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What’s the first word that comes to your mind when I say colonoscopy? I’ll start… Dread.
OK now you go on the count of three. 1-2-3…
Don’t worry if I can’t hear you because it’s more important that you know your word. Plus, I’m feeling you cosmically because I’ve heard it all when it comes to the colonoscopy. I’ve heard clients and Gut Love Community members describe a colonoscopy with words like sucks, scared, pointless, gross, overwhelming, anxious, and of course the word prep, that one comes up a lot.
Oh the prep.
Like I said, my word is dread. And you’d think by now after having as many colonoscopies as I’ve had (and that number is way too high to count), you’d think it would be old hat and I’d be over the dread because it’s not like I don’t know what’s coming. With a colonoscopy though, I’m not fearing the unknown, I’m fearing the known.
I’m not sure there’s a way to completely dissolve my dread over colonoscopies, but the good news is that after years of having them, I finally figured out the secret to having more than just negative emotions about colonoscopies. When you plan, and truly dial in your colonoscopy experience, there can be positive emotions and experiences mixed in there as well. Afterall, we’re women, with the right information we have no problem forming higher level, deeply faceted emotions.
Would I rather never have a colonoscopy again?
Hell yes, but for me with the stricturing type of Crohn’s (where your intestines love to cave in and collapse on themselves), that’s never going happen so at least I can say that I’ve discovered the secret (or should I say secrets because there’s lots of them) to more manageable, tolerable, and dare I say enjoyable colonoscopies.
Three Things You’ll Learn in This Episode
- 11 tried and true tips to move your colonoscopy experience from horrible to manageable
- This simple yet powerful step done two days before your procedure that’s game changing for every colonoscopy
- The odorless, tasteless bowel prep that’s good enough for America’s top IBD hospitals
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Mentioned in This Episode:
Your Soups On Recipe Resource
Your Juicing and Smoothie Recipe Booklet
Episode Resources:
The Cleveland Clinic Colonoscopy Prep with Miralax
Optimizing Adequacy of Bowel Cleansing for Colonoscopy: Recommendations From the U.S. Multi-Society Task Force on Colorectal Cancer
Split-Dose vs Same Day Bowel Preparation for Afternoon Colonoscopies: A Meta-Analysis of Randomized Controlled Trials
Split-Dose Bowel Preparation Improves Adequacy of Bowel Preparation and Gastroenterologists’ Adherence to National Colorectal Cancer Screening and Surveillance Guidelines
Connect With Karyn:
Karyn on Facebook
Schedule Your FREE 30-Minute IBD Consult
Episode Transcript:
WHAT’S THE FIRST WORD THAT COMES TO MIND WHEN I SAY COLONOSCOPY?
I’ll start… Dread.
OK now you go on the count of three. 1-2-3… Don’t worry if I can’t hear you because it’s more important that you know your word. Plus, I’m feeling you cosmically because I’ve heard it all when it comes to the colonoscopy. I’ve heard clients and Gut Love Community members describe a colonoscopy with words like sucks, scared, pointless, gross, overwhelming, anxious, and of course the word prep, that one comes up a lot. Oh the prep.
Like I said, my word is dread. And you’d think by now after having as many colonoscopies as I’ve had (and that number is way too high to count), you’d think it would be old hat and I’d be over the dread because it’s not like I don’t know what’s coming. With a colonoscopy though, I’m not fearing the unknown, I’m fearing the known.
I’m not sure there’s a way to completely dissolve my dread over colonoscopies, but the good news is that after years of having them, I finally figured out the secret to having more than just negative emotions about colonoscopies. When you plan, and truly dial in your colonoscopy experience, there can be positive emotions and experiences mixed in there as well. Afterall, we’re women, with the right information we have no problem forming higher level, deeply faceted emotions.
Would I rather never have a colonoscopy again? Hell yes, but for me with the stricturing type of Crohn’s (where your intestines love to cave in and collapse on themselves), that’s never going happen so at least I can say that I’ve discovered the secret (or should I say secrets because there’s lots of them) to more manageable, tolerable, and dare I say enjoyable colonoscopies.
It’s my 411 on all things colonoscopy related, especially the prep. Here we go!
