Extreme Makeover: Colonoscopy Edition

Most cases of colon cancer could be prevented with regular colonoscopies. Unfortunately, 1 out of 3 adults between 50 and 75 years of age are not getting recommended screenings. Why are so many men and women taking chances with their colon health? According to surveys and studies, the bowel preparation is one of the biggest reasons that people choose to say “no” to a colonoscopy. What these individuals don’t know is that colonoscopy prep has changed dramatically in the past decade, and it’s all for the better! New preparation methods, innovative preparation foods and a prep-day menu makeover has helped make the colonoscopy more approachable than ever before. March is Colon Cancer Awareness Month, so let's learn more about how colonoscopy preparation has improved over the years.

Same-Day Preparation Method vs. Split-Dose Preparation Method
In the past, there was only one way to prepare for a colonoscopy: the same-day bowel preparation method. This regimen required you to consume a large amount of purgative solution in a single dose on the night before your colonoscopy. There were many undesirable side effects to the same-day method, and it often caused abdominal discomfort, bloating, nausea, or vomiting. Many patients reported that they could not finish drinking the prescribed amount of fluid, which resulted in incomplete bowel preparation and inconclusive test results.

Today, the split-dose method is now almost universally accepted among gastroenterologists because it results in a better bowel cleansing. You can take the first dose of prep solution the night before the procedure, and the second dose on the morning of the procedure. Patients almost unanimously prefer the split-dose method over the same-day method because the smaller volume of liquid is more palatable.

Most doctors also prefer the split-dose method because a thoroughly flushed bowel is the precursor for a quality colonoscopy. A clear colon allows your gastroenterologist to visualize and remove precancerous polyps. If these polyps are not removed, they can continue to grow and possibly develop into colon cancer. By removing the polyps, you are taking away the possibility that a polyp can become cancerous in the future. The split-dose method creates a better environment for your gastroenterologist to detect any abnormality in the colon, making it the preferred choice for patients and doctors.

New Colonoscopy Preparation Foods
Colonoscopy preparation products themselves could get a whole lot tastier in the near future. Some specialty food companies are developing bowel-clearing beverages and foods that contain the same active ingredient, polyethylene glycol (PEG) 3350, as the prescription laxatives. Instead of having to drink a salty, medicine-like beverage, how about a strawberry banana smoothie, a vanilla shake or a lemon cooler bar that will bring about the same result? Researchers are hoping that these food products will soon be available for colonoscopy patients and that the variety of choices will ultimately help increase colon cancer screening rates. Insurance will likely not cover these new products, but people may be willing to spend a little more money for an option that is more pleasant.

Clear Liquid Diet vs. Low Residue Diet
The third improvement in colonoscopy preparation is the prep day menu. In the past, only clear liquids were allowed on the day before your colonoscopy. These included broths, soft drinks, tea, black coffee, clear juices, Jell-O, and popsicles (except for red or blue). It’s not surprising that colonoscopy patients consistently complain about their hunger throughout the prep day. Fasting accompanied by a colon flush is unpleasant, to say the least. Many doctors question whether the clear liquid diet is mandatory, and some physicians believe that a low-residue/low fiber diet is sufficient for colonoscopy preparation.

Several new studies show that a low-residue diet is just as effective as a clear liquid diet for optimum visualization of the colon. Instead of patients only being allowed to have clear liquids, foods like white rice, white bread, refined pasta, cereals, crackers, vegetables without skin or seeds, fruit without peels or seeds, tender meat, poultry, fish, eggs, and broth-based soups may be permissible. More research needs to be done, but these studies provide convincing evidence that patients may not need to starve themselves and be uncomfortable in order to have a quality colonoscopy.

Today’s colonoscopy certainly isn’t your mother’s colonoscopy of 20 years ago. Talk to your doctor about the recent “makeover” that the colonoscopy has undergone, and when it would be best for you to get screened. There’s no better way to celebrate Colon Cancer Awareness Month than to schedule your screening colonoscopy, so thank you for doing your part!