I would like to start this blog by saying I’m sorry. You would think that after having colonoscopy available in San Antonio, TX for over 40 years and putting a man on the moon we would have come up with a better colonoscopy prep by now. The reality is there have been a few different colon preps available. At one time we had fleets and the tablet prep but due to patient safety concerns these are no longer readily available. This just leaves us with the dreaded “jug”. I know firsthand what taking a colonoscopy prep is like having had my first colonoscopy at age 40. It’s no fun. I watched Monday night football from the bath room.

However, having been on the other end of the colonoscope for over 10 years as well, I will tell you the bowel prep is one of the most important parts of the exam. There is nothing you can do as a patient that will increase your chances of a successful colonoscopy more than a good clean bowel prep. And why bother taking the time to go through a colonoscopy if you’re not going to do it right.

The preparation for your colonoscopy begins the day before your exam. I encourage my patients to start on a liquid diet by lunch time and push all the fluids you can. Just these fluids alone help jump start the process and keep you from feeling too hungry. If you tend towards constipation this is even more important. The actual colonoscopy prep itself comes in many different brands but they are similar in composition and effect. The ones we use are lower in volume but it’s still quite a bit to drink. Take it slow, add some flavoring, make it cold- whatever it takes to help it go down. I will admit it won’t rank up there as one of the most fun nights of drinking you’ve ever had, but it will have been one of the most important. And for most people, you only have to do this once every 5 to 10 years. If your bowel preparation is inadequate you may need it redo it in 1 year.

Colon cancer is still the second most common cause of cancer death in the United States and the only way I can help you prevent that is by finding and removing your colon polyps. The better you do with your prep for your colonoscopy the higher likelihood I have of finding those polyps. Polyps can hide behind food and stool and be missed. This becomes even more important as we talk about flat polyps that tend to grow in the right colon and have a higher risk of progression to colon cancer.

In closing, don’t think of the bowel prep for colonoscopy as the unpleasant experience it is made out to be. Think of it like going to the gym- it’s hard work while you’re doing it but it’s the price we pay to stay strong and healthy. Do it right. The life you save may be your own.

Written by: Russell Dean Havranek, MD