Colonoscopy prep and enema

My pre-colonoscopy instructions state that "A nurse will consult with you prior to procedure and if there is any cloudiness in your last movement you may receive an enema.................... wondering if anyone had this happen to them and if so a Fleet or something more ?

That sounds really lenient: most places I have heard of won't offer you once if they find residue and will cancel the rest of the procedure and schedule a new appointment.

Carson is exactly right. Friends who are GI doctors say the same thing. It is fun to think that an enema is involved but it usually doesn't happen. Anenema just serves the lower colon and the exam is equally concerned about the upper system

Years ago (1967 to be exact) I came down with colitis. I was subject to a series of tests at the hospital; the first one was a sigmoidoscopy exam using the old-fashioned "saddle" which was cranked up until I thought I would fall over backwards. Prior to the exam a Nurse Ratchett gave me a fleet enema to see if my self-administered enemas of the early morning had been sufficiently effective. If not sufficiently effective, or if I flushed the toilet before Nurse inspection, a second enema was promised. As an added treat, my sigmoidoscopy exam was witnessed by about 25 candy-striper teenage (?) girls blushing a bright crimson. Very memorable!

@Bithesea I received several sigmoidoscopies in my younger days. All were rigid, but all started with 2 fleets. The very first one, the dr gave the enemas and then stuck his finger in and vigorously mixed thing up. It could have been because there were 2 fleets, butt that gave me st strongest poop I ever had from fleets.

Modern colonoscopies are done with flexible scopes that reach all the way to the end of the colon. Therefore the gut has to be completely cleared out. If anything is left in the upper GI tract it's going to leak into the colon and the examiner will see only food. Using an enema is WORTHLESS! One uses an osmotic PEG agent; I've had gallon jugs, and recently 2 x one liter treatments that flush out all the solids, leaving the last water out a yellow color, with no brown (yellow is the bile). An enema is insufficient.

Others having has colonoscopes recently will back me up on this

Never heard of enemas being used for colonoscopy prep these days, for all the reasons already stated. Still pretty standard for sigmoidoscopies, though, in which case it’s usually two Fleets.

At the hospital where i work (RN) we use this stuff called "Golytely" (an ironic misnomer), it's a powder that comes in a gallon container that we fill with water and the patient drinks. The clean out is from top to bottom... no enema involved.

For my colonoscopies I had to prepare by drinking a powder mixed with water for a few days. This gradually removed the waste in my system. When going to the hospital they just asked whether my waste was largely liquid, and then proceeded with the colonoscopy. I have a stoma, so managing the waste was a nuisance.

Modern colonoscopies are done with flexible scopes that reach all the way to the end of the colon. Therefore the gut has to be completely cleared out. If anything is left in the upper GI tract it's going to leak into the colon and the examiner will see only food. Using an enema is WORTHLESS! One uses an osmotic PEG agent; I've had gallon jugs, and recently 2 x one liter treatments that flush out all the solids, leaving the last water out a yellow color, with no brown (yellow is the bile). An enema is insufficient.

On their own enemas wouldn't work. I can, however, see them potentially being used to initially clear out the lower colon or as a sort of Hail Mary "touch-up" if you are almost there, but they would need to be large volume enemas and for multiple reasons would not be considered ideal.

I have heard sometimes of colonics being used, though that still leaves the question of the small intestine. Perhaps food restriction is enough? Or, more likely, it is a mixture of both "from the top" and "from the bottom" to get it done. Or it just doesn't work as well as claimed.

Moliere,

I've had two colonoscopies with colonic cleansing. First one was with a colon therapist, and the doctor gave me a b- for prep. The most recent one was with a colonoscopy center in Phila where I did it with no sedation but they offered a "hydrocleanse" which was a series of high colonics or as high as one can get with an open system which isn't all that high. Naturally there was the usual eating restrictions the day before as in don't eat. There was also some laxative stuff but not drinking a gallon of Golitely. The cleansing went on for 45 minutes, going to the toilet and having the output inspected and then more cleansing. Even so the doctor needed to do a little flushing and sucking once he got to the end as he wanted a pristine colon to examine.

This was a good experience and I will definitely do it for my next colonoscopy unless I am considered too old for it. I will push for one since I do a lot of large enemas and hold them. I'm curious to make sure I'm not stretching my colon too much and want to be assured that it is still in good shape.

