In honor of World IBD Day, I want to talk about colonoscopy prep.
Before I get started, let me write this huge massive disclaimer in bold font.
I am not a doctor. I am not a nurse. In fact, I am not a medical professional whatsoever. However, I have had Crohn’s Disease for over 20 years, during which I’ve had 3 colonoscopies (my 4th is soon), an endoscopy, and a flexible sigmoidoscopy. These are my experiences, NOT medical advice. If you are concerned about your colonoscopy prep, I encourage you to talk to your doctor.
Now that my disclaimer is out of the way, let’s talk about colonoscopies!
I am 28 years old. In the last 5 or 6 years, I’ve had 3 colonoscopies. My 4th one was supposed to be tomorrow, but I’ve had to reschedule it. I want to destigmatize colonoscopies and colonoscopy prep. It’s a common medical examination. While the prep can be unpleasant, there’s no reason to feel shame or embarrassment about getting a colonoscopy.
Related: “How Long Do You Poop After Colonoscopy Prep?” (And Other Questions)
This post contains a few affiliate links. If you click them and buy something, I might earn a small commission, at no cost to you. All opinions regarding colonoscopies are my own.
What is a colonoscopy?
According to WebMD, a “colonoscopy is an outpatient procedure in which your large bowel (colon and rectum) is examined.”
A gastroenterologist performs a colonoscopy. I see Dr. Quijano at GI North. According to their website, your gastroenterologist
“inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctors to carefully examine the intestinal lining… Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again.”
In other words, a doctor sticks a camera up your butt. This is probably why people don’t want to talk about colonoscopies.
But colonoscopies are like the great equalizers! Only half of us get pap smears and pelvic exams. The other half has to “turn your head and cough.” But most of us have rectums and colons and intestines! We can bond over this one shared procedure! Everyone in my immediate family has had at least one colonoscopy, and we openly joke about it.
Who needs a colonoscopy?
Me, obviously.
If your primary care provider refers you to a gastroenterologist, definitely see one.
If your gastroenterologist recommends a colonoscopy, definitely get one.
Otherwise, the following people need colonoscopies at some point:
- patients of Crohn’s Disease and/or Ulcerative Colitis
- anyone over the age of 50, when adults become at-risk for colorectal (colon and/or rectal) cancer
- adults with a family history of colorectal cancer
You know how you get mammograms at a younger age if you have a close female relative with breast cancer? Recommendations are similar for colonoscopies if colorectal cancer is in your family history. Depending on the details of who had colorectal cancer at what age, your doctor might recommend getting routine colonoscopies before you turn 50.
The American College of Gastroenterology has more FAQ regarding both colonoscopies and colonoscopy prep.
Colonoscopy Checklist
What is colonoscopy prep?
The day before your colonoscopy, you need to go through the colonoscopy prep. You know how hippie-dippie folks gush about “juice cleanses” that “detoxify” and “clean out” your colon? Yeah, those are all pretty much bullshit, but the colonoscopy prep literally cleans out your colon.
You spend a LOT of time on the toilet with increasingly watery diarrhea. Eventually you just shit liquid until you go to bed. It might be uncomfortable, but having a colon free of fecal matter is necessary for careful examination of polyps or abnormalities. You really don’t want an inconclusive colonoscopy–you might have to do the procedure all over again!
In addition to the colonoscopy prep, you also switch to a clear liquid diet 1-3 days before your procedure. In my experience, the diarrhea from the prep is not as bad if you start the clear liquid diet 2-3 days before the procedure.
Common colonoscopy prep options
Remember how I said that I’ve had 3 colonoscopies already? Yeah, for each of those, my gastroenterologist prescribed me a different colonoscopy prep.
This is the first dirty little secret your gastroenterologist might not tell you about colonoscopy prep.
You have options. There are multiple forms of colonoscopy prep, most of which work reasonably well. Yes, you will deal with watery diarrhea regardless of which option, but some forms might be easier for you to drink.
- 4 liters of a solution of polyethylene glycol (PEG): This is the first colonoscopy prep I ever tried. It is also the worst. The day before your colonoscopy, you drink 8 ounces of this solution every 10 minutes until you finish it off. Sometimes you might split this dose, drinking half of it the night before and half of it about 5 hours before your procedure. I forget what I used, but GoLYTELY Prep is one option.
