The colonoscopy is the golden standard for catching polyps and preventing colon cancer altogether. So if it’s so effective, why are patients so averse to undergoing a colonoscopy, even if it means saving their lives?
There’s only one reason: the dreaded prep drink. Colon preps are infamous for being extremely uncomfortable and arduous.
In the article below, we explain everything you need to know about these drinks, and how you can manage through yours to ensure you have comfortable colon prep.
Breaking Down Colonoscopy Preparation
What Is In a Colonoscopy Prep Drink?
Colon prep drinks are oral laxatives formulated to flush out the colon. Some brands come in powder form and should be mixed in with water before they are digested. Even liquid prep drinks have to be diluted with water as per the label’s instructions.
Different bowel prep kits have various ingredients that work together to induce bowel movement for colon cleansing. One of the leading brands, SUPREP, has sodium sulfate as its primary ingredient. A 6-ounce bottle also contains 3.13 grams of potassium sulfate and 1.6 grams of magnesium sulfate.
Another leading brand, PREPOPIK, has sodium picosulfate as its primary ingredient. This active ingredient is known as a stimulant laxative, which induces bowel movement for successful preparation.
Specific ingredients for each colonoscopy prep drink are available online. Regardless of what is in the drink, these kits are specifically designed to fully purge your colon so you can have a successful colonoscopy.
How Long Does Colonoscopy Prep Take to Work?
Bowel prep medicine should be taken at least 24 hours before the procedure to ensure that the colon is clean prior to the exam. On average, preps take an hour to three hours to work, depending on the brand.
A follow-up taken at a much weaker dose is commonly recommended to patients who don’t experience anything after drinking the medicine. Keep in mind that not all patients will respond in the same way as others; give the medicine some time before drinking more of the recommended dose.
Diarrhea is a clear indication that the prep is working. Patients can tell their colon is empty when clear yellow liquid comes after passing waste. This means that the colon has been thoroughly cleaned and that the prep was successful.
If nothing happens five hours after drinking the prep, it’s best to get in touch with a primary physician to get advice on what to do.
Do You Have to Drink All the Colonoscopy Prep?
Not necessarily. Depending on the time of your exam, the full solution can be ingested throughout a 2 hour period or twice in between 12 hour intervals. Below are our recommended steps for a successful colonoscopy preparation:
Split Preparation: Involves drinking the first half of the solution in the evening and the other half in the morning. This is ideal for patients with colonoscopies scheduled later in the day.
- Drink the solution at a chosen time. We recommend starting no later than 6 PM.
- To make the prep more manageable, consume the drink slowly over the course of two hours. Drink the solution in 10 to 20 minute intervals.
- Be careful not to consume the entire half of the solution in under an hour. Likewise, it won’t be as effective when taken for more than 2 hours.
- Drink recommended liquids until the colonoscopy to stay hydrated.
Full Day Preparation: Best done for patients with colonoscopies scheduled early in the day. Drink the entire solution over three hours one day before the colonoscopy.
- Drink the solution at an early time. We recommend starting before 6 PM.
- Consume the solution slowly in 10 to 20-minute intervals over the course of three hours.
- Be careful not to drink the solution for more than 4 hours. Finish the preparation and drink clear liquids to stay hydrated.
Types of Colon Prep Drinks
Various prep drinks are available on the market. Below are our recommended brands for colonoscopy preparation:
|CLENPIQ2||SUPREP Bowel Prep Kit||NULTELY||PREPOPIK|
|Preparation||Ready to drink, no mixing required||Dilution in 16-ounce container that comes with the kit||Dissolve powder in provided bottle and shake||2 packets soluble in 5 ounces of cold water|
|Flavored?||Cranberry||No||Cherry, orange, pineapple, lemon-lime||Orange, cranberry|
|Cost (average retail price)||$151.30||$110||$29.99||$171.85|
|Drug interaction||May interfere with painkillers with acetaminophen, ibuprofen, and various multivitamins||May interfere with heart/blood pressure medication, nonsteroidal anti-inflammatory drugs, diuretics||May interfere with aspirin, amoxicillin, and fish oil||May interfere with tylenol, vitamin C, and anxiety medication with alprazolam such as Xanax and Niravam|
Plenvu: New One-Liter Colon Prep Drink
High volume prep drinks have always been the norm. However, a brand new liquid drug called Plenvu is posing to replace traditional prep drinks. Uncomfortable preparation is the number one deterrent of colonoscopy screening.
Plenvu, on the other hand, is a “lower-volume, one liter bowel preparation”. With lower-volume alternatives such as Plenvu rising on the market, patients can have a more comfortable preparation, which could encourage more patients to get screened for colon cancer (source).