As someone who works in Endoscopy for a colonoscopy you have to have bowel prep to ensure that the colon is clean and stool free, In the UK we normally give our patient Moviprep , Picolax and recently stare using Plenvu. This ensures that the entire colon is clean from the caecum to the rectum.

As mentioned above a flexible sigmoidoscopy which only looks at the left side of the colon , from the rectum to the Splenic flexure ( located just under the left ribcage. We use a phosphate enema (Fleet) which will be sufficient to clear the left side of the colon. A phosphate enema will not go much beyond the splenic flexure so would be unable to clear the transverse, ascending and caecum of stool and so the endoscopist will not be able to see these areas clearly.

The use of rigid scopes have disappeared for Endoscopy , we use flexible fibre optic scope which has the ability to provide 4K resolution.

11+ years of getting colonoscopies and not one single enema offered prior to the procedure by healthcare providers. Back in the day I was so terrified and nervous that even the prep was hard and I couldn’t relax enough for it to work (until I could, but it was not what I would call pretty). My late fiancé gave me lots of enemas and encouragement while almost making me drink the various concoctions of vile fluids required to clean me out. Enemas definitely facilitated the process and made it much more bearable (and they still do) when I was really struggling but, on their own, they would not be enough.

These days I have mastered the whole prep thing and still hate it, but treat myself to as many orgasms as it starts to kick in, which is when I give myself pretty large and as hot as I can take salty water enemas. My go to solution for enemas is the one described above plus liberal amounts of Dr Bronner’s peppermint liquid soap but I don’t use any the day before being scoped. Between the meds and the fluids and the enemas it is still a guaranteed rough ride (but, since I enjoy living, it’s worth it).

While enemas are pretty much a thing of the past relative to Colonoscopies, there are preprinted handouts that simply state that an enema may be necessary if the effluent isn't free of stool. Some gastro's also have handouts that reference an enema prep as 1 of 3 options.

There are also studies that indicate a preliminary enema may enhance the typical oral preps. My recollection is that it was found that a clean lower bowel may facilitate a more thorough top down cleanse.

There is no question that a top down cleanse is necessary. A bottom up cleanse may facilitate an easier effort from above, although this isn't likely to be prescribed. I would assume that if prescribed, many would resist and there would be pushback from patients.

My colonoscopies have been with a combination of oral preps and enemas or colonics. The enemas or colonics were administered before and then after the usual oral solutions. I found that a clean bowel made the liquid effluent far more tolerable to pass, with less stool to push along. With some time prior to the actual exam, the bowel had time to dry enough to not interfere with the scope.

I've only had one colonoscopy thus far. But my wife has had a few, and each time they made her drink a gallon of what she claimed was the most foul, disgusting liquid she had ever ingested. So I was very pleasantly surprised when my GI told me I could just drink two big Gatorades with a whole container of Miralax over a series of hours and that would be fine. It certainly did the trick.

I've had two colonoscopies and I've followed the surgeon's directions to a "T" both times. An enema is wholly inadequate for colonoscopy prep. This is no time for homespun medfet enemas. Do what the doctor says and you'll be fine.

Twelve hours of yellow diarrhea isn't fun. But it isn't painful. And it's over before you know it. Get some baby wipes for your bottom. You can thank me later.

I have flunked so many of these tests cause I have a elongated colon and I can't clear it all out even with some pretty radical stuff to do it with over a weeks time.

They gave up a did a virtual colonodcopy on me.like a CATSCAN sorta.

In the past, I followed the instructions as given by the surgeon. But, I found that the afternoon before just before I start drinking that nasty stuff, I take two salt water enemas to clear the colon. I found that this makes the process easier and I don't feel that my guts are coming out of me everytime I sit on the bowl. Enemas alone will not do the job, but a combination of enemas and drinking the laxative seems to me as an easier route.

I don’t know why so many seem to have problems with the prep for a colonoscopy. Here’s my most recent experience.

