Have you ever heard anyone talk about having a colonoscopy? Usually it goes something like this: “The procedure wasn’t bad, oh but the prep was awful.” However, the prep is an extremely essential part of a colonoscopy, and if not done properly, often results in the need for a repeat procedure. To understand the significance of the prep, which consists of instructions to be followed in the days and hours prior to the procedure, it is not only important to be aware of the specifics of the regimen, but also to know the reasons a colonoscopy is done in the first place. During the procedure, a qualified physician will visualize the inside of your bowel. It is used to either screen for possible illness, to identify the cause of current symptoms, or to treat disease. The potential benefits of the procedure are great; so don’t let your concerns keep you from receiving needed medical care. Preparing for a colonoscopy means making sure you understand why you are having it done, what to expect, and what you need to do prior to your appointment to ensure that you get the greatest benefit from the procedure.
Why Do I Need a Colonoscopy?
In the United States, colorectal cancer (CRC) is the second leading cause of cancer deaths. However, in great part due to routine screening, both the incidence and the death rate are on the decline. It is recommended that all adults have a colonoscopy at the age of 50, and continue with repeat screening every 10 years. If there is a family history of CRC, your doctor will recommend screening to start earlier; and based on history and findings of each procedure, it may be recommended to have more frequent testing. Ultimately, if precancerous polyps are found and removed, cancer can be prevented. Removing cancerous lesions can prevent death.
In addition to cancer screening, there are a number of other reasons that your doctor may recommend a colonoscopy. If you experience blood in your stool, or have black stools, a colonoscopy will probably be needed to find the source of bleeding. It may also be necessary if you develop anemia with no other explanation. When diarrhea and abdominal pain do not respond to treatment and lasts for an extended period of time, it may be necessary to diagnose the problem with the help of a colonoscopy. Additionally, those with inflammatory bowel disease may need colonoscopies regularly to evaluate the progression of the disease and the effectiveness of treatment.
What Should I Expect?
When you arrive, you will have an intravenous (IV) catheter inserted so that you can receive fluids during the procedure. You will also receive either IV sedation or mild anesthesia so that you will not be aware of what is going on. The procedure itself is safe, and usually takes about 20 minutes. The doctor will use a flexible tube to visualize the inside of your lower intestines. He or she may take biopsies, or remove polyps, if necessary. Once you wake up, you will probably be given something simple to eat like crackers or juice, and when you are ready, you will be able to leave. However, you will need someone to drive you.
Preparing for the Colonoscopy
As stated before, properly preparing for your colonoscopy is key to having a successful procedure. It is important to follow the recommendations exactly as given to you by your doctor, because if you have any residual stool in your intestines, it could block your doctor from seeing a polyp, or other evidence of disease. Your doctor will give you specific instructions, but here are some general guidelines that you can expect. It will be best if you avoid foods high in fiber, including seeds and nuts, for about a week before the procedure. The day before, you will most likely be asked to not eat any food, and drink only clear liquids. This would include water, jello, chicken broth, apple juice – fluids that you can see through when held to the light. You should also avoid red liquids.
To clean your bowel, you will be given instructions to take laxatives. Sometimes these preparations come in a large container that you mix with liters of fluid; however, there are other laxatives that are commonly used now. Sometimes the entire prep is done the day before, while other doctors prefer to split it between the day before, and the day of the procedure. It is important that you follow your doctor’s instructions because they will have been tailored to meet your individual health needs. Remember, the goal of the colonoscopy prep is to cleanse your bowels as much as possible.
Once the laxative is mixed with a large amount of fluids, it may help to refrigerate it. However, don’t add ice or you will dilute it. Once you start drinking it, you will develop watery diarrhea. Some people develop diarrhea right away, and some hours later. Regardless, the goal is to end with liquid diarrhea that looks like urine. Then you will know you are most likely clean and ready for your colonoscopy. Once your prep is done, you will be asked to not have any food or drink for 4 to 8 hours prior to the procedure. Discuss this with your doctor, but you will probably continue taking any of your routine medications, such as high blood pressure medicine.
However, there are certain medications that can interfere or can cause concern. Nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen can increase risk of bleeding and should be stopped the week before the procedure. Your doctor may also ask you to stop taking iron for a few days. Anticoagulant medications, like warfarin or Plavix, should be discussed with your doctor. While they increase the risk of bleeding, stopping them could be life threatening. They should never be stopped without the recommendation of your physician.
So, now you know what to expect when preparing for your colonoscopy. The prep is definitely the most uncomfortable part of the exam, however it is essential to ensure a successful procedure. If you have any more questions regarding colonoscopies, including the prep, or if you have any other concerns regarding your gastrointestinal health, at Austin Gastroenterology, we are here to help. Call us at an office near you to set up an appointment: North Office (512) 244-2273, Central Office (512) 454-4588, and South Office (512) 448-4588. If you are an existing patient, you can request an appointment online.
