Bowel prep necessary for colonoscopy

DEAR DOCTOR K: It’s been 10 years since my last colonoscopy. I’m dreading my next one, especially drinking a gallon of liquid laxative. Has colonoscopy prep gotten more tolerable in the last decade?

DEAR READER: Yes, but that still doesn’t make it fun. And you can’t avoid it: You want the doctor to be able to clearly see every inch of your colon. For that, you need a good cleanout.

Periodic colonoscopy reduces your risk of getting and dying from colon cancer. These cancers, and growths that can turn into cancer (polyps), can be spotted by colonoscopy and removed before they spread. Find it, and cure it. But to find it and cure it, the doctor needs to be able to see it.

A person getting a colonoscopy often is given a relaxing sedative just before the procedure. You get a little sleepy and you don’t have much memory of the procedure.

I spoke to Dr. Catherine Cheney, a gastroenterologist at Harvard-affiliated Beth Israel Deaconess Medical Center. She noted that in recent years doctors have discovered that some pre-cancerous polyps are particularly hard to see. They lie flat against the colon wall. The doctor needs a really clean colon to reliably spot them.

Here’s one example of bowel prep:

1. A few days before the colonoscopy, start eating a low-fiber diet: no whole grains, nuts, seeds, dried fruit, or raw fruits or vegetables.

2. The day before consume only clear liquids like clear broth, black coffee or tea, clear juice, clear soft drinks or sports drinks, Jell-O, popsicles, etc.

3. The afternoon or evening before, drink the first dose of the laxative preparation.

4. Throughout the entire prep period, drink lots of fluids. Keeping hydrated clears your colon and maintains your electrolyte balance.

5. Six hours before your appointment, drink the second dose of the liquid laxative.

6. The day of the colonoscopy, drink clear liquids only. Don’t eat or drink anything two hours before the procedure.

Finally, if you’re still having trouble with the bowel prep, remember: This short period of discomfort could help save your life.