How to Make Your Colonoscopy Prep a Bit Easier

Gastroenterologists share their tips for what you can do to make preparing for your colonoscopy more bearable.

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The importance of colonoscopies cannot be overstated. The exam 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.

Of course, colonoscopies can be performed for reasons other than cancer screenings. People of all ages might need an exam so that doctors can investigate symptoms such as abdominal pain and rectal bleeding and 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 is to completely empty your bowels of any waste so your doctor can clearly see the lining of the intestine with the tube they insert into the rectum. It's largely that clearing process referred to as your "prep"—not the exam itself—that 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 decent amount of not-so-delicious fluids that promote bowel movements. Plus, you'll be in the bathroom quite frequently with diarrhea thanks to those fluids.

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 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says.

According to Samantha Nazareth, MD, a gastroenterologist who practices in New York City, there are liquid laxatives of all different volumes—as much as a gallon—that may or may not be combined with pill laxatives. As part of your prep, you might be prescribed a laxative powder that you can dissolve in water or clear liquids, the NIDDK says. Your doctor may also prescribe an enema, a rectal laxative that can spur bowel movements. In 2020, the US Food and Drug Administration approved prep in the form of tablets, which makers say can be an alternative to liquid colonoscopy preparations. Whatever your prep, you will receive detailed instructions from your doctor on how and when to perform it.

As for which form of prep you get, that's up to your doctor. They might take into consideration any poor preps you've had in the past, Dr. Nazareth says. 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 (aka, a prep that cleans you out well enough for doctors to get a clear look).

If you are chronically constipated, this might impact the type of prep you are assigned in order to clean your stubborn colon. She adds that insurance also may play a role in the prep you're assigned, as your provider might cover only certain preps.

So yes, thanks to the icky taste of some laxatives and the amount of liquid some preps require you to drink in a certain amount of time, Dr. Nazareth admits that colonoscopy prep can be unpleasant. Thankfully, newer preps—which require you to drink less fluid than the old-school preps thanks to improved efficacy—can be less grueling, Amit Desai, MD, a gastroenterologist on the medical staff at Texas Health Presbyterian Hospital Dallas, tells Health. "Most [of my] patients use low-volume preps," he says.

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 your doctor 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 says. "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 adds 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 and foods that are clear fluids when they are at room temperature, according to MedlinePlus. That might leave you hungry. So 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 says. 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 suggests 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 find flatter polyps.

Rather than gummy bears, Dr. Nazareth suggests sucking on light-colored hard candies (not red or purple) until they melt. To handle hunger, she also says to order ramen takeout and enjoy the broth, saving the noodles and any meat and veggies for another day. Lemon Italian ice is also sure to satisfy, says Dr. Nazareth.

How To Make Drinking the Prep Fluid Easier

As if being hungry isn't difficult enough, again, some colonoscopy preps require you to drink a lot of fluid—and 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. For one, Dr. Nazareth says you can make the prep fluid taste better by adding something like a clear Crystal Light. And Dr. Desai says you can "ask the pharmacy to flavor the prep bottles for you the day of prep. All their flavorings are clear and prep-compliant."

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 says. "Keep the prep in the refrigerator. Hold your nose and drink." After you have the prep laxative, Dr. Nazareth suggests 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 has some tips. "Patients can slow down how fast they drink the solution [but still doing 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]," he says.

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," he says. "Blot instead of aggressively wipe the anal area to reduce irritation."

Dr. Nazareth also suggests applying coconut oil or Vaseline to the outside of your anus or subbing 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 advises to "wear 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 recommends 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 says. "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 suggests having a favorite TV show or movie to watch. You can also stock up on some reading materials, which you can even read when on the toilet.

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.

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