How to Have a Wonderful Colonoscopy
I’m in the middle of prepping for my fifth colonoscopy in 4 years. I just kind of almooooooost shit my pants. Even so, I’m starting to feel like an expert.
Despite my miscalculation on the way to the throne, I’ve actually become really good at this — I think. I’ve tried multiple preparations, had engaging discussions with my second, and really good, gastroenterologist, and I’ve come to some conclusions. Also, I am writing this because I have yet to have found all of these hot tips in one place, and I find myself replying to an email about once a month, giving this advice to a different friend each time. This is my effort to provide one good place. (Help me in the comments!) of course, I am NOT a medical practitioner, so consult one first, OBVI. I am a patient and a Librarian, that’s it! And, it’s my hope that if you have ANY FAMILY HISTORY OF POLYPS OR COLON CANCER, then you will contact your Doctor and get that sewer scope you need!
A little more background: I have had IBS for most of my adult life, following some pretty heavy teen trauma. But, IBS is not necessarily a symptom of colon cancer or polyps. I also had a pretty disappointing gastroenterologist, but that didn’t mean I couldn’t advocate for myself and get the first colonoscopy that I needed. Our conversation went like this: “Nothing I have been trying is working, and that includes a year of the GAPS diet and a year of the low FODMAPs diet.” Him: “Well, then I don’t know what to tell you. Do you want a colonoscopy or something?” Me: “I don’t know. Should I get one? You tell me — you are the literal asshole-Doctor!” (I could have used a comma instead of the dash there, as this was also true.) The asshole doctor was absolutely shocked to have found more than ten, very large pre-cancerous polyps in my colon during my first colonoscopy. I was shocked and scared, but relieved, they had been found and removed.
My brother, the cancer researcher, was not. He was not shocked, that is. It was only AFTER the colonoscopy that my brother remembered that he had come across evidence that our maternal grandmother had had polyps removed later in life. He should have sounded the alarm, and we all should sound the alarm if any of us have increased risk factors. Colon cancer, if detected early, say in the stage of polyps/precancerous, is incredibly treatable. And, it’s treatable in a colonoscopy. (I have a new, excellent gastroenterologist that was referred to me by a naturopath. Referrals are a great way to find great care.)
Are you on board yet? Good! Let’s just get to the how-to’s then!
#1. Resources. My favorite resource for getting ready for the first colonoscopy was this blog post. It really helped me prepare for the worst, which wasn’t so bad, which made me feel even better. Once I got that better gastro surgeon, my favorite resource was the handout they gave me about two months in advance. Do not ignore that handout until the last minute, as you need to adjust your lifestyle about a week before your procedure. And, like most things, the better your pre-production game, the better the whole show will run!
#2. Learn more about your options for “Preps.” This refers to the nasty-ass shit you will drink, possibly along with pills, to clear out your poop chute. I have tried GoLYTELY, SuPrep, MoviPrep 2X, and am now doing the one that works best for me- a MiraLAX Prep. SuPrep was the smallest amount of terrible fluid to drink but did not work well for me. MoviPrep was voluminous and nauseating but worked well. GoLYTELY was extremely voluminous and wretched AF. The MiraLAX Prep is the least nauseating (I just mixed it with yellow, then green Gatorade) and also as effective as the MoviPrep. But, I had to get permission from my gastroenterologist ahead of time, and he needed to review my risks heavily. MiraLAX is NOT FDA-approved as a bowel prep and has its own set of risks that you ABSOLUTELY need to talk to your doctor about. But, know your options, and ask about the risks of each. I learned of the MiraLAX prep and how most patients found it more tolerable from this study. I took it with Dulcolax as indicated in the study. I basically followed the MSK instructions to the letter, with my Doctor’s approval. Drink your prep cold, and through a straw, if you can. We love those double-walled, insulated, and measure-including hospital mugs, and it turns out you can buy one yourself. Although, I think this is a thing that gastro offices should provide to each patient before their procedure, as it is easier for them to buy in bulk and perhaps a good branding opportunity? (People love swag!)
2021 Update: There is now also a prep pill called “Sutab” to ask your doctor about. I have not tried it, but I would assume it is better than any of the liquid preps: https://www.ccalliance.org/blog/prevention/new-colonoscopy-prep-tablet-approved-fda
Also, when you begin the prep, consider whether you should really be starting the prep late in the evening and trying to go to sleep when you still need to be shitting. It’s horrible. Ask a nurse or your doctor how early you can start the prep in the interest of sleeping without shitting your bed. Also, just take that whole day off, and work from home/the shitter if you can and/or have to.
#3. What to ingest, and when to start the liquid diet. Everything is going to go a lot better for you if you can start a liquids-only diet a little earlier than your team may recommend or require. It’s not fun, but if you can stop eating solids after breakfast two days before the procedure, you will be more grateful to yourself during the prep. You have to start eating a basically wonder bread and garbage diet (aka “low-residue”) about a week before the procedure, and this may throw off your rhythm and normal pooping schedule. Here are some things that worked for me:
Bone broth! (or any broth.) It’s so healing and good, really helps with the
violent feeling you may get from the prep experience. You can add some
unflavored gelatin- I used a nice grass-fed brand to get an extra hit of
protein, which makes you feel more full as well. Having a bunch to recover after the procedure is really nice and soothing as well.
Jello made me feel extremely sick. If you do not like jello, then don’t try to suddenly like it! Also, make sure you are fully aware of what colors you cannot have at all so you don’t fuck with the camera (usually red and purple, sometimes orange as well.)
Hard candy right after drinking a serving of the prep. I also had a few gummy candies that were not red or purple on hand, but the sweetness started to sick me out like jello.
#4. Other helpful things:
Heating pads, electric blankets, and something soft on your bathroom floor may all feel extra nice during the vulnerable time of pooping until you are peeing out of your butt. Maybe it’s just me, but all that fluid and pooping really gives me the chills. I just want to lie down under an electric blanket.
Tucks pads or witch hazel, and wipes. Butt cream while you’re at it. And, a good dose of pre-party butt cream is a great idea. Because RIP the skin around your butthole- this is going to be rough. Even better- a bidet, which could run you less than $30. This was my first year with that option, and it was a welcome change-up. I’m not crazy about buying wipes and other wasteful and environmentally shitty products, but I also just don’t use those products regularly to feel too badly about needing them.
No creams, lotions, deodorant, or contact lenses to the clinic. No jewelry either. This just makes the anesthesiologist’s job easier all around. If you do wear contacts, wear glasses, and don’t forget to bring a case for them. if you’re a menstruating person, it is safe to wear a tampon. Other than that, you should also only need your insurance card and an ID, and then your person. Most places won't let you take a cab or Lyft home after, let alone let you drive yourself home, so you will need a person that gives a shit about you to make sure you get home safe and sound.
As far as the procedure itself, and what to expect, talk that through with your doctor as YMMV depending on your risk factors and their established practices at the clinic. In my experience, each procedure was easy enough, despite getting less than pleasant news every time (polyps, polyps, polyps, and more polyps!), and recovery was almost immediate. I’ve even eaten Hawaiian food for dinner after three of my procedures. (Not sure I’d recommend…)
