Preparing for a colonoscopy involves cleansing your bowels with a laxative formula, which can be done using over-the-counter laxatives. This is necessary to ensure your doctor can clearly see your colon and perform the procedure effectively. The process of preparing for a colonoscopy typically starts several days in advance, with changes to your diet and medication. You will need to follow a low-fibre diet and stop taking certain medications and supplements. On the day before the procedure, you will need to consume only clear liquids such as water, broth, sports drinks, and pulpless fruit juice. You will also need to take your laxative medication, which will cause diarrhoea and other gastrointestinal symptoms. It is important to stay close to a bathroom during this time.
| Characteristics | Values |
|---|---|
| When to start preparing | Several days before the procedure |
| What to stop taking | Certain medications or supplements |
| Bowel status | Empty |
| Diet | Clear liquid diet the day before the procedure |
| Laxatives | Bisacodyl (Dulcolax), Polyethylene glycol (MiraLAX), Sodium phosphate (NaP) |
| Additional items | Clear liquids, sports drinks, ginger, lemon |
What You'll Learn
- Stop taking certain medications/supplements days before
- Buy your bowel prep at least five days before
- Follow a low-fibre diet in the days leading up
- Consume only clear liquids the day before
- Take your prep pills as prescribed
Stop taking certain medications/supplements days before
Preparing for a colonoscopy involves more than just taking laxatives. It is important to stop taking certain medications and supplements several days before the procedure to ensure your safety and the accuracy of the test results. Here are some detailed instructions on what to stop taking and when:
Blood Thinners:
If you are taking any blood-thinning medications, consult your doctor about when to stop taking them before the procedure. Common blood thinners include Apixaban (Eliquis®), Clopidogrel (Plavix®), Warfarin (Coumadin®), and Rivaroxaban (Xarelto®). Do not stop taking blood thinners without consulting your doctor first.
Diabetes Medications:
If you take insulin or other medications for diabetes, you may need to adjust your dosage before the colonoscopy. Consult the doctor who prescribed your diabetes medication for specific instructions. Do not take certain medications, such as Metformin (Glucophage® or Glumetza®) or medicines containing metformin (e.g., Janumet®), the day before or the day of your procedure.
Iron Supplements:
Stop taking any iron supplements at least five days before your colonoscopy. Iron can cause color changes in your stool, making it harder for your doctor to clearly visualise your colon.
Anti-Diarrhea Medications:
Avoid taking medications that stop diarrhea, such as loperamide (Imodium®) or bismuth subsalicylate (Kaopectate®, Pepto-Bismol®), starting five days before your colonoscopy. These medications can interfere with the effectiveness of the bowel preparation process.
Fiber Supplements:
Discontinue the use of fiber supplements, such as Metamucil®, Citrucel®, or Perdiem®, at least five days before the procedure. Fiber supplements can affect the bowel preparation, leading to an incomplete cleansing of the colon.
Vitamin E:
Stop taking Vitamin E supplements at least five days prior to the colonoscopy. Vitamin E is typically found in multivitamins, so be sure to check the labels of any supplements you are taking.
It is crucial to provide your doctor with a comprehensive list of all the medications and supplements you are currently taking, including over-the-counter medications. This information will enable them to give you specific instructions on what to discontinue and when to ensure your safety during the colonoscopy.
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Buy your bowel prep at least five days before
To prepare for a colonoscopy, you will need to buy a bowel prep kit at least five days before your procedure. This is because your bowel must be completely empty so that your doctor can clearly see your colon. A colonoscopy is a test that lets your doctor see inside your colon (large intestine) to check for signs of colorectal cancer, such as polyps.
There are several different types of bowel prep kits available, which your healthcare provider can help you identify. These kits are oral laxative formulas that you will take before your colonoscopy to clear your bowels. They typically include osmotic laxatives (or hyperosmotic agents) and electrolytes. The osmotic laxatives trigger your bowels to draw in more water, softening your stools and increasing the volume in your colon, which then triggers muscle contractions to move everything out. The electrolytes are important to prevent dehydration and significant electrolyte deficiencies, which can have severe consequences.
When buying your bowel prep kit, you will need to purchase the following:
- Four Dulcolax® laxative tablets containing 5mg of bisacodyl each (not the stool softener).
- One 8.3-ounce bottle of MiraLAX® (238 grams) or the generic equivalent.
- Two 32-ounce bottles of Gatorade® (not red). If you have diabetes, use Gatorade G2®.
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Follow a low-fibre diet in the days leading up
To prepare for a colonoscopy, it is important to follow a low-fibre diet in the days leading up to the procedure. This is because your colon must be empty for the colonoscopy to be effective. If your colon is not empty, your doctor may not be able to see polyps or other problems, and the procedure may need to be repeated.
A low-fibre diet should be followed for at least two to three days before your colonoscopy. During this time, it is important to avoid raw (uncooked) fruits and vegetables, as well as whole kernel corn, including canned corn. You should also avoid whole grains such as oatmeal, brown rice, quinoa, and wheat bread. This includes foods like whole grain bread, rolls, pasta, and crackers, as well as high-fibre cereals. Instead, opt for refined white flour products, such as white bread, rolls, muffins, bagels, and pasta.
In addition, it is important to avoid seeds, such as poppy or sesame seeds, as well as nuts and nut butters. This includes foods like peanut butter, almonds, walnuts, and sunflower seeds. However, creamy peanut or almond butter is allowed.
