Even though colonoscopy prep is a crucial part of the process, and good prep prevents you from having to get rechecked and do it all over again, it’s certainly not a pleasant experience.
But there are some strategies that can ease your discomfort as you’re getting ready for the procedure.
For those without IBD, the common instruction is to avoid raw fruits, vegetables, nuts, and seeds for at least half a day before the procedure.
But those with Crohn’s or ulcerative colitis tend to do well by following a liquid diet — particularly with clear liquids like broth, water, tea, even Jell-O — for the entire day before the colonoscopy, says Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center.
“I tend to prefer a whole day of a liquid diet for everyone,” he says. “But especially with those who have IBD, it can be a good prep strategy because it increases hydration and reduces risk of not having the bowel be clear.”
One important note is not to eat or drink anything that’s red or orange, Farhadi says. For example, you can have Gatorade, but choose the yellow or green variety, he suggests.
That’s because the prep will cause everything you consume to go through your system very quickly, without being absorbed. That means liquids keep their color in the colon, and a red drink can be mistaken for blood.
Until just recently, most colonoscopy prep was done in a fairly short window of time, with people starting the afternoon or even evening before the procedure and finishing their prep before going to bed.
But that’s part of what made it so notoriously unpleasant, says Dr. Peter Stanich, a gastroenterologist at The Ohio State University Wexner Medical Center.
“That type of standard prep was causing people to feel nausea, in part from the large amount of liquid they were ingesting at a time,” he says. “That’s led nearly all gastroenterologists to prefer a ‘split prep,’ which means you do half the evening and half in the morning before the procedure. That has made things much better.”
This works with all types of prep options, Farhadi adds.
So, even if the instructions on the bottle or the info sheet note that you need to have 8 ounces at a time continuously until you finish, you can still split up the prep and it’ll work just fine.
More good news: You don’t have to drink 8 ounces at a time, either. As long as you’re making progress in consuming the prep solution, you can drink smaller amounts while stretching out the time frame to do it.
Farhadi suggests starting earlier the day before a procedure, like late morning or early afternoon. Keep the prep in the fridge, he says, and drink some whenever you pass through the kitchen.
“There’s no rule that you need to drink a certain amount at a certain time,” Farhadi notes. “Especially if you’ve had nausea with prep before, take smaller amounts over a longer period of time. It will still work just as well, and you’ll likely tolerate it better.”
Although prep is sometimes flavored, many people find the taste only barely tolerable, and it’s worse when it’s warm, Stanich says.
That’s why keeping it in the refrigerator for a few hours beforehand, or even doing a quick chill in the freezer, can be very helpful.
Another way to cut down on that less-than-yummy prep taste is to use a straw, Stanich says. This is a favorite trick for those who’ve had multiple colonoscopies, like those with IBD, he says.
The straw allows you to drink the prep solution while “bypassing” most of your taste buds, as long as you do it quickly and don’t let the solution swish around in your mouth.
As you’re working through the prep, it can be helpful to get more movement so you can keep things moving. Maybe walk around your house a little more, or stand as you’re drinking the prep.
That said, don’t venture too far from the bathroom, Farhadi says.
“I wouldn’t go outside and garden or anything,” he says. “Especially as you start to get lower in the amount of prep you need to finish, you’re going to be very close to the toilet. So, be ready.”
“Colonoscopy prep is obviously no one’s idea of a fun time,” Stanich says. “But focusing on ways to make it easier can be helpful and make the process more tolerable.”
That’s especially true for those with IBD, since they may need to have colonoscopies more frequently to monitor disease activity and detect colorectal cancer or changes in the colon, according to the Crohn’s and Colitis Foundation.
Finding strategies that work well for you is a good way to reduce that sense of pre-colonoscopy dread.
If you’ve tried tips like the ones here and still struggle with prep, talk with your healthcare provider about trying a different type of prep solution or other tactics that can make the process easier.