Colonoscopy prep “clean out” -- what to really expect

April 23, 2024

We know that colonoscopies can be essential in saving people’s lives. At Alabama Colon and Rectal Institute, we look at a colonoscopy not just as a diagnostic procedure but a preventative one as well. By finding and removing polyps before they turn into cancer, we are preventing future problems. We typically recommend that anyone 45 years old or older have a colonoscopy, or earlier if you have a family history that puts you at higher risk. 

If we do find a colon cancer during a colonoscopy, we obtain a biopsy and make a treatment plan. Colon cancer is very treatable and often curable when caught early. If we find it at a more advanced stage, it is still treatable, but much less often curable. 

If all of this is true, why is it so common for people to put off having a colonoscopy? There are several reasons, including the fear that it will hurt (it doesn’t), the fear of having a private area exposed (it is truly no big deal to us, and we keep you covered as much as possible), and the fear of the preparation (it’s not that bad). 

Preparation for a colonoscopy -- what to expect

Many people say something like this: “I’ve heard the prep work before a colonoscopy to get me “cleaned out” is horrible! I just know I’m going to have a hard time with it.”

Different doctors and clinics take different approaches for this prep work. It is true that many facilities that conduct colonoscopies prescribe prep that involves over a gallon of liquid you have to drink in a short period of time. However, we rarely utilize this infamous gallon prep.

Instead, we use a low-volume prep. For most patients, this means a half-gallon of a liquid of their choice, most commonly clear Gatorade, but any clear liquid typically works. We hear from many patients that when they are able to utilize a drink of their choice, going through the prep is much more palatable than what they may have heard about or experienced in the past. 

So, most patients realize that the prep is not as bad as they thought it was going to be. But you must remember that the point of this prep work is to clean out, or empty, your colon. When you come in for your procedure, we want to be sure that there is no stool present. Why? If there is any residue in your colon, it may obscure the view of your colon and rectum during the colonoscopy. We want our visualization to be 100% so we can find polyps and any other concerning areas. 

Drinking liquid to clean out your colon means that you will need to be near the restroom for several hours. This is actually the worst part for many patients. During this time, the most common complaints we hear about are nausea or vomiting. These issues can often be alleviated by slowing down the pace at which you are drinking your prep liquid. 

Other colonoscopy concerns

The other main worry we hear from patients is that a colonoscopy will hurt, but we prepare you for this as well to make sure it doesn’t. A colonoscopy screen lasts approximately 30 to 60 minutes, and we will administer medication before your procedure to allow you to feel relaxed and drowsy. Then, the majority of our patients elect to have IV sedation. This means you are asleep during the procedure. 

As soon as your colonoscopy is over, we stop the IV medicine, and you wake up without nausea, a hungover feeling, or any memory of what happened. After the procedure, most patients have no pain, bleeding, or any lingering effects. 

While we know going through all of this to have a colonoscopy is not fun, it is so important. We want to catch any type of colon cancer as early as possible to treat and hopefully cure it. If we don’t find any problems, there’s a good chance you won’t need a colonoscopy again until about 10 years later. You can handle this every ten years or so!

Alabama Colon & Rectal Institute specializes in diseases of the colon, rectum, and anus

Alabama Colon & Rectal Institute performs more than 3,000 procedures each year, including many colonoscopies, at their free-standing, practice located in Birmingham, Alabama. Our doctors are known regionally for their expertise and are active in teaching surgical residents and other physicians. Visit our website for more information, give us a call to make an appointment at (205) 458-5000, or email us at [email protected].