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How to get (mentally and physically) colonoscopy ready

By Amalia Stefanou, M.D.
A colonoscopy is one of the most dreaded screenings on people’s healthcare to-do lists. Often the anticipation — and a little unpleasantness as you prep — is much worse than the actual test.

It’s one of the most dreaded screenings on people’s healthcare to-do lists. Colonoscopy time. Often the anticipation — and a little unpleasantness as you prep — is much worse than the actual test.

Here’s why getting over that mental hurdle and getting it done is so important: Colorectal cancer is the third leading cause of cancer death in the United States, taking an estimated 50,000 lives annually. Yet, it’s also one of the most treatable forms of cancer if detected early. In many cases, screening can even prevent the disease from developing.

Most people who have polyps, and even those who have colon cancer, don’t experience any symptoms. That’s why screening with colonoscopy is so important. The simple procedure allows doctors to detect cancer in earlier, more treatable stages. It allows gives them an opportunity to remove polyps during the exam and prevent a cancer from developing.

Unfortunately, a clean colon is required for doctors to find and remove polyps – and that requires some preparation. Colonoscopy prep has two parts: diet and a course of strong laxatives. It might sound daunting, but these six steps will help you sail through:

  1. Follow instructions. Your doctor will provide you with detailed instructions prior to your exam. The goal of these instructions is to help you clean out the digestive tract so your doctor can easily see polyps and other abnormalities – and so you don’t have to go back for a second look. Make sure you understand the instructions and call your doctor with any questions.
  2. Stock your bathroom. Pick up your physician-prescribed liquid laxative, along with some medicated wipes with aloe and vitamin E and skin-soothing moisturizer (such as Vaseline or Aquaphor). You might even consider applying diaper rash ointment or hemorrhoid cream before prep to help protect your skin.
  3. Watch your diet. A few days before the procedure, you’ll need to avoid whole grains, raw fruits and vegetables, nuts, seeds and meat. Instead, you’ll eat mostly white foods – things like rice, pasta, bread and potatoes, along with cooked or canned fruits and vegetables.
  4. Drink clear fluids. The day before screening, you’ll eat a clear liquid diet – things like apple juice, Jell-O, clear soft drinks, popsicles and broth. Drinking a lot of fluids will help you stay hydrated. Just avoid anything with red, blue or purple dye.
  5. Doctor your prep drink. A lot of people find the prep drink tough to tolerate. To make it more palatable, keep it cold, drink through a straw and suck on lemon flavored or tart candies after each glass to squelch the unpleasant taste. If the solution doesn’t come flavored, you can also add powdered drink mix for flavor (as long as it’s not red, blue or purple – try lemon flavor).
  6. Stay on schedule. For many people, the most difficult part of a colonoscopy is making the appointment. The key is to stay on schedule in terms of when you’re supposed to get screened. On prep day, you’ll need to be close to a bathroom. On test day, you will be sedated and will need time for the medication to wear off.

Health authorities recommend people who are at average risk of colorectal cancer begin colonoscopy screening at age 50. People who have a family history of the disease, those who have had benign polyps or people who have other risk factors like inflammatory bowel disease, should discuss when to start screening with their doctors. Some people may need to start colonoscopy screening as early as age 21.

In general, colonoscopies are safe and well tolerated. Most people don’t even remember the procedure. And after it’s over, we can tell you if there were any polyps or signs of cancer and when your next scope will be due.

In between colonoscopies, it’s important to stay on top of your gastrointestinal health and discuss any changes in bowel habits with your doctor. Most important, don’t ignore rectal bleeding. People tend to self-diagnose all rectal bleeding as hemorrhoids, but that’s not always the case. It’s better to get checked out. Not only will you gain peace of mind, but you can wait 5 to 10 years before your next colonoscopy screening.

Amalia Stefanou, M.D.

Dr. Amalia Stefanou is colon and rectal surgeon who sees patients at Henry Ford Hospital in Detroit and Henry Ford Medical Center – Columbus in Novi.

To find a doctor at Henry Ford Health System, visit henryford.com or call 1-800-HENRYFORD (436-7936).

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