How To Make Your Colonoscopy Prep a Bit Easier

Prepping for a colonoscopy is no fun, but the importance of getting this screening test cannot be overstated.

A colonoscopy can detect abnormalities or diseases, including cancer, in your rectum and colon. Colonoscopies can even prevent cancer from developing in the first place, allowing doctors to locate and remove polyps that can become cancerous. That's all why the American Cancer Society recommends that adults at average risk for the disease start regular colorectal cancer screenings at 45 and get one every 10 years until they're 75.

Other reasons for a colonoscopy include investigating symptoms such as abdominal pain and rectal bleeding to help diagnose certain conditions, such as inflammatory bowel disease.

However important colonoscopies might be, that doesn't make their preparation—notorious for being unpleasant in more ways than one—any easier to endure.

The goal of preparing for a colonoscopy, according to the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) is to completely empty your bowels of any waste so the lining of the intestine can be seen clearly during the procedure. That clearing process, referred to as the "prep"—not the exam itself—is what makes colonoscopies less than enjoyable.

For one, you have to eat a diet consisting only of clear liquids for a designated amount of time before your procedure. You also may have to guzzle a large amount of prescribed fluids that promote bowel movements. Thanks to the ingredients in the fluids, you'll spend quite a bit of time in the bathroom with diarrhea.

Fortunately, there are a few things you can do that experts say can make the experience a little more bearable.

Types of Colonoscopy Prep

Before delving into ways to make your prepping experience easier, know that not all colonoscopy preps are the same. Different bowel preps may contain different combinations of laxatives, substances that loosen stools and increase bowel movements, so that you can clean out your colon, the NIDDK says.

Liquid Laxatives

Traditional liquid laxatives used for colonoscopy prep require you to drink large volumes of the liquid—as much as a gallon—according to Samantha Nazareth, MD, a gastroenterologist in New York City.

Thankfully, there are newer liquid preps which require you to drink less fluid than the old-school preps, thanks to improved efficacy, Amit Desai, MD, a gastroenterologist at Texas Health Presbyterian Hospital Dallas, told Health. "Most [of my] patients use low-volume preps," Dr. Desai said.

Tablet Laxatives

In 2020, the United States Food and Drug Administration (FDA) approved SUTAB, a colonoscopy prep method that is taken in tablet form. It consists of 24 tablets, half of which you take the night before the colonoscopy; the rest are taken the morning of the colonoscopy.

In some cases, your healthcare provider may prescribe an enema, a rectal laxative that can spur bowel movements if oral laxatives are not tolerated or effective.

As for which form of prep you get, that's up to your healthcare provider. They might take into consideration any incomplete preps you've had in the past, Dr. Nazareth said. For instance, if you couldn't keep all of your liquid laxatives down due to the sheer volume of fluid you had to drink for the prep, the laxatives likely couldn't do their job in completely emptying your bowels; for your next colonoscopy, you might be switched to prep with a regimen that you can better tolerate so that you can have a more successful prep.

If you are chronically constipated, this might impact the type of prep you are prescribed in order to clean your colon, Dr. Nazareth added. Insurance also may play a role, as your provider might cover only certain preps.

Whatever your prep involves, you will receive detailed instructions from a healthcare provider on how and when to perform it.

Preparation a Few Days Before Your Test

The prospect of clearing out your entire colon with gusto isn't exactly a delight. One of the things a healthcare provider will give you clear instructions on is what you should and shouldn't eat in the days leading up to your colonoscopy. That's because avoiding certain foods can make your prep more successful. Stick to that guidance, as adjusting your diet a few days before your procedure might also make the prep easier to endure.

"Leading up to the day before your colonoscopy (three to four days before), it's best to start eating a low-fiber diet," Dr. Nazareth said. "Avoid raw fruits and veggies and nuts and seeds," which are high in fiber. By avoiding high-fiber foods that your body can't digest, there will be less material in your colon to clear out. Dr. Nazareth added that corn has a notorious reputation for sticking around, so you should avoid eating that, too.