Things to Do Before Your Colon Prep
5 Days Before Colon Prep: Change Your Diet
Swap foods for a low-fiber, low-fat diet. Suitable foods include:
- White bread
- White Rice
- Plain crackers
- Low-fiber cereal such as corn flakes, cream of wheat
- Lean meats like fish and chicken. Turkey, lamb, lean pork are also allowed
- Fruits and veggies without the skin or seeds
- Dairy products such as milk, cheese, and yogurt
The idea is to only eat foods that are easily digestible by the stomach. Whole grains, raw vegetables, and other stuff should be avoided days before the colon prep. Other foods to avoid include:
- Fatty food
- Tough red meats such beef and pork
- Whole grains, nuts, and seeds
- Corns, beans, peas
- Brown, wild rice, and other whole grains including bread and pasta
- Any sort of legumes
- Thick soups
3 Days Before Colon Prep: Switching to Liquid Diet
Alternate between liquid and solid meals every day leading up to three days before your colon prep. At this point, start increasing your liquid intake while decreasing solid foods. This means incorporating more soup in your diet to help your body get accustomed to a purely liquid diet in the coming days.
1 Day Before Colon Prep: Liquid Diet
Patients are not allowed to eat any solid food one day before the diet prep. Have drinks, juices, and clear soups ready to keep yourself full. Stock up on medication, wipes, and any other necessities you think will make the colon prep manageable.
Your body will not find the strength to go out after a colon prep which is why it’s important to have everything ready a day before you take the prep drink. Clear your schedule for the next day and follow prep instructions as described on the label.
What to Expect During Your Preparation
Prep periods aren’t a walk in the park. However, knowing what to expect can help you prepare for the process and improve your experience.
- Expect diarrhea. Liquid stools are an inevitable part of the process. Colon prep drinks are designed to encourage the colon to draw liquid from the body, turning waste from the upper part of the colon into expendable liquid waste. This results in frequent bowel movement in the form of liquid stools.
- Take a day off. Colon preps require a lot of time and energy. Physicians typically recommend patients to stay at home during the preparation. Bathroom visits will be frequent, which is why it’s best to stay at home during the process.
- Stock up on anti-nausea medication. Nausea is a common side-effect of colon prep. Increased stomach irritability and an active gag reflex can cause you to vomit. Taking an anti-nausea medication or simply drinking a cold glass of water can help you from feeling sick. Breaks from drinking the prep no longer than an hour long are also effective.
- Hunger and dehydration. Stick to recommended foods and liquids. During the prep, the body will expel large amounts of water in a short period of time. Prioritize rehydration as you are going through the prep. Drink large amounts of liquids to stay hydrated during the process. This will also help your colon get rid of any residual waste long after the prep drink has been consumed.
Making Sure Your Prep Is Effective
Colonoscopy preparations can be tedious, which is why we recommend doing it right the first time to avoid repetition. Not following the recommended dosage, drinking the solution too fast or too slow, and interference with medication or food are the common reasons why colon preps don’t work.
Here are some tips on how to avoid the common pitfalls of colon preps:
1. Vomiting During the Preparation
Throwing up during the preparation is one of the top reasons why these kits don’t work. Vomiting the solution prevents the colon from fully absorbing the drink. This means that the colon won’t effectively expel waste in preparation for the exam, preventing the examiner to clearly see the lining of the colon.
Tip: Drinking the colon prep without throwing up is completely achievable. Take an anti-nausea medicine to ease queasiness. Drink the solution slowly, preferably with a straw, to keep yourself from feeling sick. Take short but frequent breaks in between sips. Following up with a glass of cold water can also help keep the stomach under control.
What Happens When I Throw Up During Prep?
The solution has to make its way down to the colon to work. Without the full dosage, the colon will not be efficient in expelling waste, making it impossible for the colonoscope to properly observe the colon.
Signs of the prep working usually manifest an hour after drinking a suitable amount of liquid. When feeling sick, it’s crucial to prevent the liquid from being expelled orally. Stop consuming the drink until nausea and vomiting have subsided. We recommend taking a break for 30 minutes before drinking any more of the liquid prep.
2. Drinking the Solution Too Fast/ Too Slow
Not consuming the recommended dosage can lead to inaccurate results and a stressful prep. All preparation kits, no matter what the brand, include an instruction guide to ensure that patients go through the process as closely as possible.
By adhering to the instructions, patients can maximize their comfort while ensuring that their colon is effectively clean for the examination.
Can You Drink Colonoscopy Prep Too Fast?
Drinking too much of the solution in one go can shock your body. When this happens, too much water is pulled into the colon, leading to very watery stools. Stomach cramps can also come as a result of drinking your prep too fast.
Rushing the prep may trigger the gag reflex and induce vomiting. As discussed, most preps are best taken in 10 to 20 minute intervals, over the hours of two hours, or whichever the recommended time is on a chosen brand.
