Colonoscopy Prep Questions

I searched through the Zity site, and couldn't find answers to my specific questions below.

I have a colonoscopy scheduled for mid-December, and I need some feedback on the below for a very thorough bowel clean out ahead of the procedure.

As I stated in another post, I don't mind the golytly prep, or whatever top-down prep they prescribe.

In addition to the prep, I'd like to take the Miralax 3 or 4 days ahead of the colonoscopy day, as well as include a couple of colonics to the regimen a day or two before the procedure.

I am thinking it would be best for the colonics to be administered after the golytly prep, since the waste in my small intestine would be cleared out, and the colonic would clear any residual material from the small intestine. Would that make sense? Also, could I substitute the Miralax with magnesium citrate, or would that be in addition to?

I do not mind putting my digestive system through the wringer in order to make it as clean as possible. I do not want any complaints about the cleanliness of my colon.

I didn't mention the idea of the colonics to the GI doc, as I got the sense he might be against it.

Anything I missed, or any other suggestions?

Thanks in advance!

BBB

Whatever prep they prescribe is more than adequate for a clean exam. Additional laxatives and colonics may be fun -but aren't necessary for the exam.

Limit yourself to clear liquids for the 48 hours before the test.

Check with your GI doc. While I suspect this is not going to be popular on this site, one of the latest trends is just a low residue diet for 3 days prior to the procedure.

Check with your GI doc. While I suspect this is not going to be popular on this site, one of the latest trends is just a low residue diet for 3 days prior to the procedure.

Low residue for three days is not good enough. You need the saline or polymer solutions (like miralax or equivalent) for a good cleanse.

I had a colonoscopy a few years back and all i can say is the stuff they made me drink cleaned me out like dyno rod.....my colon was like a new brand new set of bag pipes.

Aside from making sure nothing is left to obscure a possible problem from the camera, if you enjoy a good cleanout, then a colonoscopy prep can be fun. We sometimes enjoy setting aside a weekend to clean each other out to the bare walls. But then, We use the anal fun a great foreplay, whether we play in her front door or both of our back doors. We also enjoy giving each other increasingly larger enemas during the weekend, and she goes wild when we fuck her with 4 qts in both our bellies.

Generally, you should follow your doctor's instructions. A three-day fast isn't enough. I've read the most effective preps that are pretty well tolerated are two-part:

A strong laxative to 'get you going' and pretty much empty you of the normally accumulated poo. Typically, this is either a bottle of Citrate of Magnesia or four Dulcolax tablets, but a strong dose of Senna or Milk of Magnesia or other things are sometimes used. It used to be Phospho Soda, but this has been largely discontinued. The laxative is generally given timed to make you start to poo before the second part of the prep is started.

The second part of the prep is usually a PEG solution flush. Two quarts to a gallon of solution is the typical dose. This is supposed to go through you quickly and wash out any soft poo not eliminated by the laxative. Sometimes a laxative med is added to the PEG, as in GoLytely which has Sodium Sulphate, a foul tasting saline laxative, built in. The. laxative is to speed up the solution passage

One reason for the laxative to start the prep is to reduce the bloating from the PEG solution. If just PEG is taken, it takes a while for enough liquid to build up in your colon to make you poo.

If you are constipated before a prep is scheduled to start, it's a good idea to take a laxative or enema the day before. I've had the experience of being fairly constipated, not having pood for about three days, figuring that the prep would solve the problem. For the prep I was directed to take four Dulcolax and start the PEG solution two hours later. Big mistake. My bottom end was pretty much plugged with poo and there was a lot of loose stuff, up higher urgently wanting out. Sitting on the toilet, badly needing to poo, but being unable to pass it out was no fun at all.

A couple of other hints. If you are taking PEG as part of your prep, don't drink it and lie in bed. It's much better to drink it down and stay sitting, or better walk around. That will speed the solution out of your stomach and through your system,, reducing bloating and reducing the desire to puke. If you don't do this, you may dribble loose water and poo for a long time. You want a 'flush with a gush' result.

Also, get a bidet bottle that can be filled with warm water. For example:

https://www.ebay.com/itm/500ml-Portable-Bidet-Sprayer-Personal-Cleaner-Hygiene-Bottle-Spray-Washing/174439736277

After you poo, use the bidet bottle to spray your bottom, trying as best you can to relax your opening so it gets washed a bit inside, and pat yourself dry. Your anus will be grateful.

I don't wish to complicate this any further, but I'm a 68 y/o retired physician who's also had many colonoscopies owing to my bad family history of colon polyps and colon cancer, plus multiple gastroduodenoscopies owing to serious lifelong GE reflux or GERD. Most went fine. Being an old anesthesiologist, I don't mind sedation so I've been asleep for them all with no problems or complaints.

