Preparing for a Colonoscopy

(bouncy strumming music) – Hello, I'm Dr. Lynn
Butterly, and I'm here today to talk to you about taking
the prep for your colonoscopy. You may have heard from many
people that the preparation is the worst part
about a colonoscopy, and for the vast majority
of people, that's true. Therefore, we're here today
to talk about some tips and suggestions that might
make it easier for you to take the preparation
for your colonoscopy, and to do a good job, which
is extremely important. Colorectal cancer is the second
most common cause of death from cancer in
the United States. Only lung cancer is more common
in men and women combined. On top of that, colorectal
cancer is one of the few cancers that we can actually prevent. There are two major
concepts in terms of cancer prevention and early detection. One is preventing the
cancer altogether. The other is detecting it
early so that your survival is prolonged and treatment
is more effective.

Colorectal cancer gives
us the opportunity not only for early detection,
because finding a cancer early definitely
prolongs your survival, but beyond that, with
colorectal cancer, we can actually often prevent
it from happening at all, and the way we do that is
by finding small growths in your colon, called
polyps, removing them, and preventing them
from having a chance to grow into cancer. So how do we do that? Well the way we do that is
that we do a colonoscopy, which is a test using
a long, thin tube, approximately the
size of your finger, with a light on the end,
bends in all directions. It looks through your
colon or large intestine to find these small
growths called polyps, and then we can
painlessly remove them in a matter of seconds.

There is no feeling
for removing a polyp, and in that way, it prevents
the polyp from having the opportunity to later
grow into colorectal cancer. So that is true
prevention, and therefore, we want to make sure that our
ability to do the colonoscopy and find the polyps is
as good as it can be. So how do we do that? Well, a very
important part of that is cleaning out the
colon appropriately so that we can see clearly
and find the polyps. As you might imagine, if
you've ever had a sore throat, when you go to the
doctor, and they look at the back of your throat,
it would be pretty tricky for them to see what
that looked like if your mouth were full of food. So clearly we want your
mouth to be empty of any food so that we can see the
back of your throat. The same thing happens when
you have a colonoscopy. We need your colon to be
really well cleaned out so that we can find these
polyps, even the small ones, and have the best
chance at removing them, and therefore, have
the best chance at preventing you from
getting colorectal cancer.

So, what we need in order to
do that is a good preparation. And that's why we're here today to talk to you about
some tips and suggestions about how you can
get through the prep. Remember that whatever
we say here may differ from instructions
from your own doctor, and you need to follow
the instructions from your own doctor's office. However, this will give you
some tips and suggestions, you may discuss them
with your physician if you think they
would be helpful, and utilize whatever your doctor
feels would be appropriate for you to use in
taking the preparation. There are several different
types of preparation for colonoscopy, but the one
we're gonna talk about today is a commonly used
one, a four liter jug of powder mixed with water. I know it sounds daunting,
but it is possible to get through this prep,
and we are gonna discuss some tips and suggestions
to try to make that a little bit easier for you.

Usually your doctor will
send you a prescription and let you know where to
pick up the preparation, and you will then
receive, as we said, specific instructions
from wherever you will be having your colonoscopy done. It's important to follow
the directions given to you by the center that is going
to be doing your colonoscopy, and remember that what
we're discussing here today are just suggestions
to make it easier. This is one way to do the prep, and you can always discuss
them with your endoscopist if they seem to differ
from the instructions you get in the mail.

So you are going to pick up
the preparation ahead of time. You'll also wanna be prepared,
have all your supplies on hand so that you're not
running out in the last minute trying to get the things
to make your test easier. So here are some
suggestions for getting ready ahead of time. First of all, you're also
going to be on what we call a clear liquid diet the day
before your colonoscopy.

Clear liquids are
liquids that are clear. If you hold them up to
the light in a glass, you can see through them. That's a good way to
figure out if something is a clear liquid or not. So for example, orange
juice filled with pulp is not a clear liquid. Examples of clear liquids that
you do want to have on hand would be, for
example, apple juice, white grape juice, ginger
ale, other clear drinks, jello, broth, bouillon. Those are really good
because if you feel cold while drinking the prep,
some broth or bouillon may help you to feel warmer. Some hard candies to
suck on in between taking glasses of the liquid, and anything else that falls
into a clear liquid category. If you have questions, your
endoscopy center can tell you what constitutes a clear
liquid and what doesn't. Other things you might
want to have on hand are plenty of toilet
paper, because this prep does involve spending
some time in the bathroom, a magazine or book
that you like, any special wipes to use
if you feel that those make you more comfortable
as you go along.

And anything else that helps
you to feel comfortable. It's only a few hours,
and you want to make them as easy as you possibly can. In general, the way
people take the prep is to drink one glass
every 15 minutes or so until they begin to feel full. Most people do
begin to feel full after a number of glasses,
and at that point, it's sometimes
helpful to just pause. Take a break, stop
drinking for a while, you can walk around,
take your time, in order to help the
liquid to pass on through. If you continue to try
to force the liquid down when you feel really
full, it can result in nausea or vomiting,
that does happen sometimes, but this is one way in
which you might be able to minimize that from happening. As you begin to work your
way down through the jug, you will begin to notice as
you pour glass after glass, that fortunately the amount
remaining is getting less.

