I Am Not Afraid of a Colonoscopy. I’m Afraid of the Prep!

Maggie Oliveira, RN, BSN

Health care providers agree that the best way to screen for colon cancer is with a colonoscopy. A colonoscopy can actually prevent colon cancer! No other screening test can do that, which is why a colonoscopy remains an important part of your health maintenance.

When it comes to having a colonoscopy, some common questions often arise.

What is involved?

Having a colonoscopy is a two-day process that will affect one day of work. The first day involves being on a clear liquid diet and starting your bowel preparation. The second day is the day of your procedure.

What is the bowel prep and why is it important?

Consider your arm. When your skin is nice and clean, you can see freckles, bumps and even scars. If your arm is covered in mud, what can you see? It is the same with your colon. A dirty colon will prevent the doctor from seeing something that could potentially become a problem.

That is why your colonoscopy is only as good as your prep. The colon can hold a large amount of stool. The purpose of the prep is to clean all the stool from the colon. The prep liquifies the stool and helps you to evacuate the stool. This leaves the colon clean, which helps the doctor see any polyps or signs of inflammation.

Please let your doctor know if you have chronic constipation. Patients who suffer from chronic constipation may need to start their prep two days before their procedure to achieve good results.

I already have diarrhea. Do I still need to do the prep?

Yes. Even if you have diarrhea before starting the prep, the colon still needs to be cleaned.

How do I know the prep is working?

Your stool will be coming out watery - like diarrhea and will go from a brown color to a yellowish or clear watery stool. If you find the prep is not working, call the office. A nurse or doctor can help you.

Does the amount of prep go by my weight?

No. The prep does not work that way.

Why can’t I have anything to eat or drink on the day of my procedure?

It is important that you not have anything by mouth to guarantee that the stomach is empty and also not producing gastric secretions (juices). Each time you place something in your mouth from a sip of water to chewing gum the brain will communicate to the stomach to “get ready” because something is coming.

An empty stomach is extremely important when receiving sedation. This minimizes the gastric secretions creeping up to your throat. Out of concern for your safety, the procedure will be delayed or canceled if you eat or drink anything other than sips with your medication.

Do I take my medications?

Always check with your provider for which medications you can take or should hold. Diabetics on insulin should check with their doctor for their dosage the night before and morning of the procedure.

A patient who is on blood thinners should get directions from the doctor who manages his or her treatment. A therapy plan needs to be set in place. Please have this planned weeks before your procedure to avoid interruption of care.

What if I forget and eat or do not complete my prep?

If you eat, start the prep late, do not complete your prep, or have anything but watery, light yellow/clear stool, please call your doctor’s office. Your procedure may need to be rescheduled and this is best determined before you arrive for the procedure.

Who will be in the room during the procedure?

The staff in the room during your procedure varies depending on the facility. Most teams include your provider, a registered nurse and a technician.

How long will the colonoscopy take?

A good estimate is two hours from the moment you arrive to your discharge. Please keep in mind that this is a procedure that requires sedation and the delivery of safe care to all patients undergoing procedures that day. Each patient is unique, and individuals’ needs vary. For some, the procedure may be easy and quick, while for others it may take a bit longer.

Will I feel anything or be aware?

Moderate sedation (also called conscious sedation) is a form of sedation involving an intravenous narcotic and intravenous sedative that your registered nurse will administer as prescribed by your provider. It is not meant to “knock you out.” Rather, it is to keep you comfortable throughout the procedure. Most patients are asleep. Others remain awake and if they choose, can speak with the team and may opt to watch the procedure on a screen. If you are receiving monitored anesthesia care, this deeper form of sedation requires an anesthesiologist on the team to administer the sedative medication.

What will my recovery time be?

Once the procedure is completed you will go to a recovery room where a nurse will continue to monitor you and then sit you up and offer something to eat and drink. This usually takes about 30 minutes depending on your recovery. Each patient varies. Here you will also have your discharge instructions reviewed and given to you in writing to review at home. Remember, you have received sedation and it is very likely that you may forget the conversation.

Your safety is our top priority. It is important, and it is also our policy, that you do not drive and are accompanied by a friend or family member when you leave. You may use a ride share service, taxi or bus to get home but you must be accompanied by a family member or friend. It is not safe to leave alone or to drive, even if you feel fine. If you choose to drive, be aware that by law you are driving under the influence and also placing yourself and others at risk.

When will I have my results?

In the recovery room your nurse or doctor will let you know what was done and what was seen during your exam. Biopsy results may take up to five to seven days. Your provider will inform you of results either through the MyLifespan patient portal or a letter mailed to you. You also can call the office and ask for results and a nurse will review them with you.

Know that any polyps or inflammation seen during the colonoscopy will be removed and biopsied. All tissue samples taken during your procedure are sent to a laboratory as part of routine testing.

When will I need another colonoscopy?

For screening purposes, the provider considers the type of tissue that was seen in your colon. This, along with your medical history and other factors, will determine when you will be due for another screening.

While the prep may be unpleasant, it allows us to give you the most thorough exam we can. Remember, colonoscopies save lives!

Learn more about the gastroenterology services available at Lifespan.

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