- 2 liters of PEG solution: This is the colonoscopy prep I did last year, my first time trying a split dose. The evening before your colonoscopy, you drink the first liter of solution spread out over an hour, drinking about 8 ounces every 15 minutes. You then drink 16 ounces of any clear liquid. You repeat this in the morning, finishing at least 1 hour prior to your procedure. I used MoviPrep.
- Dulcolax and Miralax: This is my favorite colonoscopy prep so far. It’s the only one available with over-the-counter medications. The day before your colonoscopy, around 1pm, you take 4 Dulcolax (or store brand) tablets. Around 4pm, you start drinking 64 ounces of Gatorade mixed with a large container (8.3 ounces) of Miralax (or store brand). You drink about 8 ounces every 15 minutes until you finish the solution. This is the schedule that I followed, but there are variations using these products, including a split-dose schedule. There are risks associated with using Miralax as your colonoscopy prep, but your doctor might decide the benefits outweigh the risks.
- Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid: This is what I’m taking for my next colonoscopy. The day before your colonoscopy, you drink 5 ounces of this solution. Then you drink 5 8-ounce servings of clear liquids. The morning of your procedure, you drink 5 ounces of the solution again 5 hours prior to the colonoscopy. You also drink at least 3 8-ounce servings of clear liquids, finishing at least 2 hours before the procedure. My prescription is for Prepopik.
Other colonoscopy prep options that I have not tried include phosphate solutions or phosphate tablets.
If you’ve had a colonoscopy before, and you greatly struggled with the prep, talk to your gastroenterologist. You might have other options depending upon your age and medical condition(s). Not all options are suitable for all patients, but apparently I’m fine using at least 4 different preps. With some medical conditions, only one form of prep is safe to use, so again, talk to your gastroenterologist.
Update: The Prepopik was relatively easy to drink. I didn’t like waking up early for the split dose, but otherwise, this is a fairly easy form of colonoscopy prep. The split dose has become more popular to improve colon-cleansing before a colonoscopy.
Colonoscopy prep tips
Want to hear the second dirty little secret about colonoscopy prep?
You don’t necessarily have to finish the entire colonoscopy prep. This goes against doctor-prescribed orders, so do your best to finish the entire colonoscopy prep.
But if you’re starting to feel nauseated from the colonoscopy prep, you have alternatives. Still drink as much of the prep as possible, on the recommended schedule.
But you can also take a break up to an hour from drinking the prep, and then resume on schedule.
Assuming you’re not on the Miralax/Dulcolax prep, you can also substitute a solution of Miralax in Gatorade for the remaining prep that you can’t tolerate. I only drank about 3/4 of the PEG solution. I just couldn’t stand finishing the rest. Then I added Miralax to my 16 ounces of clear liquids (Gatorade) to complete my prep. This is also an option to consider if you’ve thrown up during your colonoscopy prep.
Your colon is sufficiently cleared when your diarrhea is clear yellow. In my experience, this happens before finishing the entire prep. Still drink as much of the prep as possible, but you’re fairly safe once your diarrhea is clear yellow. If your diarrhea is cloudy or brown, your colon is not clean yet.
Final advice: drink plenty of clear fluids. Any form of colonoscopy prep can easily dehydrate you. Avoid red, blue, or purple fluids. No alcohol.
Best clear-liquid snacks before your colonoscopy
You will get really bored of clear liquids. However, a little bit of creativity goes a long way.
Instead of buying pre-flavored JELLO, buy plain gelatin and make your own flavors. When you eliminate red, blue, and purple colors from your flavor choices, JELLO doesn’t have many flavors left.
I buy different clear juices at the store to make my own delicious gelatin. Try apple juice or white cranberry peach juice. For extra pizzazz, use sparkling white grape juice!
You can find the directions on your plain gelatin bag or packets to create your own easy, delicious snack. Because it needs to set for a few hours, prepare this before your clear-liquid diet begins.