You can also consume ripe, peeled fruits, such as apricots, peaches, cantaloupe, and honeydew, as well as canned or cooked fruits without seeds or skin. Some examples are canned peaches, pears, or pineapple. Fruit juice without pulp, such as clear apple or white grape juice, is also allowed.
For vegetables, opt for canned or cooked vegetables without the skin or peel. This includes peeled carrots, mushrooms, turnips, and asparagus tips. Potatoes without skin are also allowed. However, it is important to avoid raw vegetables with skin or seeds, such as cucumbers with seeds and peel, as well as cooked cabbage or Brussels sprouts.
It is also important to note that, in addition to following a low-fibre diet, you may need to make other dietary and lifestyle changes in the days leading up to your colonoscopy. This includes stopping certain medications and supplements, as well as following a clear liquid diet the day before the procedure. Always follow the specific instructions provided by your healthcare provider.
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Consume only clear liquids the day before
Consuming only clear liquids the day before your colonoscopy is a crucial step in preparing for the procedure. Here are some detailed instructions and information to guide you through this process:
Understanding the Purpose
The day before your colonoscopy, it is essential to consume only clear liquids. This is because your bowel must be empty so that your doctor can clearly visualise your colon during the procedure. An empty colon ensures that your doctor can accurately identify any polyps or other issues.
Clear Liquid Diet Guidelines
When following a clear liquid diet, it is important to remember that you should only consume liquids that you can see through. Here are some specific guidelines to follow:
- Do not eat any solid foods for the entire day before your colonoscopy.
- Drink at least 8 ounces (about 237 millilitres) of clear liquids every hour while you are awake.
- Avoid drinking anything red, purple, or orange. These colours can discolour the lining of your colon and hinder the doctor's visibility.
- Stay hydrated by drinking a variety of clear liquids, including sports drinks, clear juices (such as apple and white grape, and clear broth).
- Coffee and tea are allowed, but avoid adding milk, cream, or non-dairy creamers.
- You can have gelatin, hard candy, and ice pops, but choose those that are not red, blue, or purple.
- Avoid alcoholic beverages and opaque liquids like milk or orange juice.
Examples of Clear Liquids to Consume
- Clear broth, bouillon, or consommé.
- Strained fruit juices without pulp (e.g., lemonade, apple juice, white cranberry juice, and white grape juice).
- Clear sodas, such as ginger ale, 7UP, Sprite, and seltzer.
- Sports drinks, such as Gatorade and Powerade.
- Tea and coffee without any milk, cream, or creamer.
- Water, including carbonated (fizzy) and flavoured water.
Diabetic Considerations
If you have diabetes, it is important to pay close attention to your diet the day before your colonoscopy. Here are some guidelines to follow:
- Drink only sugar-free clear liquids to help manage your blood sugar levels.
- Check your blood sugar levels frequently and consult your healthcare provider if you have any questions or concerns.
- For people with diabetes, sports drinks like Gatorade G2 (not red) are recommended to help replace electrolytes lost during bowel preparation.
Remember to follow the instructions provided by your healthcare provider, and don't hesitate to contact them if you have any questions or concerns about your colonoscopy preparation.
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Take your prep pills as prescribed
Taking your prep pills correctly is an important step in preparing for your colonoscopy. Your doctor will advise you on the type and dosage of the pills you need to take, and it is important to follow their instructions carefully.
Currently, the Food and Drug Administration (FDA) has approved two prescription bowel preparation pills: SUTAB and OsmoPrep. Both are split-dose medications, meaning you will take half the total dosage the evening before your procedure and the remaining half on the morning of your colonoscopy.
If your doctor has prescribed SUTAB, you will need to take a total of 24 tablets, with 12 tablets for each dose. Here is a step-by-step guide to taking SUTAB:
The day before your colonoscopy:
- Open one bottle containing 12 tablets.
- Fill the provided container with 16 ounces of water.
- Take each tablet with a sip of water and consume all the water over 15 to 20 minutes.
- One hour after taking the last tablet, drink another 16 ounces of water over 30 minutes.
- Approximately 30 minutes later, drink another 16 ounces of water over 30 minutes.
On the morning of your colonoscopy:
- Repeat the above steps with the second bottle of 12 tablets, ensuring you complete the dose at least two hours before the procedure.
- Continue to consume only clear liquids until after the colonoscopy.
If your doctor has prescribed OsmoPrep, you will also take a total of 24 tablets, but the timing will be slightly different:
The evening before your colonoscopy:
Take four tablets with 8 ounces of clear liquids every 15 minutes until you have taken a total of 20 tablets.
On the morning of your colonoscopy:
Take four tablets with 8 ounces of clear liquids every 15 minutes until you have taken a total of 12 tablets.
In addition to taking your prep pills as directed, be sure to follow any other instructions provided by your doctor, such as dietary restrictions and guidelines for taking other medications. It is also important to stay properly hydrated by drinking clear liquids throughout the process.
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Frequently asked questions
You should start preparing for your colonoscopy several days in advance. You'll need to change your diet, stop taking certain medications, and buy your bowel preparation kit.
In the days leading up to your colonoscopy, you should follow a low-fiber or low-residue diet. Avoid high-fiber foods such as popcorn, beans, seeds, multigrain bread, nuts, vegetables, and fresh and dried fruit.
On the day before your colonoscopy, you should only consume clear liquids such as water, fat-free broth, sports drinks, and pulpless fruit juice. Do not eat any solid foods.
Follow your doctor's instructions carefully and take the prep pills exactly as prescribed. Stay close to the bathroom as the pills will cause diarrhea. Avoid eating or drinking anything in the hours leading up to your procedure.
