Preparing for a Colonoscopy

(bouncy strumming music)

- Hello, I'm Dr. Lynn Butterly, and I'm here today

to talk to you about taking the prep for your colonoscopy.

You may have heard from many people that the preparation

is the worst part about a colonoscopy,

and for the vast majority of people, that's true.

Therefore, we're here today to talk about some tips

and suggestions that might make it easier for you

to take the preparation for your colonoscopy,

and to do a good job, which is extremely important.

Colorectal cancer is the second most common cause of death

from cancer in the United States.

Only lung cancer is more common in men and women combined.

On top of that, colorectal cancer is one of the few cancers

that we can actually prevent.

There are two major concepts in terms of cancer

prevention and early detection.

One is preventing the cancer altogether.

The other is detecting it early so that your survival

is prolonged and treatment is more effective.

Colorectal cancer gives us the opportunity

not only for early detection, because finding a cancer

early definitely prolongs your survival,

but beyond that, with colorectal cancer,

we can actually often prevent it from happening at all,

and the way we do that is by finding small growths

in your colon, called polyps, removing them,

and preventing them from having a chance

to grow into cancer.

So how do we do that?

Well the way we do that is that we do a colonoscopy,

which is a test using a long, thin tube,

approximately the size of your finger,

with a light on the end, bends in all directions.

It looks through your colon or large intestine

to find these small growths called polyps,

and then we can painlessly remove them

in a matter of seconds.

There is no feeling for removing a polyp,

and in that way, it prevents the polyp from having

the opportunity to later grow into colorectal cancer.

So that is true prevention, and therefore,

we want to make sure that our ability to do the colonoscopy

and find the polyps is as good as it can be.

So how do we do that?

Well, a very important part of that

is cleaning out the colon appropriately

so that we can see clearly and find the polyps.

As you might imagine, if you've ever had a sore throat,

when you go to the doctor, and they look

at the back of your throat, it would be pretty tricky

for them to see what that looked like

if your mouth were full of food.

So clearly we want your mouth to be empty of any food

so that we can see the back of your throat.

The same thing happens when you have a colonoscopy.

We need your colon to be really well cleaned out

so that we can find these polyps, even the small ones,

and have the best chance at removing them,

and therefore, have the best chance

at preventing you from getting colorectal cancer.

So, what we need in order to do that is a good preparation.

And that's why we're here today

to talk to you about some tips and suggestions

about how you can get through the prep.

Remember that whatever we say here may differ

from instructions from your own doctor,

and you need to follow the instructions

from your own doctor's office.

However, this will give you some tips and suggestions,

you may discuss them with your physician

if you think they would be helpful,

and utilize whatever your doctor feels would be appropriate

for you to use in taking the preparation.

There are several different types of preparation

for colonoscopy, but the one we're gonna talk about today

is a commonly used one, a four liter jug

of powder mixed with water.

I know it sounds daunting, but it is possible

to get through this prep, and we are gonna discuss

some tips and suggestions to try to make that

a little bit easier for you.

Usually your doctor will send you a prescription

and let you know where to pick up the preparation,

and you will then receive, as we said,

specific instructions from wherever you will be

having your colonoscopy done.

It's important to follow the directions given to you

by the center that is going to be doing your colonoscopy,

and remember that what we're discussing here today

are just suggestions to make it easier.

This is one way to do the prep,

and you can always discuss them with your endoscopist

if they seem to differ from the instructions

you get in the mail.

So you are going to pick up the preparation ahead of time.

You'll also wanna be prepared, have all your supplies

on hand so that you're not running out in the last minute

trying to get the things to make your test easier.

So here are some suggestions for getting

ready ahead of time.

First of all, you're also going to be on what we call

a clear liquid diet the day before your colonoscopy.

Clear liquids are liquids that are clear.

If you hold them up to the light in a glass,

you can see through them.

That's a good way to figure out if something

is a clear liquid or not.

So for example, orange juice filled with pulp

is not a clear liquid.

Examples of clear liquids that you do want to have on hand

would be, for example, apple juice,

white grape juice, ginger ale, other clear drinks,

jello, broth, bouillon.

Those are really good because if you feel cold

while drinking the prep, some broth or bouillon

may help you to feel warmer.

Some hard candies to suck on in between

taking glasses of the liquid,

and anything else that falls into a clear liquid category.

If you have questions, your endoscopy center can tell you

what constitutes a clear liquid and what doesn't.

Other things you might want to have on hand

are plenty of toilet paper, because this prep

does involve spending some time in the bathroom,

a magazine or book that you like,

any special wipes to use if you feel that those

make you more comfortable as you go along.

And anything else that helps you to feel comfortable.

It's only a few hours, and you want to make them

as easy as you possibly can.

In general, the way people take the prep

is to drink one glass every 15 minutes or so

until they begin to feel full.

Most people do begin to feel full

after a number of glasses, and at that point,

it's sometimes helpful to just pause.

Take a break, stop drinking for a while,

you can walk around, take your time,

in order to help the liquid to pass on through.

If you continue to try to force the liquid down

when you feel really full, it can result

in nausea or vomiting, that does happen sometimes,

but this is one way in which you might be able

to minimize that from happening.