Another common treat on a clear-liquid diet is light-colored hard candies. However, I’m not a big fan of hard candy. Imagine my delight when I realized gummy candy is a clear “liquid” too! Again, stick with the light colors. I treat myself to a bag of Haribo gummy bears and split it with Dan. During my colonoscopy prep is the only time Dan gets to eat the red ones–my favorite. I eat the clear gummy bears, yellow gummy bears (my least-favorite), and the orange ones.
I know this is a slight deviation from my typical blog posts, but colonoscopies are important. No one should feel ashamed or embarrassed to discuss gastroenterological health.
Do you have any questions regarding colonoscopies or colonoscopy prep? Check out my colonoscopy prep FAQs!
Do you have a colonoscopy scheduled in the next few days or weeks? Download my colonoscopy checklist! I’ve put together handy reminders for the week leading up to your colonoscopy, all of which will help your colonoscopy prep be as tolerable as possible.
This post is helpful! Not because I need the procedure, but because I am a nurse forever and always prepping inpatients for colonoscopies and it’s good to hear someone who has been through it explain it in detail. You could probably explain it better than I could, so thank you 🙂
Thank you! I hope you’ll share the link with anyone who needs extra advice.
This is a great explanation – I’ve had two colonoscopies so far and to be honest with you people made into this huge deal with the prep and it wasn’t bad at all. I try and reassure people that it isn’t bad either because people get so weirded out by poop.
I know constant diarrhea can be uncomfortable, especially for people unaccustomed to it. For me the worst part was trying to drink the 4 liters of nasty liquid for my first colonoscopy. That was pretty much the only option for awhile, so I’m glad that more prep types are available now!
Thanks for being so open about this topic! You’re so right that more people should be willing to talk about things. I haven’t had a colonoscopy but my mom has talked openly with me about them and her least favorite part is drinking the liquid the day before!
My dad just turned 55 and is trying to figure out colonoscopies. Thanks for the advice about how to the prep cleans out your colon and that there are multiple options. I’ll have to tell my dad so that he can consult with his doctor on the best prep for him. http://www.lincolnsurgicalgroup.com/colorectal-expertise
You’re welcome! I hope this will help him get the best prep option for him.
It also really helps to lighten your diet at least the day before starting the prep, but a few days before is even better. Besides jello, chicken broth is excellent for helping the prep go down.
From what I’ve read, you should avoid grapefruit juice during your prep. I don’t know if no pulp, white grapefruit juice is okay. You can ask your doctor for clarification.
Great article!! I’m scheduled for my colonoscopy in the morning but couldn’t finish the 4L of Golytely. I tried and got about halfway through it – even mixed some Crystal Lite into it. I called to cancel and when I reschedule, I’ll ask about other options. I don’t remember my hysterectomy prep being this bad. I’ve been fighting a cold and woke up this morning with body aches/chills and nose was stuffed up. Also, I’m scheduled for gallbladder surgery in 2 was and that was bothering me as well so I just felt yuck y’all around but I tried ;(
And plus one for sipping broth as an alternative to sugary clear liquids. When you cannot stomach any more white grape juice….
Ok so how did it go with Prepopik? I’m very nervous about taking this as I have mild vertigo and anxiety from menopause! I read this can make you dizzy! I have the option of using the Miralax. What did they put you “out” with? I’m so afraid of waking up dizzy! I’m supposed to do the split dose. I’m afraid I will “go” on the way to the appointment leaving the house at 11:30 am. Any help would be great….I’m afraid.
The Prepopik was really easy to take. I had no problems.
I went under general anesthesia. You wake up in a hospital bed. It’s a little disorienting at first, but they give you as much time as you need to recover, and they take you to your car in a wheelchair. Obviously someone else has to drive you.
Just follow the timing of the split dose correctly. You do the morning dose far in advance of your appointment, giving you plenty of time to use the bathroom at home. My drive to the outpatient center was about 45 minutes, and I didn’t have any urgency or accidents, although I did use the restroom one more time at the outpatient center.
Good luck! You’ll be fine. You can always discuss your nervousness with your doctor’s office. They might have some advice to soothe your concerns.
My positive experience with my first colonoscopy.
I would like to share how I prepared for my first colonoscopy.
