Colonoscopy Prep Tips

The best advice I read was to treat the day of the cleanse as a time just for me. No kids, no chores. Just instructions to take care of business at a set time. I planned the movies and shows I would watch and all the food I normally don’t eat so that it would feel like a treat. I stretched and took a lovely bath. If you have pets, it could be a good time for cuddling with them. Take the day off and give it to yourself fully. 

 

• Stop eating meat four days before the procedure. Guidelines say two days but it takes a while to digest so clean the pipes early.  

 

• Move to low residue diet three days before, as instructed. This was tricky for me as someone who eats lots of vegetables, beans, nuts and seeds. But it was a time for skinless mashed potatoes, asparagus tips and salmon, pureed soups and all the starch I could eat, like white bread and rice pudding!

 

• Prep your solution the night before so they are easier to drink cold and with a straw. I measured 32 ounces of liquid in a big pitcher and then divided in half the Miralax that came in a 8.3 ounce container. I stored the mixture in gatorade bottles in the fridge. Follow the directions they give you. With the second batch after switching to diluted apple juice, I mixed it all in the pitcher and put the pitcher in the fridge (didn’t label it as I was alone) and then poured myself 8 ounces at a time. 

 

• Use something other than gatorade to mix with Miralax. Some say be careful of things you regularly drink to not create a negative association. I went with diluted apple juice for the second round after realizing the gatorade had messed me up as I wasn’t used to all the sugar and artificial coloring. But you could use coconut water, just any liquid not red, orange or purple.

 

• Go slowly. I had the first 8 ounces down after five minutes instead of 15 minutes and felt nauseous before realizing I needed to slow down. With my second 8 ounces, I followed the instructions to drink it over 15 minutes. The nausea subsided.

 

• Have a couple different types of broth, diluted apple juice, coconut water to drink outside of the mixture. We have to drink 12 tall glasses of liquid IN ADDITION to the Miralax solution. I had my LMNT (flavored salt) packets, which helped a bit. I also had liquid magnesium to more electrolytes. 

 

• Fresh citrus is a delight—Cutting into, smelling and drinking it had me feel alive again. The gatorade wrecked my system. So the freshness of the citrus was rejuvenating and helped me get down more fluids which I didn’t realize I needed as I had a headache and my mouth was very dry. I felt weak and unmotivated to get up but after my friend brought me the citrus and I tried a different broth, I was a different person.

 

• Start the prep on the early side of the window, if possible. Mine was between 3-6pm. I drank the Ducolax and waited the hour, then at 4pm began the Miralax. I was on the toilet at about 5pm, every five or so minutes until 6. Then every 15 minutes until 7 and then less regularly. I was able to go to sleep at 10pm and woke up at 3am to start the second round. Getting five solid hours of sleep. I drank the solution from 3-4 am and then used the bathroom on and off for the next hour and then went back to bed at 5am, the exact length of a movie. That part was very simple. I felt very satisfied knowing that the hard part was complete as well. 

 

• You may be able to negotiate with your doctor if you have problems with cramping. We made a deal that if I did ALL of the Miralax prep, instead of the stimulant laxative I could take a more natural laxative I had discovered…Ducolax’s Magnesium Phosphate. I had zero cramping.

 

• Prepare for toilet time. After the first round of Miralax, I brought the iPad into the bathroom and hung out for a half hour after having a movement because it wasn’t predictable and I didn’t want to be running. However, during the second round, I stayed close to the bathroom but had time to pause the movie to take care of the movement and then returned.

 

• Take care of the delicate parts. I bought the soft toilet paper and put some castor oil jelly around the exit but did not need it. I have a bidet and didn’t really need it either. We all are different. Maybe I got lucky, maybe because I don’t eat dairy or the food I ate wasn’t acidic, I have no idea.

 

• Do things to comfort yourself. I took a magnesium bath before bed and watched shows I had been looking forward to. A good friend came over to bring me reinforcements after I switched from gatorade and that perked me up. I bought lime popsicles I would never eat because of the sugar as well as a bit of candy. 

 

The final moments have arrived…

 

• Your colonoscopy can be euphoric! I had propofol — aka diprivan. They put it in the IV and said I would "be out" shortly. After 10 seconds and I felt it hit me with a moment of panic and then I had an awesome dream. I felt so good. When they brought me back I was in bliss that lasted for about two minutes that had me telling the hospital staff how awesome they were as well as sharing some very personal details! After about two minutes I felt my state change as the cynical lenses re-clicked over my vision. I then became a bit mortified about what I had said. Beware and enjoy it, I did not know before, but Propofol Euphoria is documented in about 50% of patients. I look forward to my next procedure just for this experience.

 

• Sedation bliss should be free for all. The government has issued rules that “the plan or issuer may not impose cost-sharing with respect to anesthesia services performed in connection with the preventive colonoscopy if the attending provider determines that anesthesia would be medically appropriate for the individual.” They may tell you full sedation versus conscious sedation will cost extra but if the doctor orders it, they may not be able to fight you. I’m still waiting to see if UCLA will try to charge me. I’ll update this post if I get a bill.

 

• Cost. Make sure your doctor codes the procedure as a “screening” colonoscopy as that type is covered 100% under the Affordable Care Act. If they do find polyps it turns to “diagnostic,” then you will have to pay some portion of it. Double check your bill, UCLA tried to say the fact I had had COVID and allergies made it a diagnostic (my insurance company told me what codes they had included.) I appealed and the turned it around.

 

• Reintroduce foods gradually moving from low to more residue over the next day or so. Plant proteins are a good choice. I had a tofu, soup with well cooked veggies and rice noodles right after the procedure. Nothing like those first bites of whole food.

 

• Side effects. I noticed was that my body more heavily craved some of the simple sugars and starch I had given it during the colonoscopy prep. It took about two to three weeks to get my body re-regulated with the cravings finally going away.

  • I also noticed I got itchy right after the procedure. An antihistamine took care of it but wasn’t sure if it was a reaction from the sedation or the sugars that caused this flare. I went back to taking probiotics including Seed and Align to repopulate intentionally. For what it is worth, the cleanse cleared up whatever had been giving me gas prior to procedure. 

 

• Follow your doctor's instructions but getting through it is the most important. Don't put it off because the prep scares you. And if you are worried about starving during your "clear liquid" (be able to read a newspaper through) phase, consider negotiating with your doctor to go liquid versus "clear liquid" as a few studies show the clarity doesn't matter. Another study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848543/) shows that if prepping with Miralax then just a no-fiber diet would suffice. I would stick with generally clear liquid but the research made me feel better about having a tomato based broth when I was feeling really bad. I added some cumin and lemon juice and it perked me right up and my colonoscopy was squeaky clean so it seems my few dashes of spices and slight red color to the broth did not create a problem. (This was before my second round of Miralax so I was pretty cleaned out already.)

​

Enjoy the clearing out of your colon! If you want to clear out other spaces with ease, specifically in the body or the home, then please contact me to discuss. I'd enjoy guiding you with care and comfort on your journey.