Preparing for Your Colonoscopy

Doctor and patientA colonoscopy is usually not the highlight of anyone’s schedule, but if your doctor is recommending one, then the steps involved to prepare for it are important when considering the long-term health benefits. Fortunately, advancements have been made that provide people with more bowel prep medication options. 


Performing colonoscopies can help diagnose and monitor inflammatory bowel disease (IBD). People with IBD often need colonoscopies more frequently than the general population as the test can be vital to help accurately monitor disease activity and check responses to therapy. Some IBD patients also have an increased risk of colorectal cancer1, so doctors may advise more frequent colonoscopies to help detect and address any precancerous changes in the colon. 


During a colonoscopy a flexible tube with a camera attached is inserted into the rectum and navigated along the length of the large intestine or colon to provide direct visualization of the lining of the bowel. If needed, instruments can be passed through a channel within the tube and these can be used to remove polyps and sample (biopsy) tissue.  


The key to a successful colonoscopy is an effective bowel prep which ensures the ability to see the lining of your bowel. Being proactive, well informed, and discussing your potential bowel prep medication options with your care team are the best ways to both optimize your colonoscopy preparation while making it less stressful.


Getting ready for your colonoscopy 

Your doctor will recommend a bowel prep medication and provide instructions for your colonoscopy.

Review these instructions two weeks in advance so that you have time to get your questions answered and to plan ahead. It is important that you follow instructions given by your doctors which may involve a low fiber diet (avoiding raw fruits, vegetables, seeds, nuts, or whole grains) for a week prior to the procedure and a clear liquid diet on the day before the procedure. There may be instructions for how to take your medications in the days approaching your colonoscopy.


Then comes the time for cleaning out your colon. There are more than a dozen bowel prep medication options available. The active ingredient is a laxative, which activates your bowels to draw in water to flush out your colon. 


In many cases, the bowel preparation is given in two doses, also known as a “split prep” with half of the solution taken the evening before the colonoscopy and the remainder taken the day of the procedure, usually four to six hours before the colonoscopy. You should refer to the specific instructions given by your doctor to determine the dosing and timing of your bowel prep. 


Types of bowel preparations

Colonoscopy preparations fall into a few basic categories and can vary in the flavor and the amount of liquid you need to consume. 


The most well known are polymer-based formulas that contain a laxative – polyethylene glycol 3350 (PEG). They are usually available in powder form and are mixed with anywhere from one to four liters of water depending on which prep your doctor prescribes. The most widely known and used prep is a four-liter PEG-based formulation. In more recent years, new additions have been made to this market that offer lower volumes, as little as one liter of bowel prep medication.


Another type of bowel prep formula includes saline-based laxatives where the primary osmotic agent is sodium phosphate or sodium sulfate. Mineral salts like magnesium and potassium, which contain natural electrolytes, are also included. They can come in liquid, powder, and tablet form. These formulas may not be safe for people with certain medical conditions which is why your physician may lean toward one formula over another.

While all formulas now offer different flavors, the taste can still leave something to be desired. However, your doctor can provide you with ways to make it more palatable. Refrigerating the solution or drinking it over ice can help along with drinking it through a straw. 


Talk to your doctor about which bowel prep is right for you

In most cases, your doctor will make a recommendation for a bowel prep medication based on your medical history. If you have questions, that is the time to engage in a discussion about the different types of bowel prep medication,  and any preferences or questions you have regarding the taste, volume of liquid you will be drinking, etc. 


When you’re finished

If you have completed the preparation and your stools are not liquid yellow or clear, call your doctor’s office and find out if additional steps are recommended. If you are ready to go, give yourself some credit for taking the steps needed to take charge of your health and well-being.




Thank you to our supporter:


Salix Logo