I was prescribed “GaviLyte –N.” The concoction comes in a powder-form sealed in a gallon (128 oz.) jug. When I was ready to mix the water into the jug as directed, I used bottled “spring water” at room temperature. Once I added the water, I shook the jug until the powder was dissolved. Then placed the jug in the refrigerator to cool. I did not use the “flavor pack” that was provided with the “GaviLyte –N.” I decided to taste the solution without the flavor pack, to test if I could tolerate the taste.
I then mixed up a concentrated solution of a half package of “Crystal Light” powder, to one cup of spring water that I placed into the refrigerator to cool.
I purchased “Dulcolax” as perscribed, Seagrams ginger ale, white grape juice, lemon and lime freezer popsicles (similar to Italian ice, but on a stick), “Lemonhead” lemon drops, chicken broth and jello.
After eating a small meal, 36 hours prior to the procedure, I took 2 tablets of the “Dulcolax” before bedtime. At this time I started with clear liquids only. I was hungry, but I feel having only a liquid diet for 36 hours helped make my outcome easier.
The day of the prep., I took 2 more tablets of “Dulcolax”, as directed, 4 hours before I started to drink the “GaviLyte –N” prep. solution, and continued with only clear liquids.
I had a 16 oz. glass and filled it each time with the cold “GaviLyte –N” solution.
I would take a small amount of the concentrated “Crystal Light” in my mouth and swish it around for a few seconds before swallowing it. Then I would drink the glass of the “GaviLyte –N” prep. solution in 2 steps ( I could not gulp 16 ozs. all at once,) so I would use the “Crystal Light method” again until the glass was empty.
I followed this routine until I had pale yellow bowel movements, which took approximately 5, 16oz. glasses of the “GaviLyte –N” preparation. I then took one more 16 oz. glass, just to make sure my bowel movements were clear. I drank a total of 96 ozs. (3/4 of the jug) of the “GaviLyte –N” solution.
In my opinion, the “GaviLyte –N” solution tasted salty and maybe a salt/baking soda mixture. It smells a bit like sea water with something metallic element mixed in. It smells worse than it tastes.
During the prep. time, I had plain chicken broth warming in my mini crockpot, drank “Seagrams” ginger ale and had some orange and watermelon jello.
I did not use the white grape juice or the “Lemonhead” lemon drops.
I had 2 lemon popsicles and ginger ale after the prep. was complete.
I drank a total of 96 oz. of the “GaviLyte –N” preparation ( 3/4 of the jug). I went to the bathroom for bowel movements about 15 times. I also got up several times that night to go to the bathroom. You will go to the bathroom until all the preparation is out of your intestines. Then the urge to go is gone.
I was pleasantly surprised how well this prep went for me. I expected to feel horrible most of the day, vomit, gag and feel generally ill. I was really scared about this whole prep. ordeal.
I had researched everything possible on the internet, watched way to many youtube videos, and read blogs like this one for ideas on how not to gag or vomit while drinking this solution.
I did not have any of the negative effects from the “GaviLyte –N” I never felt nauseous, did not gag, vomit or feel any extreme bloating or pain.
I did have some body chills through out the day. I had taken a shower, put on a heavy fleece nightgown, socks and slippers and was comfortable.
The gastroenterologist said my prep. was excellent. I told the doctor what I had done with the “Crystal Light” and he mentioned I should post it on a blog.
My procedure went well. One small 5 mm polyp was discovered, which was removed. I felt a bit groggy afterwards and went home to rest. I could not have driven a car even if I had wanted to. It is important to make sure you have a ride.
These are just suggestions and my personal experience to help make this procedure tolerable. I hope you have a successful preparation and colonoscopy procedure.
I somehow came across this blog ppst while googling can you take too much bowel prep lol
I have had 2 colonoscopies, two endoscopys and one sigmoidscopy.
And once again Im sitting here doing a bowel prep and remembering I hate it so much! Im only in early 30s and think colonoscopies should be talked about more. Your blog post had me laughing so thanks for that 🙂
Love,
another girly with a diseased gi tract ❤
I’m glad I made you laugh! Two of the tests that contributed to my Crohn’s diagnosis were an endoscopy and a flexible sigmoidoscopy, but since my inflammation is in my ileum, I haven’t had those tests repeated. Now I just get a combination of colonoscopies and MREs. The MRE solution I have to drink is so bad that it makes me miss barium swallows!
thanks for sharing! i start a 3 day prep on sunday… did you find yourself feeling pretty weak? did you feel like you lost a lost of weight … and felt light headed?