I just want to make one point about preps. After one colonoscopy I had following an oral laxative prep, which I think was MgCitrate, my doctor told me that despite following all the prep directions exactly,, my bowel was not as prepped or clean as it should have been. He was able to work around it with more spraying and suction than usual.

So I'm just suggesting that additional preparations in addition to the instructions your doc gave you are in a gray area - might not be needed but may also help to improve your bowel cleaning. However, some things should be avoided. I've read some irritant enemas, even too much soap, may either mimic or even actually cause some colon reaction that looks like disease. That's also why I've always been told not to drink anything darkly colored brown or red during the prep as it can cause color changes in your colon mimicking colitis or inflammation on colonoscopy.

If I were you I'd tell your doc exactly what you're planning to see if she/he recommends avoiding anything like soapy or other irritant enemas. Just my 2¢ from my experience.

Eric

@ericmacson

There were a number of preps that used enemas some years ago, but they have pretty much gone out of favor. This may be because enemas, especially large volume bag enemas, are not nearly as common or accepted now compared to 50 years ago when they were common and routine.

However on can find some facilities that use them. or example:

https://www.gastroclinic.com/prep/colonoscopy-prep-using-bag-enemas/

Note that there is no mention of soap in any of the enemas. After the laxatives, it's unlikely you'll need anything to stimulate your bowel to empty it of poo. The laxatives will have done that. All that's needed is a wash to remove any remaining small bits of remaining poo and mucous, and plain warm water works just fine for that. I doubt it matters much if the water is taken by mouth, as with a PEG solution, or up the butt from a bag. The oral route probably washes the full length of your colon better, unless the enema is professionally given and over 2000ml.

BTW, if there are any enemas as part of the prep, the last one should be given at least a couple of hours before the appointment time. Water sometimes gets trapped up high and sufficient time for it to pass out and/or be absorbed before the colonoscope insertion is wise. A disposable diaper is not an unreasonable precaution too.

Also, I've had a couple of colonoscopies, both without any sedation. IMO, if the patient is wide awake, the doctor is a whole lot more likely to be gentle and careful. There was a bit of minor discomfort as the colonoscope went around the bends and a feeling of needing to fart a lot, but nothing serious, even when a polyp was removed. A plus is I was able to go home, after proving I could fart, without a companion or escort.

Sean,

I won't quote your long post just now but thanks for your new info and clarifications. There were definitely enemas recommended as part of colonoscopy preps and as I recall, the last one for me was requested of me in the mid-70's. None of them as you suggest ever included soap, but I brought that up only to warn potential users that I'd read about soap and perhaps other additives making your colon appear abnormal or confusing to a doc doing a colonoscopy.

Now as most here know, I'm an enema lover from half a century ago, but after the 1970's colonoscopy preps, I haven't used enemas but just the doctor-recommended prep regimen. Even though the enemas would be more fun.

Eric

You probably want to stick to the prep the doctor gives you!!

I just had my colonoscopy done yesterday morning. The three days prior to the exam I did a salt water each day of about between 1-2 quarts to clear away most of my bowels contents. I ate shrimp and scallops the last 2 days for dinner along with salad and steamed vegies. Had a 630am apptmt. So I did the sulfur prep starting a 5pm. Not much was left to clear away. I expected more. The second dose began at 230am and I ran clear. Everything went well and I was pronouced "normal".

I was provided with all that was required minus the Gator-aide. The prep required taking 3 ducolax tabs 2 hours ahead of time. Of course, I had to stop eating before all that to prepare for a 6:30 am evaluation. The laxatives got me moving my bowels but to be honest, I am super regular so it's not a big concern. I then began to drinking phase over what was 2 hours broken into two parts with a 30 min rest in between. Overall, i felt fine.

There's been an interesting development. The pharmacy called, and asked if the doctor intentionally submitted two prescriptions for the prep kit, instead of the usual one prescription. I told them that I had no idea if that was the doctor's intent or not. After some discussion, they went ahead and filled both prescriptions, just in case.

While I know the prep affects the levels of electrolytes, I'm wondering of a case of Gatorade would get me through two preps. Especially if they were implemented two or three days apart.

Just thinking out loud.

@ericmacson: If I were you I'd tell your doc exactly what you're planning to see if she/he recommends avoiding anything like soapy or other irritant enemas. Just my 2¢ from my experience.

Good advice! I've mentioned elsewhere that the prep's don't seem to clean me out enough perhaps because I'm become so use to taking strong soapy enemas. Should I ever go for another colonoscopy I'd ask the doc if my taking a soapy enema would cause a problem. I would not go into any details about my liking enemas.

Going in for my colonoscopy tomorrow. As I suffer from constipation I began my prep yesterday with a dulcolax and mag citrate. I have begun today with 3qrt plain water rinse and will begin the top down cleanout this afternoon. Any suggestions you can provide for a thorough cleanout would be appreciated as I want to make sure the prep is adequate . Last time the Dr. said my prep could of been better.