3. Not Drinking Enough of the Solution
Some patients are convinced that clear stools are a sign of a successful preparation, leading them to abandon the rest of the colon prep drink.
In reality, clear stools don’t guarantee that the procedure is foolproof. Because of this understanding, patients fail to follow the recommended dosage, at the expense of having an efficient colonoscopy.
Can You Stop Drinking Colon Prep When Stools Are Clear?
No. Prep is only considered done once all of the prep drink is consumed. Passing clear liquid stools could only reflect the cleansing of the lower part of the colon. It takes a while for the liquid to expel waste from the entire colon, which is why it’s important to finish the entire colon prep drink.
Consume the rest of the liquid even if you are already passing clear liquid stool. Drink other clear liquids to stay hydrated throughout the process. Not only does it prevent dehydration, but it also helps clean out cloudiness in the colon.
Making the Drink More Manageable
Keeping the drink down is one of the most important parts of the prep. Lucky for patients, there are different ways to make colon prep drinks more palatable. Here’s how:
Can You Add Flavoring to Colonoscopy Prep?
Definitely. In fact, some preps already come with various optional flavorings that can be added to make the drink easier to swallow. However, for mixes that don’t include any flavoring, low-calorie and sugar-free beverages can be added for extra help.
Choose a powdered beverage mix that is colorless and easily soluble in cold water. Common options include a Crystal Light packet and apple juice. Ask your physician before adding in any sugar or sugar substitutes.
On the other hand, any form of dairy can’t be added to the prep. Avoid anything with red or purple color since these may be interpreted as blood on the colon lining.
What Can You Mix with Colonoscopy Prep?
Dissolving the prep in chilled water is a common practice. However, it’s also possible to dissolve the colon prep powder in a sports drink or clear juice.
When mixing with liquids other than water, take into consideration sugar level and electrolyte presence. Constant bowel movements are bound to make any patient weak, so it’s important to ensure that the liquid and electrolytes lost are restored through drinking liquids in large amounts.
Drinks like Gatorade G2 are a perfect vessel for a prep drink. When in doubt, contact your primary physician and make sure that your mixer won’t interfere with the preparations.
Signs the Colon Prep Drink Is Working
1. Progression In Bowel Movements
The bowels are meant to change after drinking the solution. Expect initial bowel movements to be composed of firm to semi-firm stools. As the colon takes up more liquid and expels more waste, the stools will be liquid in consistency and clear in color. Keep drinking water or other clear liquids to aid in the cleansing.
2. Bloating and Cramping
Although uncomfortable, bloating and cramping are both good signs that the prep is working. As the colon pulls in water to expel waste, your stomach can get triggered, causing irritation and pain. This results in bloating and cramping in the abdominal area.
3. Clear Brown Liquid
As more and more fecal matter is expelled from the colon, your colon will start expelling waste in the form of clear brown liquid. Don’t be alarmed: at this point, the bowel movement will start slowing to a halt until no waste is present in the colon.
4. Yellow Clear Liquid
Expelling yellow clear liquid is a clear sign that the prep has worked successfully, and that the colon is clear from majority of the waste.
This can happen before all the liquid prep has been consumed. When it does, keep drinking the solution until the entire prep kit has been consumed. Otherwise, the cleanse would not be as effective.
Reducing Discomfort During Preparation
Why Is It Uncomfortable In the First Place?
It’s not just the process of drinking the actual solution that makes the prep so uncomfortable. Physical pain is often reported by patients as a result of frequent bowel movement. Here are the two most common complaints when it comes to colon preparations:
- Diarrhea: Diarrhea on its own is already inconvenient. The volume alone can make the anus raw and irritated. A rash ointment usually helps. Applying vaseline around the hole, using wet wipes, and spraying water on your anus during the movement can all increase lubrication and help with irritation.
- Stomach Cramps: Replenish your body’s water source by drinking large amounts of liquid. When the stomach cramps start, drink warm water to help ease up your stomach. Take a break when you’re consuming the drink if needed.
Helpful Tips for an Easier Colon Prep
- Keep the solution cold. Keep the drink above room temperature to make it easier to swallow. Freeze the container the night before the colon prep or simply refrigerate the mix. Adding ice cubes after mixing the prep powder in water will dilute the drink and lessen its effectivity.
- Set your pace. Some patients prefer to chug their prep while others prefer to use a straw. Take your time and drink depending on your comfort level. The important thing is to drink each and every drop of the liquid, regardless of how you do it.
- Make dietary modifications. As discussed, make changes to your diet days before the colon prep. This adjustment allows for an easier colon cleansing and a more comfortable colon preparation.
- Hold out on the spice. Spices can irritate your anus during consistent bowel movements. Avoid spicy foods up to 3 days before your colon prep.
- Keep medicine in hand. Nausea medicine is a necessity for patients who have trouble keeping the drink down. Ask your physician in advance regarding drug interactions between your chosen prep drink and the anti-nausea medicine.
