Let’s be frank. Many people find the very idea of an endoscope being inserted into their bottom unpleasant to say the least. For others, the thought of being tied to the toilet with self-induced diarrhea is, well, icky. It’s no wonder that studies show it often takes people several years to actually get a colonoscopy even after being urged by family, friends and doctors to have one! We procrastinate even though we know that colon cancer is the second leading cause of cancer deaths and that a colonoscopy can prevent colon cancer from even starting.
Most people who have had a colonoscopy will tell you that the worry is far worse than the actual preparation and test. The overwhelming majority of people are asleep during the procedure and new products have made the "bowel cleansing" easier. To help you get rid of your fears and get on with the idea of having a potentially life saving colonoscopy, we will go through the experience step by step and give you an idea of what to expect. We'll answer some of the most frequently asked questions -- and we'll answer them directly.
Why do I have to clean out my bowels?
A colonoscopy is the process of looking at your intestines and colon to determine if there are precancerous or cancerous polyps or tumors. A tube called an endoscope that has a camera on the end is what allows doctors to see inside. As the scope slowly moves through your large intestine, the doctor can see the lining of your colon. How well he or she sees potential problems depends on how clear your colon is. How clear your colon is depends on you and how well you prepare for the test. It’s that simple. If your colon isn’t completely clean, you may have to go through the procedure again.
Is preparing for the test as bad as they say?
Most people say that the preparation or bowel cleansing is the worst part of a colonoscopy. Don’t let horror stories cause you to delay having the test. Delays can mean cancer that could have been detected and removed, remains growing in your colon. Today the products for preparing your bowels have greatly improved over those used even a few years ago.
You won’t have to miss work the day before your colonoscopy. You can now start taking the cleansing mixture the evening prior to the test. But there is no getting around it -- you will have diarrhea that requires you to stay close to the bathroom the evening before the procedure. Starting the day before the test, you will also have to limit your intake to clear liquids.
What if I just don’t like the idea of an endoscope in my colon?
You will be given a sedative before the test is administered that puts you into a comfortable, drowsy, twilight sleep. By the time the procedure starts, most people are not even aware of what is happening. In fact, many people say getting the sedative is a wonderful experience!
The Typical Preparation
When you are preparing for a colonoscopy, you will need to carefully read and follow your gastroenterologist’s instructions. Outlined below is the general manner in which Riverside doctors ask patients to prepare for a colonoscopy. A word of caution—this is a typical colonoscopy preparation used by some Riverside doctors and is intended to show you what preparing for a colonoscopy is like. You should always follow the directions given to you by your physician.
Sample Colonoscopy Preparation: Bowel Cleansing
First the easy part:
SEVEN DAYS before your colonoscopy, here are your typical marching orders:
- Do not take iron supplements
- Do not take aspirin or other anti-inflammatory agents (you can take Tylenol)
- Do not eat corn, seeds, nuts and peas
- During the week before the big day, get your prescription for Moviprep (or other similar products) filled. Your doctor will have given you this prescription.
- Buy some drinking straws
NOTE: Your Riverside gastroenterologist will give you instructions about any medicines you take. If you are allergic to LATEX, let the doctor's staff know ASAP!
Not so bad so far, is it?
It’s the day before your colonoscopy and now it's time to get serious.
FIRST THING IN THE MORNING—mix your first dose of solution so it can chill in the refrigerator all day.
ALL DAY—follow a clear liquid diet. “Clear” means a liquid that you can see through. Don’t drink anything with red flavors, alcoholic beverages or dairy products. For example, you can have:
- Coffee without milk or cream
- Tea without milk or cream
- Sprite/ginger ale
- Bouillon or broth
IN THE EVENING:
At 6 p.m., begin drinking the solution you made in the morning. Every 15 minutes you’ll drink more of the solution until the full container is empty. Then you’ll drink TWO glasses of water or the clear liquid of your choice (about 16 oz). While the time may vary, within an hour you'll start making frequent trips to the bathroom.
Some tips from the veterans:
- Drink fast rather than sipping.
- Use your straw to help get it down quickly.
- While you are drinking the solution, remember that a study showed that 86 percent of people rated the taste “acceptable” or “satisfactory.”
- Staying hydrated can improve your recovery time from the colonoscopy.
Before bed, mix your next batch of mixture and let it chill in the refrigerator overnight.
Colonoscopy day is here.
What time you drink more of the liquid depends on whether your colonoscopy is in the morning or the afternoon.
If it’s in the morning, get up by 5 a.m. and drink the rest of your mixture as well as additional glasses of clear liquid. If you have an afternoon appointment, you can sleep until 7 a.m. and then drink your mixture. By now your trips to the bathroom should be producing a clear liquid. Put on comfortable clothing such as a sweat suit that’s easy to slip on and off. After the colonoscopy procedure you'll be drowsy from the sedative and you will want to make putting on your clothes as easy as possible.
See, that prep wasn’t so bad! Now, here’s a run through of what you’ll experience when you get to the doctor's office for your colonoscopy.
You’ll be welcomed by a receptionist, who will have you take care of some paperwork. You may need a photo ID and your insurance cards, so make sure you bring them.
At this point, your spouse or the person who will take you home can run some errands or simply wait. You’ll be here for about an hour or two.
The nurse will take you to a small private room and have you change into a gown. Nurses will set up devices so they can monitor your heart rate, blood pressure and blood oxygen level. Then they will start an intravenous or IV line.
You’ll receive pain relievers and a sedative through the IV line. This is often the last thing patients remember. The sedative puts you into a twilight sleep—a pleasant, sleepy, relaxed state in which you don’t feel or remember anything.
While you are in this sleepy state, the gastroenterologist will start the colonoscopy. A thin, flexible tube is gently inserted into your rectum and slowly eased into your large colon. Attached to the end of the tube is a light and a tiny video camera, which sends color pictures of your colon to a monitor screen. Because of the great job you did on cleaning your bowels, your gastroenterologist can see the entire colon wall and spot any growths or abnormalities.
The entire procedure takes about 20 minutes and maybe more if a polyp is removed. By the time you start to wake, the procedure is long over. You’ll be given time to recover but you’ll still be drowsy. This is why you need that ride home! Before you leave, the gastroenterologist will talk to you and tell you about the test and what he saw. It's time to go home and rest for the balance of the day!
Congratulations! You have just completed the most effective action you can take in protecting yourself from colon cancer. Now, help save another life. Go out and tell your family and friends to get tested, too.