As you begin to work your way down through the jug,

you will begin to notice as you pour glass after glass,

that fortunately the amount remaining is getting less.

However, as people get about halfway through sometimes,

they sometimes can feel discouraged.

It feels like a lot to do.

Just remember, the end goal is to have your colon

be really clean so that the doctor can find

all the polyps there are.

So don't get discouraged.

Take a little break.

Walk around if you need to,

and then come back to it, and you will know

that taking the prep and having a successful colonoscopy

has got to be easier than getting colorectal cancer.

So keep that in mind, try not to get discouraged.

You will make it to the end, and when you do,

your colon will be clear.

Now there's some other tips about taking the gallon jug

if that's the prep that you're taking,

and one of those is to split the prep in half.

So half the preparation, the afternoon and evening

before the test, and the other half or part of it

the morning of the test.

Not every endoscopy center gives these instructions

this way, and it is important to follow

the instructions that you are given,

but if you are given instructions for a split prep,

that may help you, because what you will be doing

is working on cleaning out the colon the night before,

trying to get a decent night's sleep.

There is liquid that reaccumulates overnight,

and therefore, taking a few glasses in the morning

can help to get that last bit of liquid out.

Remember to give yourself plenty of time for this,

because you're only drinking every 15 minutes or so

until you feel full, taking a break,

and then taking the rest.

And also, you want to finish the preparation

an hour and a half to two hours before you leave the house,

because you want it to move through you

while you still have a bathroom handy,

and not while you've gotten in the car

and are driving an hour and a half to your colonoscopy.

So keep that in mind, that finishing the prep

well before leaving the house is another helpful tip.

Now in addition to splitting the prep into two sections,

you want to keep the end goal in mind.

The end goal is that what you are passing

should look pretty much like what you're drinking.

If you are passing brown fluid of any kind,

your colon is probably not cleaned out enough,

and it would be a good idea to contact the endoscopy

center for instructions.

If you are drinking the second half

of the preparation on the morning of the test,

which you will finish well before leaving the house,

then your goal is to have what you pass

when you go to the bathroom look like pretty much

what you're drinking, or slightly yellow tinged, not brown,

no food particles, no other kind of particles, but clear.

One of the things that you can do if you don't like

the taste of the liquid is to flavor it

with a flavoring such as Crystal Light,

which is available in any grocery store,

comes in different flavors.

You want to avoid any red or purple-looking liquid

the day before the colonoscopy only because

we want to be sure that nothing appears to be blood

in your colon if there's no blood there.

That's the reason that your instructions

will probably say to avoid red or purple liquids.

So the Crystal Light comes in flavors,

and what we would recommend is that you obtain

several different flavors, because if you only use

one flavor, you will probably never want to drink

anything that flavor again for a good, long time.

So, give yourself a selection.

Don't add the flavor directly to the entire gallon,

because if you do that, you will be stuck

with one flavor for the entire drink.

What's better or more useful in many cases,

is to add the powder, the Crystal Light powder

to your glass of the prep, so you have the prep,

pour it into your glass, you're going to flavor it

with a little Crystal Light, you're gonna vary

the flavors of Crystal Light that you use

so you have a little bit of variety,

and for many people, that helps to get over the taste

and get through the preparation.

There are some other things that you can do

to this preparation to make it a little easier to drink.

One of the things is to remember that if you have it

in the refrigerator, and as you drink it,

you're getting shaking chills

and it just feels too cold to you,

you can take it out of the refrigerator

and let it return a little closer to room temperature.

On the other hand, if you're drinking it

at room temperature and it feels awful

and you'd like it to be cold,

you can put it in the refrigerator.

So in other words, you can vary the temperature

in order to make it a little more palatable.

Some people find that drinking through a straw also helps,

especially if they're starting to feel a little full

and maybe a little nauseated.

So you can take a break, you can then get yourself a straw

and begin drinking through a straw.

So straws would be another thing to have on hand

if you have trouble drinking large amounts of liquid.

Remember the objective is to have what you pass

when you go to the bathroom be clear,

looking a lot like what you've been drinking or like water,

or maybe slightly yellow tinged,

but no brown, no particles.

If you are passing brown liquid,

call your endoscopy center for instructions,

and that will help you to be cleaned out.

The other things we talked about are the clear

liquid diet, the broth, bouillon,

all the things you want to have on hand to help you.

You can take those the day before the test

and on the morning of the test,

but it will be important to have nothing by mouth

at least two hours before the procedure,

and those instructions may vary according

to your endoscopy site as well.

There are also very important instructions

about what to do with your medications,

which medications to take, which ones not to take.

If you're a diabetic, what to do with your insulin,

and it is extremely important that you have those

instructions and have spoken with your physician

and your endoscopy center so you know just what to do.

Then you just need to go to it, stick with it,

it will clean out your colon.

If you do the prep correctly, your doctor will have

the best chance possible to find any polyps that could

be within your colon, to get rid of them,

and to reduce your chances of getting colorectal cancer.

So keep the goal in mind, it is to prevent you

from getting colorectal cancer, and that's worth it.

So, here's to your health.