right the first time. And when it’s all over, award yourself an imaginary ‘merit badge’ – in colonoscopy preparation!