Let’s Talk About Colonoscopy Preparation

In the fight against colorectal cancer, knowledge and preventive measures are our strongest allies. Colorectal cancer is one of the most common cancers worldwide, affecting individuals of all ages. While age is a significant risk factor—most cases arise in those over 50—recent trends show an increase in diagnoses among younger adults. Because of this, experts now recommend screening starting at age 45. 

Certain individuals are at a higher risk for developing colon cancer, including those with a family history of colon cancer or colon polyps, a personal history of precancerous colon polyps, African Americans, some Jewish groups, and individuals with inflammatory bowel diseases like Crohn's disease or ulcerative colitis. Lifestyle factors such as diet, tobacco use, excessive alcohol consumption, and obesity can also contribute to an increased risk. Early detection through regular screening is critical to preventing colon cancer and improving outcomes. Colonoscopy is the gold standard for colorectal cancer screening.  

Preparing for Your Colonoscopy 

Why is colonoscopy the most effective screening tool for colon cancer? This procedure involves a detailed examination of the entire colon using a flexible, illuminated tube with a camera. If polyps are found, they can be removed during the procedure, reducing the risk of developing cancer. A properly cleansed colon allows for the best possible visualization, making preparation an essential part of the process.  

Unfortunately, concern about the inconvenience or possible discomfort of preparing for a colonoscopy often keeps people from life-saving screening. Have no fear! The process does not need to be scary or complicated.  

What to Do in the Weeks Leading Up to Your Colonoscopy 

• If you have diabetes, contact your prescribing provider for medication instructions. 
• If you take a prescription blood thinner (such as Coumadin, Plavix, Eliquis, Brillinta, Xarelto, or Pradaxa), our nurses will coordinate with your provider on when to pause these medications. 
• If you take Ozempic (semaglutide) or another GLP-1 medication, discontinue use three weeks before your colonoscopy due to anesthesia concerns.  
• If you have children or are a primary caregiver, arrange for childcare or dependent care during your preparation and on the day of your procedure. 
• You must have a responsible adult to drive you home from your appointment, as you will receive intravenous sedation (propofol) during the procedure. 
• You can expect to resume normal activities such as driving and working the day after your procedure. 

One Week Before Your Colonoscopy 

• Stop all vitamins and supplements, including fish oil and iron. 

• Stop fiber supplements such as Metamucil, Benefiber, or Citrucel. If you need alternatives, check with your managing provider. 
• Begin a low-residue and low-fiber diet, which allows for easier digestion and preparation.  

The Day Before Your Colonoscopy 

You must follow a clear liquid diet for the entire day. Clear liquids include: 

• Water, clear broth or bouillon, black coffee, or black tea (sweeteners are allowed, but no milk or creamer) 
• Gatorade, PowerAde, Vitamin Water, or Pedialyte (must be clear, yellow, orange, or green- no red) 
• Lemonade, limeade, ginger ale, and clear sodas (no cola or root beer) 
• Apple juice, white grape juice, or white cranberry juice 
• Jell-O and popsicles (only yellow, green, or orange) 

Drink at least eight glasses of water or clear liquids to stay hydrated. The more fluids you consume, the better you will feel during preparation. 

Your gastroenterologist will provide a regimen of fluids to help flush your system. Follow the instructions carefully. Make the most of this time—grab a book you've been meaning to read, watch a movie, or do something relaxing while preparing for your procedure. 

The Day of Your Colonoscopy 

You may continue clear liquids (except broth) up until three hours before your procedure. 

Three hours before your procedure, you may take the following medications with a small sip of water. 

• Daily narcotic 
• Anti-anxiety medication 
• Blood pressure or cardiac medication 
• Seizure medication 
• Asthma inhalers 
• Thyroid medication 

After taking your medications, take nothing by mouth—including water—three hours before your procedure. Failure to follow this rule will result in cancellation of your appointment. 

What to Expect After Your Colonoscopy 

Following the procedure, you will need a responsible adult to drive you home. If no abnormalities are found, a repeat colonoscopy is generally recommended in 10 years for individuals at average risk. Taking steps now to complete your screening can make a significant difference in your long-term health. 

Colonoscopy is a key tool in preventing colorectal cancer. With proper preparation, you can help ensure the most accurate results and take control of your health. 

Elliot Gastroenterology delivers expert, compassionate care and utilizes cutting-edge technology and medicine to help you stay healthy and return to wellness.

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 Dr. Myles Keroack is board-certified in gastroenterology and is accepting new patients at Elliot Gastroenterology.