Ensuring a smooth experience during colonoscopy preparation

Many patients say that the preparation, a.k.a. bowel prep, is the worst part of a colonoscopy. We surveyed 250 patients from the Colonoscopy Assist program over a period of 3 months about their experience with colonoscopy prep. Each patient was asked to complete a questionnaire after their scheduled appointment and note suggestions on what would make the prep process easier.

From the survey, we found that there are many simple adjustments to make the prep process a breeze... Here are some tips we created based on patient feedback:

Tip 1: Hydrate, Hydrate, Hydrate

During bowel preparation, large amounts of fluid are lost in order to fully evacuate the colon. Replacing these fluids in the form of hydration is an important but commonly overlooked component of the bowel-preparation process. Given that many adverse events associated with bowel purgatives may be attributed to dehydration, maintenance of adequate hydration prior to, during and subsequent to colonoscopy may prevent potential dehydration-related complications. 

Tip 2: Do not use your favorite liquid to accompany your prep medicine

If you mix your prep powder with your favorite flavored liquid, there is a good chance that the drink will no longer be appealing to you in the future.
 
Tip 3: Chill your bowel prep liquid

Chilling your bowel prep liquid reduces any unpleasant tastes and reduces nausea. You can place the preparation in the refrigerator, or set it on top of ice to cool it. You should not put ice directly into the preparation as it will melt, dilute and increase the total amount of fluid that you have to drink.

Tip 4: Drink your liquid through a straw

Drinking the preparation through a straw will decrease the degree to which you taste it and may help. If you experience nausea you should try drinking the preparation a little more slowly.

Tip 5: Take a cup of yogurt with you to your appointment

It is possible for the bowel prep process to remove some of the normal flora of your intestines. This can make it more difficult to digest food, or just make your system feel "off" in the days following the procedure. Adding yogurt with active cultures to your diet as soon as soft foods are permitted can help with this issue.

Tip 6: Consider purchasing high-quality (very soft) toilet paper or wet wipes for use during your bowel prep

You will be going to the bathroom frequently, and soreness may develop if you use harsh paper. Vaseline will help too. Also make sure to wear loose comfortable clothing and stay near a restroom  during your prep.

Tip 7: Ensure that somebody else can tend to children

With frequent trips to the restroom, you will not be in a position to tend to children. Additionally, as with any medical procedure, it’s normal to be fatigued afterwards.

Tip 8: Start your prep early in the afternoon

More than half the patients going through a prep will have a complication or need to call their physician. By starting your prep early, you will have access to the physician’s office before they leave for the day.

While these tips may seem intuitive, they are often overlooked. It is important to keep in mind that the prep is a vital part of your colonoscopy. If your colon is not cleansed properly of all stool and other particles, it may interfere with the overall examination and may cause suspicious polyps to go unnoticed, or even worse, may interfere with the actual insertion of the lighted scope.

A special thanks to Dr. Sakina from Colonoscopy Assist for compiling and sharing the data in this post.

Ali Poonawala is the Program Director at the Colonoscopy Assist Program. The program assists uninsured and underinsured patients with colonoscopies.