Colonoscopy Prep: Laxative Solution Cleanser Explained

A pre-colonoscopy laxative solution cleanser is a type of bowel prep that is used to clean out the colon before a colonoscopy. This procedure is necessary to ensure that the doctor can clearly see any abnormalities in the colon, such as polyps or other signs of colorectal cancer. The laxative solution is typically taken orally the night before the procedure and can be purchased over the counter or prescribed by a doctor. It is important to follow the instructions provided by your healthcare provider to ensure the colonoscopy is effective.

What is a bowel prep kit?

A bowel prep kit is an oral laxative formula that you take before a colonoscopy to clean out your bowels. It is important to prepare your bowels before a colonoscopy so that your healthcare provider can see inside your colon properly. If your colon is not clear, the procedure may need to be rescheduled.

There are several different types of bowel prep kits available, which can be prescribed or bought over the counter. They typically consist of osmotic laxatives and electrolytes in tablet or liquid form. Osmotic laxatives are substances that your bowels cannot naturally absorb, and they trigger your bowels to draw in more water from your body to force the substances through. This softens your stools and increases the volume in your colon, triggering muscle contractions that move everything out. Electrolytes are included to prevent abnormalities in electrolyte levels, as the purging process can be very dehydrating.

One commonly prescribed type of bowel prep kit is a polymer-based formula containing polyethylene glycol 3350 (PEG). PEG is a large molecule that cannot be absorbed through your colon, causing a hyperosmotic effect. PEG formulas are typically in powder form and are mixed with large volumes of water. They are considered a gentler option for people with irritable bowel syndrome (IBS) and those at risk of complications from fluid and electrolyte depletion, such as those with kidney, liver, or heart disease. However, they often require drinking high volumes of formula, which can be difficult for some people. Brand names for PEG-based formulas include GoLYTELY, NuLYTELY, MiraLAX, Halflytely, and MoviPrep.

Another type of bowel prep kit is a saline-based formula containing sodium phosphate (NaP) as the primary osmotic agent, along with other mineral salts such as potassium and magnesium. These formulas are available in tablet form, making them easier to take for some people. However, they carry a higher risk of side effects such as electrolyte imbalances and are not suitable for those with certain pre-existing conditions. Brand names for NaP-based formulas include Suprep and OsmoPrep.

How to prepare for your colonoscopy

Colonoscopy prep involves cleansing your bowels with a laxative formula so that your doctor can see inside your colon during the procedure. Signs of colorectal cancer, such as polyps, are often small and cling to the inside walls of your colon, so it is important that your colon is clear.

Your doctor will be your best source of information about how to prepare for your colonoscopy. They may prescribe you a laxative or recommend an over-the-counter option. They will also give you instructions on when to take the laxative, but it is usually the evening before your procedure. You may also need to complete a bowel prep before other procedures, such as a lower GI X-ray exam or colectomy.

There are several different types of laxatives, which come in different forms, including tablets and powders. They include:

• Polymer-based formulas (PEG)
• Saline-based formulas (NaP)

You will also need to make changes to your diet in the days leading up to the procedure. A low-fibre diet is recommended 2-4 days before the colonoscopy, followed by a clear liquid diet on the last day.

• White bread, pasta, and rice
• Well-cooked vegetables without skin
• Fruit without skin or seeds
• Lean meat, chicken, or fish
• Sports drinks
• Clear juice (apple and white grape)
• Clear broth
• Soda
• Coffee and tea without milk or creamer
• Gelatin and ice pops

You should avoid anything coloured red, blue, or purple, as the dyes can discolour the lining of the colon and make it harder for the doctor to see. Alcohol should also be avoided, as it can cause dehydration.

Two to four hours before the procedure, do not consume anything, including liquids.

Other things to keep in mind:

• You may need to stop taking some of your usual medications before the procedure, including anticoagulants (blood thinners) and medicines for diabetes.
• You must have someone to accompany you home after the procedure, and you will not be able to drive.
• You may feel bloated or gassy for a few hours after the colonoscopy, and it is normal to see a bit of blood in your first bowel movement.

What to eat and drink before a colonoscopy

Preparing for a colonoscopy involves cleansing your bowels with a laxative formula. This is done to ensure your doctor can see inside your colon clearly. In addition to taking laxatives, you will need to make changes to your diet in the days leading up to the procedure.

