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Bowel preparation is an essential part of a successful colonoscopy, so you need to make sure that you completely understand the instructions provided concerning your bowel preparation.
If your bowel is not free of all waste (stool) before the procedure, polyps and lesions can be missed; the colonoscopy may take longer (increasing risk of complications); or the whole process may need to be repeated or rescheduled.
Bowel preparation for a colonoscopy isn’t pleasant, but must be done correctly and completely, or the entire examination (including bowel preparation) may have to be repeated.
Bowel preparation works like a strong laxative to quickly eliminate solid waste from the digestive tract, resulting in diarrhoea (and necessitating easy access to a toilet while completing the preparation process).
The exact colonoscopy preparation instructions depend on the bowel preparation your colonoscopist has selected for you, the time of your colonoscopy, any prior experience you’ve had with preparations and on your medical history.
Some of the most common bowel preparations are:
Click on the above links to access Consumer Medicine Information (CMI) which provides further detail and important facts to know before, during and after taking your preparation.
While a CMI is written by the pharmaceutical manufacturer, the content is defined by legislation to ensure it is accurate, unbiased and easy to use.
The afternoon or evening before the colonoscopy (typically 12-18 hours prior), you will drink a liquid that triggers bowel-clearing diarrhoea.
You will be given instructions that will explain what you should and should not do in preparation for the colonoscopy.
You will also get a list of what you can and cannot eat or drink.
A few days before the colonoscopy procedure you should start eating a low-fibre (low residue) diet: no wholegrains, nuts, seeds, dried fruit, or raw fruits or vegetables.
Fruit juices, white bread, refined breakfast cereals, meat and dairy foods are allowed.
Dark colouring in your bowel can lead to inaccuracies during the colonoscopy, so avoid drinking or eating anything coloured red or purple.
The day before the colonoscopy procedure, you should not eat any solid foods. Instead consume only clear liquids like clear broth or bouillon, black coffee or tea, clear juice, sports drinks, popsicles, etc.
The day of the colonoscopy, as on the previous day, drink clear liquid foods only.
Drink plenty of liquids to stay hydrated, even if you don’t feel especially thirsty.
Don’t eat or drink anything two hours before the procedure.
In general, these preparations are safe, and most people have few problems with their use.
Tell your colonoscopist or pharmacist as soon as possible if you do not feel well while you are taking the bowel preparation.
A good bowel prep is essential to a good colonoscopy and critical to detecting bowel cancer or preventing it through the detection and removal of polyps.
In Australia, inadequate bowel prep is observed in around 7% of all colonoscopies. Bowel Cancer Australia’s resource can help you ‘bowel prep’ prior to colonoscopy.
The exact colonoscopy preparation instructions depend on the bowel preparation your colonoscopist has selected for you, the time of your colonoscopy, and any previous experience you’ve had with preparations.
Different bowel preparations flush out the bowel using different methods and vary in the active ingredient they use, how they taste, how much liquid is involved, and in how they’re dosed.
The preferred method is known as split dosing.
You take half the prep the night before the procedure and the other half about six hours before the procedure.
It may clean the bowel more thoroughly compared to taking all the preparation the day before the procedure.
No matter what preparation you take, follow the instructions provided with the preparation as well as those given to you by your colonoscopist, and remember to cease taking any medications that may increase the risk of bleeding if a polyp is removed, as per your colonoscopist’s instructions.
Once the preparation begins to work, it’s best to stay in the bathroom if possible due to the urgency and frequency of needing to use the toilet.
Wear loose comfortable clothes and keep items close at hand that you might like to use, including your phone, laptop, magazine, books, or office work, as well as plenty to drink.
To avoid chafing, use disposable baby wipes or water to rinse, instead of toilet paper.
Eventually the colour of your diarrhoea will begin to get lighter, which is one indicator that the bowel is getting cleaner. However, finish the preparation as instructed and drink plenty of clear fluids to remain hydrated.
If the bowel preparation is still working in the morning when you go for your colonoscopy, don’t be embarrassed to ask for a bathroom when you arrive. People ask this all the time and staff are used to it.
Some minor side effects are common during the preparation including nausea, bloating, and abdominal distention.
If you chilled the preparation prior to drinking it, you could experience some shaking chills from consuming so much cold liquid in a short time period.
These minor types of side effects call for holding off on the preparation for a bit, then trying to restart after the symptoms pass. If you can’t restart, call the colonoscopist for recommendations.
More serious side effects include dizziness, fever, or severe headache.
They could indicate dehydration or allergic reaction and should result in an immediate call to the colonoscopist.
You can find other more serious side effects that have been reported in the Consumer Medicine Information provided by the manufacturers of the bowel preparations.
Review this information when you get your prescription and contact your colonoscopist with any questions or concerns.
If you’re worried about a potential side effect, call your colonoscopist.
Remember to listen to your body during the bowel preparation process.
Persistent or severe side effects shouldn’t be ignored.
If you can’t finish the bowel preparation, let the colonoscopist’s office know as soon as possible.
It’s better to cancel and reschedule the appointment than to have an incomplete colonoscopy because your bowel wasn’t sufficiently clean.
Every person’s feedback about their colonoscopy experience is unique and valuable. Help us ensure the patient voice is heard, so that future colonoscopy care reflects what patients want and need.