[MUSIC]
Hey my friend, Karyn Haley with you today on the Cheeky Podcast. 80 episodes in. That’s how far we’ve come together. How have we not talked about this before? Colonoscopies are something that all of us deal with when we have Crohn’s and colitis. I have notes upon notes upon notes to help people when they’re going into a colonoscopy but for the podcast, I wanted to wait until one was really fresh in my mind so that I could give you my best most up-to-date insights. Information that could really help you the next time or the first time you go in for this procedure because it doesn’t have to be as scary or as horrible as it seems to turn out for so many of us.
Let’s bump up your colonoscopy experience and take it from horrible to at the very least tolerable and I’ll even tell you about the parts that you can actually enjoy.
In true “me” fashion, you know I love to get into the weeds and the details of our IBD topics, so in this episode, I’m taking you all the way through the colonoscopy experience because it’s not just about the procedure itself. It’s about the prep and the days leading up to the prep and the days and months after the procedure that still reverberate in our bellies. Oh, we’re getting into it all so buckle up, get something to write with and let’s get into it.
Now before we get to deep, it bears mentioning that when I’m talking about colonoscopies here, I’m mainly talking about my own experience coupled with client experiences as well. These experiences may not completely coincide with your colonoscopy experience, but I bet there will be tidbits that will fit for you. Things you can take away to help with your experience. If any of what we talk about today helps you out, then listening to this episode will be worth it.
You also know that I’m not a medical professional and I’m not talking about colonoscopies as a medical professional today. I’m talking about my experience from the patient side. You’ll always want to talk to your doctor about the specifics of your case before adopting the ideas mentioned today because we’re all different. There’s a couple scientifically researched ideas we’ll talk about regarding the various preps and how to best take them for the colonoscopy and you can see all of that research to make an informed decision for yourself in the show notes at karynhaley.com/80
OK, sound good? Let’s start and we’ll go in order of the way things will happen for you if you are in a true colonoscopy situation. So we’ll start a few days before the procedure.
Chances are by a few days before, you’ve already been to your doctor. He or she has set a date and time for your colonoscopy and you have all the “what to do and when to do it” handouts from your provider. And let me just say as a side note, while we are on the topic of the date/time for your procedure, personally, I like to schedule my colonoscopies for the first thing in the morning. The first procedure of the day and yes, you can request this. As long as your procedure isn’t urgent or an emergency, they will make it happen for you. You just have to ask. After the prep, you might be exhausted, or not feel well, your bottom may be sore, you might be hangry by this time because you haven’t eaten in 24 hours. So my motto is, get it over with and get on with your life. When we talk about the prep, we’ll talk about other ways to think about this, other options for you to consider (and it’s crucial to tailor this to what works best for you), but for me, it’s first thing in the morning for the colonoscopy.
OK, so a few days prior, sometimes there are medications that need to be stopped and even some supplements that may need to be paused until after the procedure, but the biggest thing you’ll want to do a few days prior is get your supplies ready. As you’ll see, if you want to have a successful and tolerable and even somewhat enjoyable experience, there’s more to get ready than just the prep. And rushing around getting things together the day your prep is not the way to get through this thing calm, cool, and collected. So, keep calm with getting your colonoscopy supplies ahead of time and carry on. We’ll talk in greater detail about what those supplies will be, but planning is key here. Before the shi*t hits the fan (or the toilet), make sure you have everything you need for a successful prep.
Two days prior to your procedure is when things really rev up in the colonoscopy department. You have all your supplies including all your food and drinks and you’re ready to go. When I start my two days before with colonoscopy preparations, it ensures that I will be cleaned out for the procedure which means the doc can get a good look around (you definitely don’t want to be doing this again for quite a while, am I right?) and that I may not need all of the prep. Again, this is me personally. I’m tiny and size and weight does make a difference.
Food is a big part of the two days before your procedure and I’m going to get to that, but I also want to say that this is also a day to be as relaxed as possible. You’ve got a big day coming up tomorrow and the next day as well. Give your body the rest it needs to be to bring your best self to the table. So that means, no appointments, no extra activities, have a normal day, try and let any negative events go—just think Zen two days before. Trust me, it’s a small thing, but it matters.
Now on to the most important thing I do two days prior to my colonoscopy (1 day before the prep). I change the way I normally eat so that my diet is very, very low residue. Now, if you’ve had a colonoscopy before, your doc may have told you, two days before, begin to eat a low fiber, low residue diet. No nuts, seeds, no popcorn, etc.