Three to Four Days Before the Procedure

You should start eating light and having smaller meals. Doctors recommend a low-fiber diet that includes:

• Lean meats like well-cooked beef, lamb, ham, veal, or pork
• Fish, shellfish, or poultry
• White rice, noodles, or white pasta
• White bread or toast
• Eggs, especially boiled or poached
• Fruits without skin or seeds
• Vegetables without skin
• Low-fat dairy products like milk, cream, or cottage cheese

You should avoid foods containing fiber, such as whole grains, fruits with skin, vegetables with skin, pulses, and nuts.

One Day Before the Procedure

You should only consume clear liquids on the day before your colonoscopy. This includes:

• Clear juices like apple, white grape, or lemonade without pulp
• Clear broth, including chicken, beef, or vegetable
• Sports drinks
• Tea and black coffee without any milk, cream, or lightener
• Water, cordial, or clear soup
• Gelatin or popsicles without red or purple dye

You should avoid solid foods and drinks with red, blue, or purple dye, as they can discolor the lining of the colon. Alcohol should also be avoided as it can cause dehydration.

Two to Four Hours Before the Procedure

You should not consume anything, including clear liquids, for at least two hours before your colonoscopy.

When to start your prep

Colonoscopy prep is a process that can begin a few days ahead of your procedure. It involves taking a laxative medication and restricting your diet to clear your colon of stool. This allows your doctor to clearly see any abnormal areas in your colon during the procedure.

A few days before your colonoscopy:

• Adjust your diet by eating smaller portions and low-fiber foods. Avoid nuts, seeds, corn, peas, apple skins, and other high-fiber foods that are hard to digest.
• Stop taking vitamins, supplements, and any prescription or over-the-counter anti-inflammatory or blood-thinning medications, as directed by your doctor.

The day before your colonoscopy:

• Continue your low-fiber diet and clear liquids only. Avoid solid foods and red liquids.
• Drink plenty of clear liquids, such as sports drinks, clear juice (apple, white grape), clear broth, tea, and coffee without cream.
• In the afternoon or evening, take the first dose of your prescribed laxative preparation. The timing will depend on the specific bowel prep used and the time of your colonoscopy.

The day of your colonoscopy:

• Continue with clear liquids only, avoiding solid foods and coloured liquids.
• Stop drinking any liquids two to four hours before your procedure.
• A few hours before your appointment, take the second dose of the laxative prep. This is known as the "'split dose' and is recommended by the American Gastroenterological Association and American College of Gastroenterology as it cleans the colon more thoroughly.

It is important to follow the instructions provided by your healthcare provider and to start your prep on time. This will ensure that your colon is adequately prepared for the colonoscopy, allowing for a successful procedure.

What to expect after your colonoscopy

A colonoscopy is a procedure in which a doctor uses a flexible tube with a camera on one end, called a colonoscope or scope, to look inside your rectum and colon. The rectum and colon make up most of your large intestine. In the days leading up to your procedure, you will be instructed to follow a low-fibre diet and take laxatives to ensure your colon is clear.

After a colonoscopy, the sedatives or anaesthesia will take time to wear off. You will stay at the hospital or outpatient centre for about 30 to 60 minutes after the procedure. You may feel cramping in your abdomen or bloating during the first hour after the procedure.

Once the sedatives or anaesthesia wear off, the doctor may share what they found during the procedure with you or, if you choose, with a friend or family member. You will receive instructions on what to do after the procedure, which you should be sure to follow. As you won't be able to drive after the procedure, you will need to have pre-arranged transport home.

You should expect a full recovery and return to your normal diet by the next day. If the doctor removed polyps or performed a biopsy, you may experience light bleeding from your anus. This bleeding is normal. If the doctor performed a biopsy, a pathologist will examine the tissue, and results can take a few days or longer to come back.

After a colonoscopy, it is normal for your bowel movements to be irregular or different from your usual habits. This may last for up to a week after your procedure. If you experience any of the following, you should seek medical care right away:

• Severe pain in your abdomen
• Bloody bowel movements that do not get better
• Bleeding from the anus that does not stop

Frequently asked questions