How To Prepare for a Colonoscopy

A colonoscopy is more than a cancer screening test — it can find cancer early and even help prevent it from developing. While it’s an important screening, it’s understandable if you’re nervous about the procedure, which involves using a long, flexible tube with a camera to look inside your colon and rectum. Knowing what to expect — including how to prepare and what to eat before a colonoscopy — can help your screening go more smoothly.

Before your colonoscopy

A key part of getting ready for a colonoscopy is taking bowel prep to clear out your bowel. Bowel prep directions vary depending on whether you’re taking the Gatorade^® and Miralax^® split dose, Suprep^® or a different prep. The week of your procedure, you’ll receive a call from your doctor’s office to go over your specific prep instructions, discuss appointment details and answer any questions you have. You may also receive this information in your My Health Online account.

Ahead of your screening, you’ll also want to take these steps:

• Discuss medications and conditions. Tell your doctor if you’re pregnant or if you take blood thinners such as Coumadin^® (warfarin), Plavix^®, Lovenox^®, Aggrenox^®, Pradaxa^®, Effient^®. Your doctor needs to know if you’re taking medication for blood pressure or diabetes, or drugs to help with weight loss. Examples include Wegovy^®, Ozempic^® and Mounjaro^®. If applicable, bring emergency inhalers or migraine medications to your appointment.
• Plan for a ride. You’ll be given a light sedative during your colonoscopy, so plan to have someone drive you home. Your driver must be over 18. Public transportation or a rideshare service like Lyft or Uber are allowed only if you have an adult over 18 accompanying you. Someone should stay with you for at least four hours after your procedure. If you anticipate issues finding a ride or a person to stay with you, talk to your doctor. There may be options available through your doctor’s office or hospital.
• Stop taking NSAID pain relievers. 5-7 days before your procedure, stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, Motrin^®, Advil^®, Naprosyn^®, Aleve^® and Relafen^®. You may continue to take a single aspirin (81 mg tablet) daily or Tylenol.
• Complete your bowel prep. Follow your doctor’s instructions for bowel prep. In general, you’ll be on an all-liquid diet that can include water, tea, coffee, apple juice, white grape juice, white cranberry juice, sports drinks, vitamin waters, Jell-O^®, broth and soda. Don’t drink creamers, dairy or any red, blue or purple products. Your prep instructions will also be in My Health Online. Call your doctor’s office if you have questions.
• Call your doctor if you’re sick. Let your doctor know if you feel sick or if you develop a rash or open wound before the procedure. In some cases, the screening might need to be postponed.

Get procedure ready

There are a few things to do the day of your appointment:

• Shower or bathe the night before or morning of your appointment
• Wear comfortable, loose clothing and flat shoes
• Avoid contact lenses (bring glasses instead), lotions, makeup, nail polish and scented products
• Bring a photo ID and your insurance card

During a colonoscopy

You’ve done the prep and you’re all ready to go. So, what happens during your colonoscopy appointment?

A nurse will check you in and write down the name and phone number of the person who is taking you home. For patients under 18, a parent or guardian must wait in the lobby during the procedure.

Your doctor will discuss sedation or anesthesia with you before your procedure, and then they’ll complete the screening. Afterward, a nurse will stay with you in a recovery area until you meet the criteria to go home. This usually takes about 30 minutes.

After a colonoscopy

A colonoscopy is a safe, effective procedure, but it can sometimes cause side effects such as temporary dizziness, nausea or vomiting, or abdominal pain. These should decrease over time. In rare cases, you can have some bleeding or develop an infection. Call your doctor if you develop a fever or experience heavy bleeding.

It’s normal to feel drowsy after the procedure. Take the rest of the day to relax and avoid driving, operating machinery, drinking alcohol or using drugs.

A nurse will call you the next business day to check on how you’re doing and see if you have any questions. You should be feeling normal and be back in the swing of things in about a day.

Colonoscopy alternatives

Colonoscopy doesn’t just look for cancer — it can also help prevent it by removing precancerous polyps during the procedure. That’s why many gastroenterologists still consider colonoscopy the best test. But if for some reason you cannot have a colonoscopy or don’t want to, there are alternatives, including stool-based tests.

For these tests, you’ll receive a kit and will be asked to collect a sample of your stool to send back for testing. These are done every one to three years, depending on the test.

Another option is a CT colonography, or virtual colonoscopy. This test uses a CT scan to take pictures of the colon rather than requiring a scope into the rectum. The bowel-cleaning prep for a virtual colonoscopy is similar to prepping for a colonoscopy. The test is typically done every five years.

Finally, you can consider a sigmoidoscopy. This procedure is similar to a colonoscopy but looks at only the lower part of the colon. As a result, the preparation requires a less thorough bowel cleanse. It’s typically done every five years.

Keep in mind that if another screening test finds something concerning, you’ll likely still need a colonoscopy afterward.