I once had a doctor who recommended taking this idea one step further. I’ve tried it several times since and it’s been a game changer for every colonoscopy experience since. The more in your digestive system when you start your prep, the more that needs to come up. The less in your digestive system, the less that needs to come out. So with the low residue foods I just mentioned, I also add to that two days prior, no meat, no dairy, no raw, no bread, no cereal… easy to digest food only. Foods that don’t stay in my body long and foods that my body doesn’t have to work hard to digest.
So what do I eat two days before? I eat eggs, well-cooked veggies… I might have a mashed banana, applesauce or pear sauce, and loads and loads of bone broth. Beef stock, chicken stock… so good and soothing for your gut and rich so it stays with you. If you’re a big meat and potatoes lady, this might make you feel hungry (eating this way) so the bone broth is important because it keeps you fuller longer. I also eat homemade pureed soups, and drink smoothies and fresh pressed juices.
See how all of this two days before is either drinkable or easy to digest. Make the prep easier on your digestive system. Two days before your procedure and one day before your prep, go low, low, low residue. If you want some help with smoothie idea, juicing ideas and soup ideas for this day, I’ve got you covered. Back in episode 22 and episode 24 of the podcast, I talked all about smoothies and juicing and about the gut healing power of soup. In these episodes, I offered extra recipe resources to help you get started and they are still available. To this day, these are two of my most downloaded resources I offer. Maybe you already have them. When it’s colonoscopy time, it’s time to dust them off or go get them ASAP. You can get your juice and smoothie recipes at karynhaley.com/drinks and your soup recipes at karynhaley.com/soup. All the soup recipes can be pureed so that’s a bonus because when all of this is behind you, you can go back and make some of the soups in their traditional form.
There’s one last but not least thing I must mention about two days prior and that is, in keeping with your Zen attitude, to go to bed early and get a good night’s sleep. You want to be well rested for tomorrow.
OK, that’s two days prior. Now lets’ look at the big day—the colonoscopy prep day. Because if you’ve been through this before, you know that this really is the big day. After this day, the colonoscopy procedure itself is a walk in the park. First, let’s talk food, or more to the point the non-food you’ll be consuming. Today is fasting, clear liquid day. You’ve already done lots of the work the day before with your low, low residue diet. Today, you are just taking it one step further.
Today is about clear liquids. Your doctor will give you a list of approved liquids, but I’ll also add in my two cents of some of my favorite beverages. The main liquids I consume on prep day are homemade or high quality commercial bone broth, tea, and water. These are my healthy go-to’s I drink with no limits. They are the driver’s behind staying physically strong, keeping my gut as happy as it can be that day, and knowing I’m still adding to my health. Other things I keep on hand are coconut water, apple juice, white grape juice, ginger ale, homemade jello (made with one of the clear juices I mentioned), fruit pops made with real fruit like mango or lemon (no dark colors like red or purple or blue), Italian ice (again lemon or mango) and I find that throughout the day, it’s helpful for me to rotate between a hot beverage and a cold beverage. It just keeps it more interesting and palatable.
So that’s pretty much what you’ll be drinking and can drink until midnight on prep day. Your list may be a little different than mine, but it’s all liquid and it’s all clear.
OK, now the next part of the day we should definitely cover are general prep day Tips. I’ve got 11 tried and true tips to get you through, as well as find enjoyable pockets in this challenging day. This is where little pieces of enjoyment can filter in. If the day is going to be crappy (pun intended) we might as well find ways to have enjoyable moments in there as well. We deserve it!
#1- Whatever prep you are given, make sure it’s super cold. HUGE. Make it cold.
#2- Drink through a straw. And put that straw to the back of the throat and just efficiently suck it down so you taste as little as possible. You want a tight suck here to avoid air, but the straw really helps you avoid all the bad taste.
#3- Have lemon wedges available to suck on after each gulp. Bite into it like you just downed a shot of tequila. In fact, close your eyes and pretend it’s tequila. It tastes better. Just be careful because you don’t want to swallow lots of pulp. You can avoid this by spitting it out after. Not pretty, but who cares?
