Colonoscopy. What a delightful word. From the Latin – literally – a camera up your bum.
Unfortunately for those of us with IBD, colonoscopies (and endoscopies) are a relatively frequent ordeal. After nearly five years of diagnosis, four full colonoscopies and a few flexible sigmoidoscopies, I consider myself one of the luckier ones. Some IBD patients undergo scopes much more frequently, and often while they are ill.
If you’re currently getting ready for your first ever scope, or are someone who’s just had terrible experiences in the past, perhaps you will find some of the tips below helpful. If you’re reading as someone who has never had a colonoscopy, and won’t for quite some time, welcome to the magical world of Colonoscopy Prep™. We’re waiting for you.
Prepping to Prep
The term “prep” itself is exactly how it sounds. You are literally preparing your body for the colonoscopy procedure. But, before we get there, let’s take a look at a little something I like to call “prepping to prep.”
Colonoscopies are usually scheduled several weeks in advance, unless they are on an emergent basis. While this gives you time to fret about the discomfort and inconvenience you will experience, it also gives time to get ready. I am by no means an expert, but I have discovered a few ways to make the prep day as pleasant as possible by means of self-care.
- Pick up your prep solution from the pharmacy a few days in advance to have it ready. Make things as easy on yourself as possible – forgetting until the morning you are supposed to start prep will make a not-great situation much more stressful.
- Once you have your prep solution, read over the prep instructions in detail to make sure you understand how your doctor or hospital prefers to do prep. They can each be different. If you have questions about how to prep, this extra time will allow you to call your gastroenterologist’s office to confirm.
- Arrange for any time off from work or school. Depending on how your hospital does things, you may need to take a few days off – one or two for prep, and one for the actual day of the scope.
- Make a shopping list. Prepping means no solid food for at least a day or so. With your prep guidelines in hand, make a list of anything you might need to pick up from the grocery store. Hospitals will usually provide you with a list of fluids you can and can’t have. You may also wish to get yourself some extra cushiony toilet paper. Don’t skimp – you’re gonna need the good stuff.
- Ask a friend or family member to be your driver. If you are receiving sedation for your colonoscopy, you will need someone with you at your appointment who can drive you home afterwards. At my hospital, the nurses are not allowed to release patients without an assigned driver.
In this case, the ‘P’ stands for two things: prep, and poop.
Once the prep solution kicks in, you are going to be in the bathroom. A lot. Your goal here is pretty much to be pooping straight liquid. I’m not going to lie to you; towards the end it feels like high velocity lava.
Despite the (usually) nasty tasting prep solution, the cramping, the inhuman sounds that will emanate from your belly, and the pooping (oh, the pooping), I try to make prep days kinda-sorta fun for myself. Make it about self-care. Pamper yourself. Reward yourself for going through this process. Some of the tips I have from experience are below:
- As above in the shopping list tip, TREAT YO SELF TO GOOD TOILET PAPER. If you’re feeling especially fancy, maybe try dissolvable, flushable wet wipes. After the 20th bathroom trip, your bum will need a gentle touch.
- Give yourself some variety in prep liquids. While water, and electrolyte drinks like Gatorade and Powerade are the gold standards for scope prep to ensure you don’t become dehydrated, drinking those exclusively for a day and a half is not fun. Try different textures, temperatures, and flavours. I like to make myself a few kinds of Jello (not red), make black tea, eat freezies (again, not red), and heat up clear chicken or beef broth for “meals.” Trust me, after all the sweet, you will want something salty. Hot broth that feels like “eating” is much better than caving for those suddenly irresistible chips and jeopardizing your prep.
- Wear your comfiest clothes, and maybe even reward yourself in advance with new pyjamas. Easy up and DOWN is key. Elastic waists are your friend. Do not think you can wear jeans and a belt on prep day. It will not end well for you.
- Do some activities that you enjoy. For obvious reasons, these will need to be activities that can be done at home, and can be easily interrupted. Waterskiing is probably not advisable. I like to have a stack of favourite movies to watch, some games on my phone, adult colouring books, and a novel. As a bonus, the novel can easily accompany you to the toilet!
- Keep your sense of humour. Listen, when you think about what colonoscopy prep really is – medically-induced explosive diarrhea – it’s actually kinda funny. Or it would be if it wasn’t you. Granted, for IBD patients who are flaring or in pain, it’s the opposite of a funny situation. But for most of us, the prep itself, while less than optimally comfortable, is not painful. Laugh at the sounds you’re going to make. Try not to get mad when your spouse or family members laugh at those sounds. Crack (ha) some jokes. You’ll feel better about it.
Once you get to the hospital on the day of your colonoscopy, you will be taken care of by medical professionals for the next steps.
You’ll get undressed, put on a gown, and get a bed to wait in. I recommend bringing socks if you’re like me and always cold. You’ll next have a questionnaire with a nurse, and if you’re receiving sedation, will have an IV placed. Once you’re in the procedure room, your doctor will explain the consent form for the colonoscopy. You might have a nasal cannula for oxygen, and a fingertip monitor placed. At my hospital, after this stuff, it’s dream time. The hard part is over. I have a favourite nurse named Sally who smooths my hair while I slip away, incoherently mumbling about how fast the sedation drugs work.
The next thing I know, I’m waking up, and it’s all over. Once or twice I started to become aware of myself before my doctor was quite done, and had a grand old time talking to her about what I could see on the screen. Looking at my own colon, not a care in the world.
After spending a few minutes in the recovery area *ahem* “expelling air,” it’s time to go home. And by home, I mean to Five Guys for the most delicious burger I’ve ever tasted in my life, every time.
Colonoscopies are a fact of life with IBD. We may as well make the best of them when we can. I can do it, and you can do it too.