During your prep, you'll likely have to follow a clear liquid diet, which means having only clear fluids (or foods that become clear fluids at room temperature), according to MedlinePlus. That might leave you hungry. Another way to ready yourself is to stock up on things you can consume—and even enjoy—during your prep without messing up the strict dietary guidelines your doctor sets for you.

"Prepare herb-infused broth the day before for savory cravings," Dr. Desai recommended. Thyme-infused beef broth or sage-infused vegetable broth can also be oddly satisfying if you're craving something to eat. To help with hunger, Dr. Desai also suggested eating clear gummy bears, avoiding any red or purple ones, as these colors can affect the color of your colon and make it difficult to identify flatter polyps.

Dr. Nazareth suggested sucking on light-colored hard candies (not red or purple) until they melt. To handle hunger, Dr. Nazareth also said to order ramen takeout and enjoy the broth, saving the noodles and any meat and veggies for another day. Lemon Italian ice is another option, Dr. Nazareth said.

How To Make Drinking the Prep Fluid Easier

With colonoscopy preps that require you to drink a lot of fluid, it can be hard to chug it all down, either because of the taste or the amount of liquid you have to drink. There are ways to make it a bit easier, though:

• Add some flavor. Dr. Nazareth pointed out that you can make the prep fluid taste better by adding something like a clear flavor of Crystal Light. Dr. Desai said you can also ask the pharmacy to flavor the prep bottles for you the day of prep. "All their flavorings are clear and prep-compliant," Dr. Desai said.
• Be creative. The way you drink the fluid can also make prep more bearable. "Drinking with a straw bypasses the tongue to avoid the taste," Dr. Nazareth said. "Or keep the prep in the refrigerator. Hold your nose and drink." After you drink the prep laxative, Dr. Nazareth suggested consuming a beverage you actually like—and that's permitted—such as coconut water, or coffee or tea without creamer added.

If you manage to get the prep liquids down, another battle might be keeping it down. For patients who have trouble with that, Dr. Desai had some tips. "Patients can slow down how fast they drink the solution [but still do it in the time directed by their doctor] and use ginger-based supplements which are natural antiemetics [meaning they can help prevent vomiting and nausea]," Dr. Desai said.

How To Care For Your Bottom on Prep Day

Arguably less pleasant than not being able to eat solid foods and having to drink lots of not-so-tasty fluid is the fact that everything in your digestive tract will be emptied. That means you're going to be spending a significant amount of time in the restroom. All that sitting and wiping can lead to an irritated bottom.

You can mitigate some of that unpleasantness, though, according to Dr. Desai. "Medicated pads (such as witch hazel) and lidocaine cream can help with anal pain," Dr. Desai said. "Blot instead of aggressively wipe the anal area to reduce irritation."

Dr. Nazareth also suggested applying coconut oil or Vaseline to the outside of your anus or swapping out toilet paper for flushable wet wipes. So while spending all that time on the toilet might not be fun, you can get through it in a less painful manner.

Since you'll be going and coming from the bathroom so often, Dr. Desai also advised wearing comfortable clothes that are easy to take on and off.

Perspective Is Key

Colonoscopy prep is physically uncomfortable in a variety of ways, but Dr. Desai recommended thinking about what you're going through in a big-picture fashion to improve your disposition during this not-so-fun endeavor.

"It is helpful to remember that in a lifetime, for most people, colonoscopies are done infrequently and help prevent colon cancer," Dr. Desai said. "Keeping this in your mind can help you get through the process."

And if the big-picture approach isn't enough of a motivator for you, then try taking your mind off of the prep as much as possible. Dr. Desai suggested having a favorite TV show or movie to watch. You can also stock up on some reading materials, which you can even read when you're sitting on the toilet.

A Quick Review

Colonoscopy prep is notoriously unpleasant, but getting a colonoscopy according to screening guidelines can prevent you from developing colon cancer, or catch it early if it's found. Fortunately, some newer types of prep laxatives are easier to tolerate than the typical high-volume liquid method.

So while no one enjoys having to do everything that's required before having a colonoscopy, it's a temporary discomfort that in the end is worth it. Spending a day clearing out your colon might not be at the top of your bucket list, but doing so may give you many more years to do the things that are on that list.