#4- Another option instead of or in addition to the lemon wedge is to have a chaser. Again, like my reference to shots—much better than what you’re drinking and I am so not a shot gal! Your chaser should be different than what you are drinking your prep with. It could be lemonade, tea, apple jucie—but be careful with your choice because after this, you may not ever want to drink that juice again. It’s about the pared association and all that.
When you were a kid and you had the flu, did you ever not want to eat what you had right before you threw up? Same principle. I remember so vividly this one time throwing up after chewing grape huba buba gum. Do you remember huba buba gum? To this day, I can’t go near grape gum. Same principal so choose your chaser wisely.
#5- There’s several things I’m going to recommend you have on hand. One of those things is a heating pad or a hot water bottle pad. Very soothing when your belly is doing summersaults.
#6- Another thing that’s great to have handy just in case is sitz bath. I talk about this contraption all the time and I’m amazed by how many C + Cer’s don’t know what I’m talking about. A sitz bath is a round bucket you fill with warm water. It sits on your toilet and you can soak a sore bum in it. I got through my whole freshman year in college with a sitz bath. Look it up on Amazon. You’ll love it.
#7- Again, just in case, it’s a good idea to have a bucket or as my mom who was a nurse always called it, an emesis basin handy. Sometimes the prep can make you feel nauseous. You may never need it, but having it ahead of time and not needing it is better than running to puke in the toilet you just pooped in.
#8- Throughout the day, always have whatever you’re drinking close by. Remember, it’s clear liquids only today, so have that drink handy always. And keep sipping it so you stay as full as you can. You never want to go in search for something to drink when you are hangry. It doesn’t turn out well.
#9- When it’s time for your prep, whether it’s time for you to start going to the bathroom or not, this is your time. Once you start the prep, you are in YOU time and no one else’s time. This means that you create a space close to your bathroom. Ideally in your bedroom where a bathroom is close by. Gather up your electronics—streaming shows are going to be your best friend today. Thank God today we can help the prep time pass binge watching our favorite TV show. If you are a magazine gal, stock up on guilty pleasure magazines like Us or People. Maybe you’re into crafting or gardening or health magazines. I like to gather these up as well so I have options and they to give me something else to do when I get bored watching TV. Music and candles are a must too. They just bring peace and calm to any environment. Bring all of these things to your spot and hunker down when you start the prep, not when you start to go #2. The whole prep time is your time. Comfy blankets, even a boyfriend pillow (you may have had one when you were pregnant) is great. Dust that off get it out. Create your own safe YOU space. One that ideally has a bed or a couch and is close to the bathroom. Let your family know that during this time there’s no distractions other than the ones that you choose to take your mind off the prep. No work, no family obligations, no pets to take out, just you. Enlist the help of older kids, your spouse, your parent, a friend… whoever can make sure you don’t get disturbed—someone who can help you make it happen. Remember, it’s your time and you deserve it.
And when I talk about the enjoyment part of prep day, this is it. This is your enjoyment. All the creature comforts that will make this day all you. Yes, it can suck to have to keep getting interrupted to go to the bathroom, but then you can get back to your comfy space and know it’s all about you and it’s just for you.
#10- Along with comfy blankets and other creature comforts, make sure you are wearing clothes that say comfy to you. No zippers or tight fitting pants. Comfy is the name of the game.
#11- Last tip before we get into the lovely prep is that if you start to get anxious, know that it’s completely normal. Lots of people do. If your distractions don’t help, use the time to journal or go inward and visualize yourself in a different place. Wherever your happy place is. Deep breathing and meditation can help too. If you’re a long time listener, you know I love the free app Insight Timer. Download it on your app store. It’s great for anxiety during moments like this.
OK, that’s 11 tried and true tips you can use no matter what prep you choose. Now, today is all about the prep and it’s where I get the most questions and the biggest complaints from you so let’s spend some time here because I want this part, the worst part of it all, to be as annoyance and pain free as possible for you. Doing those 11 tried and true tips is part of it, but let’s dive a little deeper and talk specifically about your colonoscopy prep.