There's been an interesting development. The pharmacy called, and asked if the doctor intentionally submitted two prescriptions for the prep kit, instead of the usual one prescription. I told them that I had no idea if that was the doctor's intent or not. After some discussion, they went ahead and filled both prescriptions, just in case.

While I know the prep affects the levels of electrolytes, I'm wondering of a case of Gatorade would get me through two preps. Especially if they were implemented two or three days apart.

Just thinking out loud.

I'd call and ask your doc why you wound up with two kits. I'm a retired doc and never heard of that before. My only guess might be if it was really done because you had a poor prep on a prior colonoscopy.

Eric

@BigBagBoy

I'll offer another explanation for the double Rx order - Fumble Thumbs.

These days, most practices use an Electronic Magic Record [if you think it's a Medical Record, I have some prime land in Florida for ya!] and a double-click, or two staffers (you don't think your doctor actually does those things, do you?) overlapped and never noticed.

Another update. I called the GI docs office, and asked about the two prep kits. The office informed me that I would need only one kit, so one kit it is.

I'll do follow up enemas after the prep goes through me. Make my insides squeaky.

I was a GI Lab nurse for awhile. Usually we had the patients drink a bottle of mag citrate 6 hours before their scheduled arrival time. Between the mag and Golytely or Suprep, patients were cleaned out.

UCH I hate the prep for this thing. Twenty for hours before is fasting water and clear gelatin only to eat and the dreaded evac u kit. This comes with the directions on how to use it inside . The one I use does . Be prepared to dump waste like never before. If you can be sure to stay home or close to a toilet this thing means business. One time I was just going to have the test walking over with the gown on to the room with the Nurse and had a tremendous rumbling urge to dump I took off to a toilet. The fire alarm went off at the same time . I just went to the toilet any way. The Nurse that was bringing me over was given a bad mark for loosing a patient. It was just a fire drill. I heard that from the toilet. I felt bad about that. Possibly it would have been better to dump gallons of clear gelatin all over the floor.

When you drink the prep solution it should be compulsory to be in fishermens waders just incase the unexpected happens ......

When you drink the prep solution it should be compulsory to be in fishermens waders just in case the unexpected happens ......

Sounds like a very messy solution since any leakage is collected in your waders? If you need a leakage/diarrhea precaution why not just a Double Balloon enema Catheter inflated or a snug inflatable butt plug to keep it in before drinking it? Or even a diaper? I'm a longtime enema lover but only if I can expel it and stay clean except maybe my butt cheeks. No interest in seeing, contacting or even smelling it if you can avoid it.

Eric

So tomorrow is the big day, which means today is prep day. I re-read the prep instructions to be sure I fully understand the process. The doctor wants the first part of the prep to start at 5:00 pm this afternoon and the second part to start at 9:00 pm. So the final prep will not be early tomorrow before the procedure. However, I think if I time it out correctly, I can do a couple of enemas early in the morning before I go in. Also, I'm thinking I might be able to have at least one enema between the 5:00 pm prep and the 9:00 pm prep. Of course, that depends on how I feel, and how long it takes for the first prep to move through my digestive tract.

I definitely will be drinking lots of water to keep me hydrated, so a few gallons of water will be entering my body from both ends.

Follow up post.

Around 2:30 am, a few hours before the procedure, I got up and gave myself two enemas to feel fully cleaned out. The doc prescribed the SupPrep to be taken at 5:00 pm and 9:00 pm the night before. For some reason I did not feel fully cleaned out, hence the two enemas. The first was 4 quarts out of the 5 quart bag. I released the contents and the water came out 90% clear. The next enema, I drained the remaining quart of water. Once released, the water was yellow, with what I am assuming was bile. The bile was transparent, not opaque.

After that, I felt really cleaned out, and comfortable enough to go back to sleep.

At the surgery center, the intake medical specialist (I am assuming a nurse, but not sure) asked me about the prep. I told him it went well and I supplemented the prep with a couple of enemas. He nodded his head, and went on with the other questions required before the procedure began. At least he didn't act alarmed, or said anything to the negative about using them.

The procedure went without incident, however the GI doctor noticed I have diverticulosis but no perforation or abscess. Not bad news, just something to be aware of and address. On the paperwork, he noted I needed to have a high fiber diet, and a follow up colonoscopy in a year. I am actually looking forward to it. I also hope it's a yearly thing, not every 5 or 10 years.

For the endoscopy portion of the procedure, I was told to wait for the pathology report in two weeks. According to the paperwork, I have superficial gastritis without bleeding, and a hernia in my diaphragm, without obstruction.

Back to the colonoscopy. I have a virtual consult with the GI doc after the holidays. I intend to ask him about enemas and/or colonics before the procedure. The enemas really seemed to help the clean out prep, so I hope he's OK with me doing them.

Anyway, overall a good experience and glad I am proactive in getting the exam done on a regular basis (yearly or a decade apart).