Navigating a Colonoscopy: A Step-by-Step Experience

Colorectal cancer is one of the most preventable cancers with proper screening, yet screening rates remain well below a target of 80% in the United States.¹ Colonoscopies remain the gold standard out of the all various screening modalities available because it is the only one that allows for the removal of polyps during screening, preventing them from developing into cancer.¹

Among top reasons for avoiding colonoscopies is fear that the test is difficult or painful. Let’s bust that myth!
The worst part of a colonoscopy for most people is the prep, but the truth is that it really isn’t that bad. However, this step is critical because without a good prep, the procedure may have to be repeated.

There are other prep options

Most people don’t know that there are many preps available, and the one prescribed is usually dependent on what the clinic uses. However, it is worth talking to your doctor about which one works best for you so that you have an effective prep. Most people prefer preps where you don’t have to drink so much of the prep mix, others prefer pills instead of the prep mix, and still others may want something with minimal taste. Whichever you prefer, just remember that you have a choice.

Making prep as comfortable as possible

It is helpful to gather all the supplies you need in the bathroom, and to have a bathroom just for yourself if possible. Examples of what you may want to have are extra soft toilet paper or baby wipes, butt paste, disposable gloves, bottled water, a tablet or laptop, and a TV tray. I try to get my prep started earlier (closer to 3:00 pm) because it takes my body a little longer to get going, and this way I can get a good night’s sleep.

Some people like to chill their prep and use a straw because it minimizes the taste for them. I prefer to pinch my nose, chug it, and immediately chase it with something that will cut the taste like apple or cranberry juice. However you drink your prep, you will know that you have done a good job when there are no solids coming out and it is basically a light yellow-clear color.

It is super important that you stay hydrated while prepping because you are losing so much fluid, so make sure to drink water with electrolytes or use oral rehydration solutions starting the day before and continuing throughout prep.

If you have a “split-dose” prep, it means that you will have to drink the second half of your prep the morning of your colonoscopy. This can be uncomfortable for a lot of people because you can feel the “gotta go’s” on the way to the clinic. I put on a diaper instead of regular underwear so that I can relax on the drive rather than having to clench the whole way.

What to expect before the procedure

Once you check in, a nurse will start an IV in your arm. This will be used to put you under “twilight sleep” where you are sleepy, but still responsive. You will be comfortable and experience no pain. In fact, most people don’t even remember the procedure when they wake up!

While you are under, the gastroenterologist will insert the colonoscope (a tube with a light and camera on one end) into your rectum and go all the way through your colon to check for polyps or abnormal tissue. Air will be pumped into your bowel to make it easier to see inside. The colonoscope can also be used to remove anything of concern for biopsy. Finally, they will remove as much air as possible and withdraw the scope. Recovery is normally very quick, and you will usually be released after about a half hour in the recovery area.

After you get released

One thing to note when you leave is that you will not be allowed to be picked up by a rideshare like Uber or Lyft. You must have a designated driver, so make sure that you have that planned in advance. You will likely be very hungry since you have to be on a liquid diet and fast during prep, but I highly recommend that you do not plan on eating at a sit-down restaurant. You may be more comfortable ordering food to go, or having a meal prepared at home. Although they remove as much air as possible during the procedure, you may be more gassy than normal for the day.

That’s it! This may seem like a lot and you may feel a little overwhelmed reading all this, but I promise you that it is really not that bad. You will look back on the procedure after you are done and realize that once you get started, the rest falls into place. And remember, this could save your life!