In terms of what you may be taking to get yourself cleaned out, there’s several options doctors prescribe. Some you will need a prescription for and some are over the counter. If you’ve never had a colonoscopy before, or if you’re wondering what else is out there (at least in the U.S.), these are the common ones. There’s Suprep which is not super tasting in any way shape or form. There MoviPrep, which is nothing like watching a movie, there’s also a particularly bad tasting prep called GoLYTELY. Are you serious? Go lightly? I beg to differ. I’ve had all of these at one time or another. But probably the worst tasting was GoLYTELY. Way back in the day, it was the only prep on the market. It comes in this huge jug. It looks like water, but it tastes worse than drinking gallons of ocean water.
I remember my first time with this prep. It was the summer before I went to college. I was living at home and my mom recruited all my brothers (I’ve got 3 older brothers) go come home and support me. We all sat around the kitchen table. Me with my go-not-so-lightly and my brothers, each with a can of beer. Every time I chugged a glass of GoLYTELY, they would chug a beer. Crazy as that seems, it was very sweet and very supportive. We sat around and laughed and played cards until the mixture sent me to the toilet, but I’ll never forget it. I never felt more supported by my older bros.
Fleets phosphosoda is an over the counter prep, but my favorite prep and the one that’s been a game changer for colonoscopies for me is the Miralax/Dulcolac prep. Sure, none of these preps are a walk in the park, but at least with this method, there’s no bad taste because when you mix the Miralax with your beverage of choice, if just tastes like your juice. It may not be as strong of a prep as some of the others I mentioned earlier and I think that’s why some doctors don’t prescribe it, but with my low, low residue diet the day the day before, there’s not that much in my digestive tract so it just cleans out what’s there.
And it’s not just my doc prescribing this prep method. The Cleveland Clinic, one of the premier IBD hospitals in the country has this protocol as a colonoscopy prep on their website. I’ll link to their info in the show notes so you can check it out and talk to your doctor if a better tasting, gentler prep is something that sounds good to you. Of course, like I mentioned earlier, everyone is different and this all needs to be approved by your doctor, but it’s certainly worth printing it out and asking your doctor if it’s a possibility for you because it’s so much more palatable than Suprep and the like.
Whatever prep you do, it won’t be the most fun part of your day, but as we all know, sometimes a colonoscopy is necessary. And remember, the prep is very time limited—maybe 12 hours of your life. You can do it. It will pass. And it’s scary to think about what your doctor might find. That makes all of this more nerve wracking as well. But it also can to give you and your doctor exactly the information you need to move forward. This is your official starting place so you can move forward with confidence you are on the right path.
When you get that packet of information from your doctor about your colonoscopy and the prep, chances are there will be times slated on what to drink and when to drink it. This is something you can also discuss with your doctor. Many of my preps have said to start at 5pm in the evening, but if I do that, I know I’ll be up all night going to the bathroom. I’ll end up cranky, exhausted, angry, and hangry by morning. Personally, I like to start my prep at noon. That way, by 8pm I’m done, usually cleaned out and I can still drink fluids and relax until bedtime. I also like the earlier start time for me because it gives me some flexibility with the pacing of drinking the prep. If I start to feel a little nauseous and upset in my belly, I can slow it down a little because there’s no rush.
Another option to consider when it comes to prep timing is something called split dosing. It’s when you take ½ of the prep the night before and the other half in the morning. I’m seeing lots of my clients talking about their doctors using this method lately and it seems very interesting. I’ve pulled a couple research articles showing the benefits of split dosing to put in the show notes. One study found that split dosing of the colonoscopy prep improves the quality of the bowel prep. If this is something that’s of interest to you, you can print the studies out to share with your doctor to see if it’s a good fit for you.
In the case of having your procedure scheduled for after 12pm the next day, the split dosing option really makes sense to me. You can do part of the prep in the evening, hopefully get a good night’s sleep and then start again in the morning with the second ½ of the dose. The Cleveland Clinic literature about the colonoscopy prep talks about split dosing as a preferred method even if you are scheduled for your colonoscopy before noon the next day. I’m sure it’s because of this latest research showing that it improves the quality of the prep. Of course, let’s say you are scheduled at 9am the next day. This would mean getting up in the wee hours to do the second half of the prep. It’s not the way I prefer because I really value that good night sleep the night before, but isn’t it good to know that we have options? It’s about picking the one that’s best for you.
