Anxious about your colonoscopy? You don’t have to be

Let’s face it, when most of us see or hear the word “colonoscopy” our butt cheeks clench involuntarily. Most of my patients complain that one of the worst things about turning 50, is the thought of going in for this particular procedure (you will probably need one earlier than 50, if you have a family history or other risk factors). I agree! there is nothing fun about self-induced diarrhea or having a scope wiggled around your rectum.

However you’ll find that the thought of a colonoscopy is actually more scary than the procedure itself.  Here are some pointers on how to make that colonoscopy more bearable, and less scary:

• It doesn’t have to be expensive: First of all, you don’t have to worry about cost. Colonoscopies are one of the many procedures that fall into the screenings recommended by the United States Preventive Services Task Force, and that have to be covered without copay by insurance companies under Obamacare. A colonoscopy is the best way to see the entire colon and also if any precancerous polyps are seen they can be removed right there and then. However, if you are extremely apprehensive about having a colonoscopy there are other options such as “flexible sigmoidoscopy” and “fecal occult blood tests”

• You don’t have to drink a whole gallon: You may be prescribed a huge gallon of colon prep e.g. PEG to clear out all the contents of your colon (therefore causing some diarrhea) so that the scope can have a better view of your colon walls. If over 4L of PEG is too much to drink, ask your doctor for a low volume prep such as Moviprep, or Suprep, Half Lytely or Prepopik. If those are too expensive, use oral bisacodyl plus 2 liters of generic Polyethylene glycol (PEG) as a cost saving plan. If you absolutely have to take a high volume colon prep, ask your prescriber to write the directions as a split-dose i.e taking half of the prep an evening prior, and the other half on the morning of the procedure.

• It doesn’t have to taste bad: To improve the taste of your colon prep, it is advised to chill it by putting it in the fridge; or you may also add lemon juice or crystal light. Drinking with a straw is also a good way to improve palatability. When mixing your prep in order to improve the taste; avoid red, blue or purple flavors or drinks because they may stain the colon and look like blood, which may cause false alarm during your procedure. Here’s the rule: If its not red/purple and you can see through it, you can use it for mixing. Keep in mind that while alcohol may be a clear liquid but it is advised not to take alcohol in the days running up to your colonoscopy because an anesthetic is used during the procedure and it can cause unpredictable reaction when combined with the alcohol in your system.

• You MAY not need to stop taking your regular medications: If you are taking any meds, let your prescriber know and do not stop taking any medication without first consulting your doctor. Most medications can be taken with a sip of water up to 4 hours before the colonoscopy. However anticoagulants, NSAIDS, iron and fish oil may need to be held up to a week.

• You will probably not even feel it: A colonoscopy is typically done under general anesthesia so it wouldn’t be as bad as you think. Also, look on the bright side; due to the sedating medications, you will have to get someone to drive you home after the procedure while you sit back and take a nap!

• P.S: A colonoscopy irritation can occur in the perianal region after your procedure. Do not panic, this is common. Avoid using toilet paper (use pre-moistened wipes instead) and also use warm compresses on the area 3 or 4 times a day. After the compress, slather apply some balmex to the irritation. Also, avoid hot, spicy foods for a while.

I hope with these tips, I have been able to convince you to go in for that colonoscopy. I hope you will find that the procedure does indeed sound so much worse than it actually is (and when you do, don’t forget to come back and leave me a comment :)) Also, look on the bright side – after all is said and done, you’d have lost a couple of pounds plus you’ll be 100% sure that you don’t have colon cancer!