I’m not sure what I was given for my last colonoscopy a little over 8 years ago. Anyway, IT WASN’T THAT BAD!!! Starting at 3 pm the day before the 7 AM event, I began drinking a glass of the stuff every 15 minutes until it was gone (about 2 or 3 hours later). About 6 pm I had a pretty full, but not urgent, feeling of an imminent BM. I “assumed the position” on my toilet and had a very pleasant, but non urgent, LARGE BM…nothing urgent. An hour or so later, I assumed the position again, this time I experienced a rather strong, loosey-goosey release into the bowl. Within the hour, I was sitting every 20-30 minutes just spraying liquids into the bowl. By 10 pm, things slowed down and I took a final “squat” for the night. It was virtually clear liquid…and not much of it, at that. Had a good night sleep. Woke up at 6 am and sat for a minute or two releasing just a short squirt of clear liquid. Showed up at the clinic at 7 and was promptly taken back and put to sleep for the procedure. When awakened, doc told me I had done a “nice job” of cleaning out! My First stop after I was released was having a BIG BREAKFAST at Cracker Barrel! I’m due for another colonoscopy in about 18 months. I am actually looking forward to it…hoping I will have another “rather pleasant” experience.

I've had to do it twice so far. The first time was with miralax. It was disgusting and was easily the hardest part of the whole process. Mainly cuz I'd drink a glass or two and feel full so it made each subsequent glass that much more uncomfortable. Like I was overstuffing myself with something I already didn't want. The next one I did took these two 16oz bottles of what tasted like grape cough syrup, which was much easier. In either case the next biggest problem was my anus burning after having to wipe so many times. I hate the prep so much.

@KC_Patient diaper cream around & in the anus is a good idea, too.

Sorry, I don't know how you quote text.

Yes, colonoscopy prep can be 'No fun ' and exhausting... enemas and colon cleaning sometimes works...when my old-time doctor scheduled me for a colonoscopy he told me to start eating differently 3 days in advance, start Monday for the Thursday procedure... lots of liquids, clear juices, no red meats or beets, etc etc... not to bother with enemas (even if they are fun!) and drink the prescription 'stuff' as per directions... result two easy trips to the toilet, no cramps, and no raw anus, easy time.. and a A+ grade on colon cleaning.... and after that he tells me he found nothing![

Fleet? good luck! It's way more and I found the 2 step one, with step 2 at 3am worse that the one step one which was no fun either.

but if doctors were kinkier... who knows what might happen.

So last year I had to do this. My experience wasn’t that bad. My brain made it worse.

Generic PEG solution. Got a tip to put a bunch of Crystal Light it it and get it as cold as possible. Both recommended 😃. Worst part was not eating freah veggies and seeds (of alll things) for a bunch of days ahead of time. Stayed close to the bathroom the whole evening but did other things.

Best tip I got was don’t schedule first thing in the morning. Rather do 11 or so. The reason is that you have to start the second part about 5 hours before the procedure. Much better to start that at 5 or 6 than 2 in the morning.

Honestly wasn’t that bad. I was done with the first part about 10 and got a decent sleep. Someone suggested getting some baby wipes and I think I used a few of them but not many. Took a good shower before going in.

In all seriousness — do it. It’s a pretty simple thing and finds issues. They found a pretty sizeable polyp which turned out to be benign but the comment from the doctor is “you would have not enjoyed it if we found that a few years later.” And “ this is one of the reasons we changed the guidelines”.

And what is probably TMI the absolute worst part was cleaning up the toilet afterwards….

diaper cream around & in the anus is a good idea, too.

Wait!? It's safe to put diaper creme inside?. Do you have a brand you recommend?

@ragatel I used Vaseline last time but it didn’t work. Ask your doc but I thought I read somewhere that zinc oxide based creams were safe externally. Whatever you use put it on your anus all the way up your perineum. The nurse described the burning as stomach acid.

The Golytely generic came with a lemon flavored drink pouch but my doc said I could use lemonade crystal lite. I should have listened to him. The generic flavored lemonade tasted awful. Just make sure it is yellow and not pink lemonade flavored. I chugged it with an 8oz bottle with a small opening. That way I couldn’t taste the salty electrolytes or feel the slimy texture of the PEG 3350. PEG 3350 is used as an industrial lubricant but never drink the industrial version. It’s not food grade.

The clean-out burned me for two days. I ended up using a hydrocortisone ointment (or cream) to make it stop. Try not to wipe, just dab. Or get a squirt bottle and rinse then pat dry. Wiping really hurt.

Blot, don’t wipe and you won’t irritate your skin , at least not as much!

If you get the two part prep with an early morning appointment (e.g. start the second prep at two in the morning), don’t pig out on coffee to stay awake.

@ragatel I wouldn't put it in your rectum, just around the anus & external sphincter.

Thanks for the advice. I'm dreading the next one a little less now.

Thanks for the advice. I'm dreading the next one a little less now.

For me, the worst part was arranging for a ride home after the procedure! You’ll do fine, don’t fret over it.