However, as people get about
halfway through sometimes, they sometimes can
feel discouraged. It feels like a lot to do. Just remember, the end
goal is to have your colon be really clean so that
the doctor can find all the polyps there are. So don't get discouraged. Take a little break. Walk around if you need to, and then come back to
it, and you will know that taking the prep and
having a successful colonoscopy has got to be easier than
getting colorectal cancer. So keep that in mind, try
not to get discouraged. You will make it to the
end, and when you do, your colon will be clear. Now there's some other tips
about taking the gallon jug if that's the prep
that you're taking, and one of those is to
split the prep in half.

So half the preparation,
the afternoon and evening before the test, and the
other half or part of it the morning of the test. Not every endoscopy center
gives these instructions this way, and it is
important to follow the instructions
that you are given, but if you are given
instructions for a split prep, that may help you, because
what you will be doing is working on cleaning out
the colon the night before, trying to get a
decent night's sleep. There is liquid that
reaccumulates overnight, and therefore, taking a
few glasses in the morning can help to get that
last bit of liquid out. Remember to give yourself
plenty of time for this, because you're only drinking
every 15 minutes or so until you feel full,
taking a break, and then taking the rest. And also, you want to
finish the preparation an hour and a half to two hours
before you leave the house, because you want it
to move through you while you still have
a bathroom handy, and not while you've
gotten in the car and are driving an hour and
a half to your colonoscopy.

So keep that in mind,
that finishing the prep well before leaving the
house is another helpful tip. Now in addition to splitting
the prep into two sections, you want to keep the
end goal in mind. The end goal is that
what you are passing should look pretty much
like what you're drinking. If you are passing
brown fluid of any kind, your colon is probably
not cleaned out enough, and it would be a good idea
to contact the endoscopy center for instructions. If you are drinking
the second half of the preparation on
the morning of the test, which you will finish well
before leaving the house, then your goal is to
have what you pass when you go to the bathroom
look like pretty much what you're drinking,
or slightly yellow
tinged, not brown, no food particles, no other
kind of particles, but clear.

One of the things that you
can do if you don't like the taste of the
liquid is to flavor it with a flavoring such
as Crystal Light, which is available
in any grocery store, comes in different flavors. You want to avoid any red
or purple-looking liquid the day before the
colonoscopy only because we want to be sure that
nothing appears to be blood in your colon if
there's no blood there. That's the reason
that your instructions will probably say to avoid
red or purple liquids. So the Crystal Light
comes in flavors, and what we would recommend
is that you obtain several different flavors,
because if you only use one flavor, you will
probably never want to drink anything that flavor again
for a good, long time. So, give yourself a selection. Don't add the flavor directly
to the entire gallon, because if you do
that, you will be stuck with one flavor for
the entire drink.

What's better or more
useful in many cases, is to add the powder,
the Crystal Light powder to your glass of the prep,
so you have the prep, pour it into your glass,
you're going to flavor it with a little Crystal
Light, you're gonna vary the flavors of Crystal
Light that you use so you have a little
bit of variety, and for many people, that
helps to get over the taste and get through the preparation. There are some other
things that you can do to this preparation to make
it a little easier to drink. One of the things is to
remember that if you have it in the refrigerator,
and as you drink it, you're getting shaking chills and it just feels
too cold to you, you can take it out
of the refrigerator and let it return a little
closer to room temperature.

On the other hand,
if you're drinking it at room temperature
and it feels awful and you'd like it to be cold, you can put it in
the refrigerator. So in other words, you
can vary the temperature in order to make it a
little more palatable. Some people find that drinking
through a straw also helps, especially if they're
starting to feel a little full and maybe a little nauseated. So you can take a break, you
can then get yourself a straw and begin drinking
through a straw. So straws would be another
thing to have on hand if you have trouble drinking
large amounts of liquid. Remember the objective
is to have what you pass when you go to the
bathroom be clear, looking a lot like what you've
been drinking or like water, or maybe slightly yellow tinged, but no brown, no particles.

If you are passing brown liquid, call your endoscopy
center for instructions, and that will help
you to be cleaned out. The other things we
talked about are the clear liquid diet, the
broth, bouillon, all the things you want to
have on hand to help you. You can take those the
day before the test and on the morning of the test, but it will be important
to have nothing by mouth at least two hours
before the procedure, and those instructions
may vary according to your endoscopy site as well. There are also very
important instructions about what to do with
your medications, which medications to take,
which ones not to take. If you're a diabetic, what
to do with your insulin, and it is extremely
important that you have those instructions and have
spoken with your physician and your endoscopy center
so you know just what to do. Then you just need to
go to it, stick with it, it will clean out your colon. If you do the prep correctly,
your doctor will have the best chance possible to
find any polyps that could be within your colon,
to get rid of them, and to reduce your chances
of getting colorectal cancer.

So keep the goal in mind,
it is to prevent you from getting colorectal
cancer, and that's worth it. So, here's to your health..

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