When I start the clear liquids really early (72 hours before my appointment), I lose about 5 lbs, but I gain 2-3 lbs back within a week of eating normally. When I start the clear liquids just 36 hours before my appointment, I don’t lose any noticeable weight.
I’ve never felt light-headed during colonoscopy prep, and that includes being on clear liquids while rehearsing for a musical! So singing and dancing for hours with only clear liquids in my belly. If you start feeling light-headed, that’s most likely from not eating enough. Drink lots of broth!
I had a colonoscopies 3 months ago and well while the prep went somewhat okay lol I struggled with it I’d MoviPrep it was horrible to drink took me so long to actually drink it I thought I’d never get to the end. I think it was harder to drink so much because I’ve had surgery to remove half of my stomach. Anyhow I finally finished it and went in to get it done I can’t be put to sleep as I’m Allergic to anaesthetic so I was given Sedation Instead thinking that be grand I won’t remember mmmm well that didn’t go to plan I was in so much pain they had to stop and I wasn’t able to have it done. Now I’m back to the start taken prep again this time fleet soda while I drink less with this I actually vomited with this one none stop I guess I’m not having any luck lol. But seems to be still working as when I go to the bathroom it’s clear thank god. This time I’m having a ct colonoscopies hopefully this one is better option for me. I wish their was an option without drinking lol. On the plus side I lost 8pounds 😂 the reason why I have to have it done is because my iron is staying dangerously low even after a transfusion and I’ve a strong history of colon cancer in my family too.
Thanks for writing this up it made me laugh how you explained it all I am one of those that finds this embarrassing.
I’m not to worried about the prep, but i’m very nervous about being put to sleep. I have never been put to sleep, is it safe?
I’ve been under anesthesia multiple times over the last 22 years, and I’ve never had a problem. Just be diligent to follow all instructions regarding food/liquid intake–having an empty stomach isn’t just about cleaning out your colon, but also to protect you while under anesthesia. I would also write down all your medications in advance of your appointment. The anesthesiologist needs to know what medications you take to put together the right dosage, and it’s just easier for you if you write them down in advance.
I’m have a colonoscopy 2 days after Christmas. The doc knows i dehydrate very easily and always end up in the ER days after the procedure. I’ve been existing off 5oz baby food, saltine crackers and smartwater for over 5 months. Already been transported to hospital 2xs for dehydration. The prep he has given me is horrific. A total of 14 senokot pills. 4 bottles of magnesium citrate and 567 mgs of miralax mixed with water. I can not do this. I’m not constipated.. I go to the bathroom. I’ve already lost over 40 lbs and I’m extremely weak. If he makes me do the extreme prep I will be rolled out of here on a gurney. And i can’t make him understand!
Do you have any way of getting a second opinion? If you dehydrate easily, a doctor should help you take precautions to be safe during the colonoscopy prep.
The colonoscopy prep isn’t for constipation; it’s to clean out your colon thoroughly, to make sure nothing remains.
Thank you SO much for the great options and tips!! I went in for a colonoscopy this week, but they couldn’t do it because (my bowels) weren’t clear enough. Maybe I shouldn’t been so honest in telling them I couldn’t drink 64oz of the Miralax with Gatorade. I can’t drink 64oz of ANYTHING in a day! They told me to go home and start OVER?! 🤔 I told them I’m half way there, but they insisted on this. So, I chose not to do it for now, I was “starving” and week. All I wanted to do was EAT, EAT, EAT! And that’s what I did, but unfortunately I also had accidents with diarrhea for days afterwards. Just a horrible, embarrassing and awful week. When I actually do this, I will probably chose the Sodium Picosulfate prep. Thanks again, I truly appreciate it!
You’re welcome! I hope your next attempt is successful.
Can’t seem to find where to buy prepopik, Anyone know where. I live in Virginia, US
Prepopik is a prescription. If your pharmacy doesn’t have it in stock, they should be able to get it within a few days.
I am so excited about the Gummies.. Today begins my 36 hour fast– OOH Gummies, here I come 🙂 TY