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Geisinger becomes the first member of Risant Health

Just thinking about a colonoscopy can cause people to shudder in fear or embarrassment. But more people may dread the prep work than the actual procedure based on stories they've heard from friends or family who have gone through it years ago.

But, things have changed over the past few years, making preparation for a colonoscopy much easier than what you might think.

"The process of getting your body ready for a colonoscopy is significantly easier than it was in the past," said Amitpal Johal, MD, director of Endoscopy and associate director of Gastroenterology for Geisinger Medical Center.

What hasn't changed? The bowel and colon need to be empty in order for the colonoscopy to be performed properly.

"Any residue in the colon may obscure your doctor's view of the colon and rectum during the exam, which can result in a longer procedure, a missed polyp, or even the need to repeat the procedure soon," Dr. Johal said.

In the past, one component of cleaning out the colon consisted of drinking a solution consisting of a laxative and electrolytes - and a lot of it. You used to have to drink 18 eight-ounce glasses of this stuff, which has a very harsh taste, the day before the procedure.

"Some doctors may still recommend this regimen before a colonoscopy, but largely doctors are taking advantage of improvements to this part of a colonoscopy," Dr. Johal said. "Now, patients may be able to take smaller amounts of the liquid concoction in combination with pill laxatives followed by fluids of their choice for the next few hours, beginning the afternoon or night before."

In fact, the dosage of the laxative pills or liquids is often split up now instead of enduring it the entire day before your colonoscopy - your dose may be split between the night before and the morning of the procedure.

Your doctor will also likely ask you to alter your diet before your procedure.

"Typically, you won't be able to eat solid food for 24 hours before your colonoscopy," Dr. Johal said. "You can replace solid foods with clear juices, sports drinks, Jell-O, or clear liquids, such as water, tea or coffee without milk or cream."

You'll have to avoid any food or drinks containing red, blue or purple food coloring - they can be confused with blood during the exam. You may also be advised to avoid seeds, nuts and other foods high in fiber before taking clear liquids. Additionally, you may not be able to eat or drink anything after midnight the night before the colonoscopy.

Your doctor may also ask you to use an over-the-counter enema kit the night before or a few hours before the exam to further empty the colon.

"Even though colonoscopy prep may not be your favorite life experience, it's much easier today than it was in years past," Dr. Johal said. "Plus, it's the first step toward potentially saving your life - colonoscopies can catch pre-cancerous polyps and colon cancer in its earliest stage when it's most treatable. And the procedure itself is really like taking a quick nap - you don't feel a thing."
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