How to Prepare for a Colonoscopy

A colonoscopy — and the steps required to get one — can cause a spike of anxiety, but don’t worry. Understanding the health benefits and the correct way to prepare for this routine procedure can assuage any apprehension.

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Plus, if you have an upcoming colonoscopy, you’re in good company. More than 15 million people in the U.S. undergo one every year.

What Is a Colonoscopy?

A colonoscopy is an invasive procedure in which a physician places a long, flexible tube outfitted with a small video camera into the rectum. The camera allows the doctor to view the entire colon and search for abnormalities or changes that could be warning signs for colorectal cancer.

“A colonoscopy is the best tool to screen for colorectal cancer as the procedure lets a doctor examine the large intestine for polyps, growths inside your colon that can turn into cancer or detect colorectal cancer at an early and curable stage,” says Dr. Carol A. Burke, a gastroenterologist in the department of gastroenterology, hepatology and nutrition at Cleveland Clinic. “Removing polyps during a colonoscopy decreases the risk of colorectal cancer.”

Colorectal cancer, according to the American Cancer Society, is the third most common cancer (excluding skin cancers) and, for both men and women, the third leading cause of cancer-related death. However, colorectal cancer rates have been steadily dropping, thanks to screenings like colonoscopies.

[SEE: Colon Cancer Symptoms That Are Easily Overlooked.]

How to Prepare for a Colonoscopy

Adequate bowel preparation is key for an effective colonoscopy, says Dr. Paul Johnson, a colon and rectal surgeon at Methodist Le Bonheur Healthcare in Memphis, Tennessee. Proper prep increases the physician’s ability to detect small or flat polyps and decreases the rate at which they might miss polyps.

“In short, poor bowel prep means repeat colonoscopy,” Johnson explains.

The steps you need to take to prepare for a colonoscopy include:

— Three days before the procedure, cut down on your consumption of high-fiber foods.

— Consume a clear liquid diet the day before the colonoscopy.

— Drink prescription bowel-cleaning liquid the morning of and the day before the procedure.

— Arrange to have a responsible driver take you home after the procedure.

Three days before the procedure, cut down on your consumption of high-fiber foods

Fiber

residue, even small particles, can be harder to remove through suction during the colonoscopy. They can leave debris covering the lining of the colon, and the physician doing the colonoscopy can have more trouble seeing polyps, Burke says. So, a low-residue diet beginning three days before the procedure is a common standard.

High-fiber foods include:

— Beans.

Seeds (including flax, sunflower and quinoa).

Nuts.

— Multigrain bread.

Fresh or dried fruit.

— Popcorn.

— Salads.

— Vegetables.

[See: Colon Cancer Diet.]

Consume a clear liquid diet the day before the colonoscopy

A clear liquid diet often includes:

— Gelatin.

— Clear soup.

— Clear juices.

Water.

Tea.

— Coffee without cream or milk.

Drink bowel-cleaning liquid the morning of and the evening before the procedure

Bowel-cleansing liquid acts as a laxative to clear your colon, thus making it easier to detect any polyps. Burke says the recommendations are to:

— Consume the first half of the bowel preparation the night before the colonoscopy and the second half about four hours before a morning colonoscopy.

— For an afternoon colonoscopy, drink all of the bowel preparation in the early morning on the day of the colonoscopy.

— Don’t allow more than four to six hours between the ingestion of the last dose of the bowel-cleansing preparation prep and the start of the colonoscopy.

Consuming the bowel-cleansing liquid in a split dose results in “decreased intensity and duration of (bowel movements), less patient inconvenience, improved bowel preparation and increased … polyp detection rates,” according to research published in 2016 in the American Journal of Gastroenterology. Burke is one of the study’s co-authors.

Burke notes that once-stigmatized bowel preparations have improved because:

— The taste of the prescription bowel preparation liquids is more palatable.

— Liquid bowel-cleansing formulas are more efficient than they used to be, so you don’t have to drink nearly as much as you did in the past.

— Different bowel preparation options are available, including lower-volume preps — 3-liter, 2-liter and 10-ounce bowel doses, or even preparation tablets for some patients.

Ask your physician about the best bowel preparation options for you.

Arrange to have a responsible driver take you home after the procedure

A colonoscopy requires sedation, so medical offices will typically require you to have a responsible person — a friend or a relative — drive you home after the procedure once you’re discharged.

[READ: Everything You Need to Know About Colorectal Surgery.]

Emerging Research

Colonoscopies are largely considered the gold standard of colorectal cancer screenings. A 2022 New England Journal of Medicine study of about 85,000 people, however, has drawn attention in the world of cancer. This study suggests that colonoscopy screenings led to just an 18% reduction in colorectal cancer and no significant decrease in death.

However, both Burke and Johnson point out caveats. First, only 42% of participants underwent a colonoscopy; when additional analysis considered if all participants had undergone a colonoscopy, the results showed a 31% reduction in the risk of colorectal cancer and a 50% reduction in deaths. Second, this study was performed in Norway, Poland and Sweden. In the U.S., American Indian, Alaska Native and Black Americans are more likely to have colorectal cancer and more likely to die from it, compared to their white counterparts. Finally, it’s essential for physicians to stay in touch with their patients through follow-up appointments. This way, they can keep an eye out for any new polyps. The study didn’t include follow-up guidelines or data on whether participants and physicians were tracking polyp growths.

In general, colonoscopies are still one of the best ways to suss out colorectal cancer. So, if you’re at least 50 years old, according to U.S. Preventive Services Task Force guidelines, it’s a good idea to make that appointment.

[READ: 9 Exercises Men Should Do Every Day.]

More from U.S. News

Questions to Ask Your Oncologist at Your First Cancer Appointment

Colon Cancer Diet

Questions to Ask Your Doctor About Prostate Cancer

How to Prepare for a Colonoscopy originally appeared on usnews.com

Update 07/27/23: This story was previously published on an earlier date and has been updated with new information.

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