Welcome to Colonoscopy Prep 101: a Class No One Actually Takes But We’ll All Definitely Need. Look, a colonoscopy—which is when a medical professional essentially inserts a long, flexible tube into your butt—can be a spectacularly useful tool when it comes to detecting changes or abnormalities in your colon (the longest part of your large intestine) and your rectum (the part of your large intestine closest to your anus). This can help your doctor investigate a range of weird gut and butt symptoms, like abdominal pain, persistent bleeding when you poop, or chronic constipation. It’s also one way doctors can screen for colorectal cancer.
For all its benefits, though, getting a colonoscopy is kind of like going to the dentist times a zillion: You know it can make a huge difference for your health, but it’s honestly scary and seems like the opposite of a nice way to spend your time. Luckily, some gastroenterologists have come to the rescue. Here, doctors explain 12 ways to make getting a colonoscopy a heck of a lot easier.
Colonoscopy recommendations generally depend on your risk of getting colorectal cancer. Typically, average risk would include: having no strange GI symptoms, no personal or family history of colorectal cancer or polyps (clumps of cells that form on the lining of your colon and can be cancerous), not having inflammatory bowel disease like Crohn’s or ulcerative colitis, and not having any genetic conditions that predispose you to colorectal cancer.
If that sounds like you, the Centers for Disease Control and Prevention (CDC) recommends getting your first colonoscopy when you’re 50. The exception is if you’re black, in which case the American College of Gastroenterology (ACG) notes that you might want to start at 45, given that black people have the highest rates of colorectal cancer. Either way, after your first one, you’ll need a colonoscopy every 10 years if nothing about your health changes.
Things get way more granular when talking about recommendations for people with an above-average risk of colorectal cancer, like if one or more of your first-degree relatives (a parent, sibling, or child) has had a precancerous polyp or colorectal cancer before age 60, or if two or more of your first-degree relatives have at any age. Then you’ll want to get screened when you’re 10 years younger than the youngest age of the person with cancer or polyps, or at age 40—whichever comes first—with screenings every five years after that, according to the American Cancer Society. (Unless this is happening because they have a hereditary syndrome that you might share, which can drive up your screening frequency or lower the age at which you should first get tested.)
As another example, if you have ulcerative colitis involving your entire colon or Crohn’s disease, you should get a colonoscopy 8 to 10 years after you were initially diagnosed, the ACG says, then every 1 to 2 years after that along with a biopsy. (Both conditions can increase your risk of colon cancer.)
As you can see, the specifics really depend on your circumstances, which is why it’s important to give your doctor all the details possible when discussing when you should start getting colonoscopies.
Your colon has to be totally empty for your doctor to examine it thoroughly (more on exactly how that happens later). Cutting back on fiber can help. Fiber is a nutrient your body can’t digest and that helps soften your poop, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). It’s in things like beans, whole grains, and the skins of many fruits and vegetables.
You might think loading up on fiber pre-colonoscopy would be your best bet, so you poop as easily as possible. But since your body can’t digest it, it could be harder to fully clear things out. Limiting fiber may make it easier for your body to expel all the, well, crap in your colon, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. (A low-fiber diet is really only necessary when your doctor recommends it for a medical reason like a colonoscopy—otherwise, getting enough fiber is essential for making sure you're pooping regularly.)
Prep is essentially a laxative that helps clean out your colon so your doctor can see everything in there. “The colon is long and stretchy,” Christine Lee, M.D., a gastroenterologist at the Cleveland Clinic, tells SELF. “It has great capacity to hold or store stool inside your body until it is more convenient for you to eliminate.” Enter prep, which causes some pretty intense diarrhea so a medical professional can spelunk inside your colon as easily as possible.
Here’s a simultaneously reassuring yet unfair fact: “The procedure itself is easy compared to the prep,” Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California, tells SELF. Learning all you can about what it entails and the available options can help you avoid some of the unpleasantness.
The afternoon or evening before the colonoscopy, your doctor will likely have you drink a gallon of polyethylene glycol (PEG, a liquid that will cause diarrhea), according to the ACG. In general, you drink half the solution the afternoon or evening before you go in for your colonoscopy and the other half around five hours beforehand. Your doctor may also want you to take a laxative pill to help make sure you’re totally cleaned out, the ACG says.
If this sounds like an overwhelming amount of liquid to drink, ask your doctor if you can use one of the prep solutions that comes in a smaller volume or in pill form, but is similarly effective. (Fair warning: Pill formulations can require taking around 30 tablets between the evening before and day of your colonoscopy.)
