The Day Before Your Colonoscopy Screening

What Should You Expect on the Eve of Your Colonoscopy Screening?

Colonoscopy Appointment
What should you expect on the day before your colonoscopy appointment?. Catherine Lane / Getty Images

What do you need to know and do on the day before your colonoscopy test? From your diet to your prep to the often anxious feelings the day before, let's talk about what your colonoscopy eve will be like.

The Day Before Colon Cancer Screening

Preparing for a colonoscopy often begins more than a day ahead of time. You may have been given a diet to follow with foods to avoid during the week. Yet most of the preparation is done the day before.

Knowing what you can and can't do, and carefully following the guidelines of your prep, makes it less likely that you will have to face this day again. Too often, people are not adequately prepared and have to go through this anxiety-provoking prep time yet again.

The information below is simply guidelines that most gastroenterologist's recommend. Keep in mind that your doctor may give your instruction that differ, and the advice of your physician should always be followed first. In addition, everyone is different, and the preparation can vary depending on other medical conditions you may have.

What Can You Eat the Day Before Your Colonoscopy?

The day before a colonoscopy, you will begin having only clear liquids, starting with either lunch or dinner. If you can see through the liquid, it is OK to drink it, with the exception of a few liquids containing certain dyes.

You cannot have any liquids that contain red or purple dye, such as grape soda, red and purple Kool-aid, or other drinks with artificial flavors If the drink could possibly be mistaken for blood, even if very dilute, it's not a good idea to drink.

It's also important to avoid any "almost clear" drinks, such as orange or grapefruit juice which contain pulp.

Examples of clear liquids that are OK to drink during your colonoscopy preparation include:

  • Ginger ale
  • Apple juice
  • White grape juice
  • Plain, clear soup broth
  • Seltzer or sparkling water

If you're looking for more options, you can check out this more comprehensive list of foods allowed on a clear liquid diet.

Approximately three to four hours before your exam, you will stop eating and drinking everything, including clear liquids.

What About The Medications You Take?

Most of the time you should take your regular medications as directed. One of the exceptions are some blood thinners. Since these can take time to leave your body, most physicians recommend stopping these a week or more ahead of time. Over-the-counter medications such as aspirin, Advil (ibuprofen) and Aleve (naproxen) should also be stopped well ahead of time. If you have been taking any of these drugs, or blood thinners such as Coumadin (warfarin) call your doctor right away as your colonoscopy may need to be rescheduled. Sometimes a blood thinner is continued even with the risk of bleeding, as the risk of not taking the medication may outweigh the risk of bleeding during a colonoscopy. These concerns should be worked out well ahead of time with both your regular physician and the physician performing your colonoscopy.

Iron supplements and fiber supplements should also be stopped well ahead of your colonoscopy.

It's important to note than there are nutritional and herbal supplements that can thin the blood as well. These should also be avoided for a week or two rather than simply the day before your colonoscopy.

On the morning of your colonoscopy some people are instructed to take their regular medications and some are told to hold these drugs. What is best for you will depend on the particular medications you are taking and the conditions for which you are taking them. Call your physician if you have any questions.

Your Colon Prep - How is My Colon Cleared Out Before Colon Cancer Screening?

In addition to having only clear liquids, you will begin your colonoscopy prep the day before your test.

There are several different preparation options.

Often, you will be taking a strong laxative (purgative.) You will be advised to drink one-half to one gallon of liquid laxative total, taken eight ounces at a time, approximately every 10-15 minutes, until all of the solution is gone.

Most people begin having bowel movements within one to four hours of beginning to take the laxative. For some people, bowel movements begin almost immediately, so once you start this process, don’t stray too far from the bathroom! In addition to watery stools, you may have a lot of gas, and bloating can sometimes be uncomfortable. Your doctor may prescribe a medication such as Reglan to reduce heartburn and nausea or Mylanta to reduce gas, but only take these drugs under the advice of the physician who will be performing your colonoscopy.

Enemas are also commonly prescribed as part of a bowel prep. There are many different types of enemas, and your doctor will choose the one which is most likely to result in cleaning your colon for best visualization. Talk to your doctor about any possible side effects.

Many laxatives have a taste which makes people hesitate to finish. You may wish to have a beverage on hand such as ginger ale which can cover some of the taste more effectively than water.

Here are a few tips of things not to do while prepping for a colonoscopy that may help if you find yourself needing a pep talk.

What’s Normal When I'm Preparing for Colon Cancer Screening?

It is normal to feel bloated, to have mild chills, and to feel a little dizzy when you first begin taking the laxative. This is due to the large amount of liquid you are drinking and the quick emptying of your colon. It is normal to have some cramping, and diarrhea is a normal part of the clearing out process, too.

It is not normal to vomit or to faint or pass out. If any of these things happen, call your doctor’s office right away.

The Importance of a Good Prep

The better your colon prep, the more accurate results your doctor can give you. Colon cancer is far too common, being the 3rd leading cause of cancer-related deaths for both men and women in the United States. Thankfully, screening colonoscopies are making a dent in those statistics. In fact, screening colonoscopies are thought to be one of the most significant advances leading to a lower cancer death rate than in the past.

Colonoscopies are unique among cancer screening tests in that they serve a role both in prevention and early detection. Early detection refers to the attempt to find cancer in the early stages when it is most treatable. When a colon cancer is detected on colonoscopy, it is often found in the earlier stages before it has spread, and is more likely to be curable.

Unlike other cancer screening tests, however, colonoscopies go beyond early detection to prevention. When a benign colon polyp—the type that can turn into cancer—is found, a colonoscopy provides the opportunity to remove the polyp before it has a chance to become cancerous.

Bottom Line on Preparing for Your Colonoscopy

Screening colonoscopies can lower your risk both of developing colon cancer and dying from cancer should you develop the disease. Visualizing your colon via a colonoscopy is an excellent way to detect precancerous or cancerous changes, but is only as effective as a colon prep allows. An inadequate colon prep can make results less accurate, or even make it necessary to reschedule your exam (and go through all of these steps again.)

Most people are extremely relieved after having their colonoscopy, and are glad that they made the effort to do a proper prep and follow through on their test. The day before your exam is likely the most important step as it prepares your colon for the test. Understanding the purpose of your exam and taking the time to learn about preparing for the test have been found to make a positive difference in colon cancer outcomes. In taking the time to read through this information you are well on your way!

Sources:

Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw Hill education, 2015. Print.

Kurlander, J., Sondhi, A., Waijee, A. et al. How Efficacious are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review. PLoS One. 2016. 11(10):e0164442.

Liu, Z., Zhang, M., Li, Y., Li, X., and Y. Li. Enhanced Education for Bowel Preparation Before Colonoscopy: A State-of-the-Art Review. Journal of Digestive Diseases. 2017. 18(2):84-91.

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