How Important Following Prep Instructions Are before a Colonoscopy

No one gets excited about having a colonoscopy. But it’s not the actual screening procedure that most people dread; it’s the bowel prep. You’ve probably heard horror stories about bad-tasting laxatives and the constant trips to the bathroom, but it’s important to keep the end result in mind. The goal is to empty the colon completely so you can have a successful and thorough colonoscopy. What could be worse than going through the preparation and then repeating the whole process because the results were inconclusive?

If you want to have a quality colonoscopy, your bowel preparation is just as important as the skill of your doctor. During a colonoscopy, a flexible, lighted tube, called a colonoscope, with a camera attached to it is inserted in your rectum and guided around the bends of the colon. The purpose of a colonoscopy is to look for any abnormalities, including growths called polyps that can turn into cancer. Your gastroenterologist needs complete visibility of your entire colon in order to detect precancerous polyps, and this requires your full compliance with bowel prep instructions. Failure to comply can result in missed polyps and the development of colon cancer.

Before your first colonoscopy, you will have a consultation with your gastroenterologist to discuss important information regarding your personal health history and family health history. You will also receive specific oral and written instructions regarding your bowel preparation, and it is important that you review these instructions completely and ask any related questions.

There are many different types and brands of prep, but they all include a combination of the following: a clear liquid diet and pill or liquid laxatives. Your instructions will include a list of acceptable clear liquids that will not compromise the visibility of the colon lining. These liquids include: fat-free bouillon or broth, gelatin, strained fruit juice (no grape juice or any liquid with red color), water, plain and unsweetened coffee or tea, or diet soda. In addition, you will be instructed not to eat or drink anything after midnight the night before the procedure, and you may be asked to stop taking certain medications. Finally, your instructions will ask you to arrange for someone to drive you home after the colonoscopy because the sedation medication will make it unsafe for you to drive until the next day.

According to a study in The American Journal of Gastroenterology, gastroenterologists miss up to 8 percent of colon cancers during a colonoscopy (1 in 13). One reason for this margin of error is impaired visibility during the procedure due to inadequate bowel preparation. Besides impaired visibility, insufficient bowel preparation can cause:

  • Increased risk of complications
  • Prolonging of the procedure
  • Repeat examinations
  • Increased cost to patient
  • Missed wages

Colon cancer is 90 percent treatable when diagnosed in its early stages. People are advised to get regular screenings beginning at age 50 if they are at average risk for colon cancer. African Americans should be screened beginning at age 45, and those who exhibit risk factors for colon cancer or who have a family history of colon cancer should be screened earlier as well. Getting screened at the appropriate time and following bowel preparation guidelines are two of the best ways to prevent colon cancer and have a clean bill of digestive health!