If your upcoming list of appointments includes a colonoscopy, a test in which a colonoscope is threaded through the rectum and the length of the colon, along with a light and a digital camera, so that your doctor can look for precancerous abnormalities, you may be … dreading it.
And the part you may dread the most is not the test itself, for which most people are put to sleep with light sedation, but the notorious lead-up, which involves drinking a bowel preparation designed to clean out your colon the day before the test, along with nothing else but a clear liquid diet.
While few people have ever considered it at all fun to prep for a colonoscopy, there are ways to make it more bearable — and the screening test more successful — even before you begin chugging the prep.
We asked an array of experts for advice. Here’s what they told us.
Many doctors may require you to follow a strict clear liquid diet only for one full day before you begin your actual prep, but many others say you should start making changes a few days before that in order to take away the stress of a less-than-ideal prep and get the best colon clean-out possible, says Christine Lee, MD, a gastroenterologist at the Cleveland Clinic.
- Keep stress levels in check. “The four or five days before your colonoscopy aren’t the time to be stressed or to endure a 12-hour flight,” says Dr. Lee. “You want to make sure your intestines have a good flow and that you’re going to the bathroom every day.”
- Get constipation under control early. “At least a week before, you should consider taking some form of laxative,” Lee says. “Taking a capful of an over-the-counter laxative like MiraLax will help that bowel prep day become easier for you, because the more backed up you are, the more miserable your experience is going to be when you go through the actual bowel prep.”
- Skip the multivitamin. “We urge people stop taking anything with supplemental iron in it,” says David Greenwald, MD, the director of clinical gastroenterology and endoscopy at Mount Sinai Hospital in New York City. “That’s because iron turns the insides of the intestines dark green or black and makes it difficult for us to see inside.”
- Downsize meals and fiber during the lead-up. Low-fiber foods liquefy and clear out of your system more easily than large, high fiber meals. (Focus on soups, smoothies, rice, and eggs.)
Avoid Troublemaker Foods
Some foods are just heavy and harder to clear out of the colon, like red meat, or have heavy skins that are hard to digest and that hang around, like corn, or even, in the case of nuts, clog the scope.
Steer clear of the following:
- Red meat
- Fried food
- Raw vegetables
Prep for the Day Before — and Get Creative
The goal of the day before a colonoscopy is to clear everything out of your colon, the better for your doctor to be able to peer inside for abnormalities. That means not only drinking a prep to clean out the colon, but not ingesting anything extra that needs to be cleared out, and not eating things with colors (like red) that might stain the colon and cause concern if spotted during the screening. A simple trip the grocery store with a colonoscopy-friendly shopping list could make the difference between misery and tolerableness the day before.
Clear beverages Apple juice, Gatorade, coconut water, ginger ale, Sprite, white grape juice, and 7 Up are all great go-tos to sip throughout the day, as long as all the juices are pulp-free, Lee says. “Coffee and tea are also okay provided you don’t add milk or cream,” she says. “The last thing you want to do is mix lactose in there and experience crampy abdominal pain.” One pro tip: Make ice cubes out of clear apple juice. “Slowly melt the ice cube in your mouth,” says Cherry Dumaual, 69, who had her first colonoscopy at age 45. “It really helps.”
Savory broth “This includes vegetable, chicken, or beef,” Lee says. “We especially suggest this for its protein content.” For a flavorful broth, strain wonton soup and sip only the broth. “You can save the solids — the dumplings and veggies — for another day,” says Dumaual.
Clear candy This includes clear sucking candy such as Life Savers and even clear gummy bears, says Dr. Greenwald. “Again, avoid anything red or purple because it can look like blood in the colon,” he says.
Jell-O “While gelatin isn’t technically a liquid, Jell-O is great psychologically because it feels like you’re chewing on something,” Lee says. “It also stays in your intestines longer and makes you feel a little full, but make sure to avoid red or purple Jell-O,” she cautions.
Popsicles “Anything that melts will work,” Greenwald says. “So popsicles and lemon ices are great choices — again avoid any with artificial red or purple coloring.”
Downing the Prep
By most accounts, the least favorite part of prep is drinking the colon cleanse your doctor has prescribed. Pro tips include chilling the beverage, mixing it with some of the approved clear liquid drinks, drinking it through a straw, and alternating sips of the prep with sips of something more palatable. In other words, whatever works for you.
And that’s it. In the best of all worlds, you'll wake up after your procedure to the good news that not only is your colon polyp-free, but you did an A-plus cleanup.