OK, we’ve covered a lot today about colonoscopies. Probably more than you ever even wanted to know about the days leading up to the colonoscopy procedure. We talked about a few days before ideas for success, how to eat a couple days prior, and some ideas for your clear liquids day, tried and true tips for the prep day, different types of procedure preps and time of day to consider taking them. So much for you to think about and hopefully it will help when it’s colonoscopy time for you again. Remember, as with all episodes, take what serves you and leave the rest behind.
For the colonoscopy itself, I’m going to leave you in the capable hands of your doctor. There’s choices to be made about whether to have it in a hospital setting or a clinic, whether to be put out, put in twilight sedation or given nothing at all. Lots to consider there, but that’s really a good conversation for you to have with your doctor. For the most part, by the time you get to the colonoscopy itself, the hard part is over. You did it the day before and the procedure itself will be a snap after all you’ve been through. There’s just one more part of the colonoscopy that far too few providers are talking about. The after part. Later that day, that week, next month… what happens after the colonoscopy, besides the treatment plan your doctor you and you discuss?
Here’s the deal with a colonoscopy. For the purposes of this episode, we are assuming you need the procedure. There is no way around it. You’re experiencing symptoms that make it necessary for it to happen. In my opinion, doctors can be alittle colonoscopy happy and I’m curious if colonoscopies are a little over prescribed, but that’s a topic for another episode. For today, we’re going with the theory that you needed this procedure. It brought about great information for you to move forward, but the problem now is that you’ve completely cleaned out your digestive tract—the good bugs, the bad bugs—all in rapid succession and then you had a procedure where the colonoscopy scope was inserted and as sterile as that can possibly be, it’s possible that there were some bad bugs introduced into your digestive tract as well. The whole thing from prep to finish is quite an assault on your body. So, how can you best serve your body now? How can you make sure you get back on track and with the healthiest digestion possible?
Well, first let’s talk about the right after. Like that day, after. That day, after your procedure, you’re going to want to rest. You may have been put under or even just with twilight sedation, you’re not going to be quite yourself. You aren’t allowed to drive after for a reason so resting is key. You might also feel ravenous. How long has it been since you’ve had solid food? Well, a while. But before you eat like a horse, it’s a good idea to start small and see if your body is ready for solid food again. A good after colonoscopy meal might be some mint tea, an egg, some bone broth or some soup… light, easy to digest foods. See how you do with that first.
If your first meal goes well, it’s OK to add more for the second meal. Just take it easy and build back up slowly. Many people experience gas, bloating, some loose stool after the colonoscopy procedure and eating in a way that supports your digestive system is helpful to get you back on track sooner.
After a day of rest and eating with your bowel’s needs in mind, it’s a good idea to get on a probiotic to start to restore your microbiome. Repopulate, rebuild, and re-balance your gut. Probiotics are a good way to get moving in that direction. If you eat fermented foods like homemade yogurt or sauerkraut, that can be helpful too.
Remember, this clean out and this procedure really wreak havoc on your digestive system. It will take time to get back on track. Be patient. It will happen. You know, one of the things I see clients for most is getting back on track after a colonoscopy. Clients will often say, “I was never the same after that colonoscopy.”
Not enough is being said about this. It’s not something we hear about from our providers, but gut dysbiosis after a colonoscopy is really common and needs to be handled carefully, patiently, but also deliberately. If this is you, if you’re struggling right now after a colonoscopy, know that it’s very normal. I hear about it all the time and it can get better. I’m here to help. Reach out at hello@karynhaley.com and we’ll figure it out together.
So after the colonoscopy, gentle gentle, gentle, on your system. Get back to your normal diet slowly. Try a probiotic to help repopulate the gut and if you’re still struggling, get in touch. I’m happy to help.
What did I miss? What did I not cover today with regard to the colonoscopy? Whatever questions or comments you have, I’m here for you. No one should feel like they are going into a colonoscopy afraid and alone. I did this episode because I want you to know that you are not alone. With Crohn’s and colitis, we all go through this at some point. And even though a colonoscopy will never be up there with your top life experiences, it doesn’t have to been horrendous either. You can get through it with a little planning and a lot of self care.
You’ve got this my dear. Now go conquer that colonoscopy!
Until we meet again, I’m wishing you a cheeky and healthy gut healing journey. Chat soon!
These statements have not been evaluated by the Food and Drug Administration.
This podcast, video, and blog post is not intended to diagnose, treat, cure, or prevent any disease.