- Get some clear juices and soup. Refuel your body with approved drinks and food. This includes clear juices like apple juice and broth and bone-based soups. When picking out drinks, choose those with electrolyte to keep your systems in balance.
- Plan your first meal. Hunger, fatigue, and nausea can make any colonoscopy preparation challenging. Set your first meal in mind as a goal to keep yourself focused throughout the preparation.
- Keep entertainment ready. Preps can feel long and arduous so make sure to keep entertainment ready. Use this time to catch up on a show, watch a new movie, or finish an old book.
- Use flavorful juices as a mouthwash. When the flavor of the prep gets too overwhelming, use clear juices to fight the flavor by using it as mouthwash. Swish the juice around your mouth for a couple of seconds and spit it out. Repeat frequently to prevent vomiting during the process.
- Ask around for alternatives. Aware of certain complications? You may request a different kind of bowel prep if you think the one prescribed to you won’t work. There are dozens available on the market, from powder to pill form, to generic to branded.
Liquids and Colonoscopy: Diet, Hydration, and What to Avoid
What Is a Clear Liquid Diet?
Patients are kept on a clear liquid diet to ensure that the colon doesn’t have any residue or waste. Normal foods leave particles and residue that may affect colonoscopy reports.
The rule of thumb for this diet is making sure the food is clear; as long as you’re able to see through the food, it is considered a clear liquid diet. These foods include:
- Icicle pops without dairy, fruit or nuts
- Fat-free broth or soup
- Sports drinks without red or purple dye
- Tea and coffee without milk or cream
- Colorless gelatin
- Beverages such as lemonade and fruit punch
- Apple, white grape, lychee juice, or any other clear juice without the pulp
- Water (it doesn’t matter if it’s carbonated or flavored)
Liquid diets are limited precisely because they are not meant to be palatable. The purpose of the diet is to maximize the prep drink, while keeping the body hydrated. Liquids limit the strain on the intestine and keep the body up and running even without significant nutrients.
Liquid diets are only recommended for tests and should not be extended beyond the necessary timeframe. Patients will be allowed to resume regular meals once the colonoscopy has been completed.
Liquid Diet Sample
Listed below are some ideas on what a clear liquid diet looks like:
|Gelatin bowl, with optional sugar or honey||Bowl of broth, without spices, oil, and any fat||Bowl of broth, without spices, oil, and any fat|
|Cup of coffee or tea, without dairy products||Cup of coffee or tea, without dairy products||Glass of clear juice without pulp|
|Glass of clear juice without pulp||Glass of clear juice without pulp||Soft drink or sports drink|
|Frozen icicle pop without dairy products and coloring||Gelatin bowl, with optional sugar or honey||Frozen icicle pop without dairy products and coloring|
Frequently Asked Questions
What do you drink before and after a colonoscopy?
Drinks with electrolyte are the most ideal drink before a colonoscopy, but just about any clear liquid will do. The digestive system needs to adjust after a colonoscopy, so don’t consume tough meats, alcoholic beverages, and raw vegetables and fruits just yet. All kinds of fruit juice are allowed then. Stick to soft foods such as peanut butter, mashed potato, and scrambled eggs until the body settles.
Can you drink alcohol before a colonoscopy?
Alcoholic beverages are not allowed before a colonoscopy. After the exam, fill your body with substantial food and give it time to readjust before consuming alcohol.
Can I drink coffee before a colonoscopy?
Yes, coffee and tea are fine. Sugar and other sweeteners are optional as long as you don’t add dairy products.
What juices are allowed before a colonoscopy?
Clear, pulp-free apple juice is the go-to fruit drink for colonoscopy prep. White cranberry, white grape, and lemon juice are all good options as well.
Are all kinds of gatorade allowed before a colonoscopy?
Sports drinks are an amazing source of electrolytes and should be a part of anyone’s colon prep. However, avoid gatorade drinks that have red and purple coloring. To be safe, stick to ones that are colorless or very lightly colored.
Are There Alternatives to Colonoscopy Prep Drink?
There are no other ways to clean out the colon except by drinking a colon prep drink. With many options available, you are bound to find one that works best for you.
For example, the process of drinking the prep drink Pico-Salax only involves drinking two glasses of water instead of the usual three to four liters. For anyone who is scheduled for screening, this seems like a much better option compared to the others.
However, doctors say that patients should be wary with low-volume preps. While convenient, there is no recognized study stating that low-volume options are just as good as high-volume ones. As gastroenterologist Dr. Michael Bernstein said in a report, “The downside is that it doesn’t tend to be quite as good at cleaning out the colon.” (source)
Colonoscopy preparations may be inconvenient, but they are nothing compared to having to fight actual colon cancer. Get in touch with us today to learn how we can make your colon prep comfortable.