No matter which version of prep you take, it’s essential to drink as many liquids as the instructions recommend so you stay adequately hydrated.
Trying to drink what essentially amounts to liquid chalk isn’t fun. It’s totally fine to add flavoring to your prep (though some do come with flavoring already), Dr. Lee says. “We generally recommend a sugar-free, low-calorie powdered beverage mix that is easy to dissolve in the colonoscopy prep kits,” she says. “This can help in some people as it can improve the taste and make it more palatable.” (Crystal Light can be a good option, Maria Grifone, R.N., M.S.N., a GI triage nurse at Massachusetts General Hospital, tells SELF.)
However, it’s important to avoid anything with red or purple coloring, because that can stain the wall of your colon and your doctor might mistake it for blood, Dr. Lee says. If you want to be 100 percent sure that the flavoring you’re hoping to add is fine, ask your doctor or other medical professional.
It’s all about trying to make the drink taste better, Dr. Farhadi says. “It’s like drinking warm beer vs. cold beer—it makes it a little more palatable,” he explains.
Throw it in a fancy, frosted mug if it’ll make you feel better (it probably won’t, but, listen, we’re trying).
The day before your colonoscopy (or earlier) you’ll be limited to liquids or liquidy foods like popsicles, Jell-O, clear broth, coffee or tea (without milk or creamer), sports drinks, and hard candies, according to the Mayo Clinic. “These don’t add to the stool burden that requires further cleaning,” Dr. Lee says. They can also lessen your taste buds’ burden if you, say, suck on a hard candy after drinking the colonoscopy prep solution. Finally, taking in so many liquids can help you maintain your diarrhea-compromised electrolyte balance, according to the Mayo Clinic.
Be sure to check in with your doctor about any specific foods or drinks you’re wondering if you can or can’t have, and also to find out your cutoff for eating or drinking anything at all before your colonoscopy.
The whole point of the colonoscopy prep is to make you poop a ton. “You’re going to be wiping quite a bit,” Dr. Bedford says. To help you get clean without irritating the delicate skin on your anus, he recommends using plush toilet paper (now’s the time to splurge on multi-ply toilet paper if you don’t already) or wet wipes. The chemicals in scented toilet paper or wet wipes might be irritating, though, so look for unscented ones if that concerns you. Applying petroleum jelly to the area between going can help protect the skin, too, Dr. Bedford says.
No matter which kind of prep you use, the time between when you get the urge to poop and when you actually do can be scarily short, Dr. Bedford says. This isn’t the time to wear those amazing pants you just bought that have buttons and a buckle and a cute hidden zipper. Instead, wear something loose and easy to remove in a flash. Comfort is really key, which is why if it’s at all possible, you’ll want to go through this entire colonoscopy prep experience somewhere restful, like at home.
You’re going to be spending some quality time in your bathroom after you take your colonoscopy prep, so make sure you have magazines, a good book, or some other form of entertainment handy to ride it out. “Sometimes you get in and a gush of fluid comes, and then you have to wait five more minutes for the next one,” Dr. Farhadi says. “You don’t want to leave the toilet because when it comes, it’s explosive.”
Just avoid using something like your phone or a tablet, unless you like the idea of getting even more poop germs than normal all over your device.
A medical professional will likely administer some form of sedation before your colonoscopy, according to the ACG. As a result, you’ll be drowsy, shouldn’t feel any pain during the procedure, and might even forget the actual experience once it’s over. Best case scenario, really.
You might feel bloated or gassy for a few hours after your colonoscopy as you clear air from your colon, the Mayo Clinic says. Walking can help, but so can simply letting your body do what it needs to do.
"Let it go,” Dr. Bedford recommends. Trying to hold it in could just lead to discomfort. You can also try these tips for handling painful gas, like consuming peppermint oil or peppermint tea, which may keep your intestines from spasming too much and increasing your gas.
Ask your doctor if there’s any reason you should hold off from eating your typical diet after your colonoscopy. Otherwise, you can generally start eating regularly again within a day, but it’s a good idea to take it slowly and avoid heavy foods until you’re confident your stomach can handle them, Dr. Farhadi says. “You basically just underwent a stress test for your gut,” he says. “You don’t want to stress it further.”
As you’ve probably surmised, preparing for a colonoscopy isn’t quite like winning the lottery. Just try to remember that the colonoscopy prep is the hardest part. “After that, everything is easy,” Dr. Farhadi says.
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