Geat a Head Start The less you have in your gut before you start flushing out your colon, the easier the process will be. "I approach the prep as if it were a cleansing diet," says Dede Cummings, coauthor of Living with Crohn's & Colitis. "A few days beforehand, I start eating smaller, lighter meals, like skinless baked chicken, rice cakes, and applesauce."
Drink the Liquid in 1 Day If you can, schedule your appointment for the afternoon, and then begin drinking your prep liquid that morning. Although the American College of Gastroenterology suggests drinking half the prep at night and half the next morning, a recent study at Thomas Jefferson University shows that patients who saved the entire prep for the morning of the procedure experienced less abdominal pain and had uninterrupted sleep because they weren't running to the bathroom all night.
Keep a Chaser On Hand Wash down the drink with water, Gatorade, or ginger ale, advises Sunanda Kane, MD, a professor of medicine and staff gastroenterologist at the Mayo Clinic in Rochester, MN. "You can't dilute the prep with another drink in the same cup, but you can drink them side by side," she says. Your colon must be completely clear to get an accurate reading, so follow prep guidelines exactly, says Harminder Singh, MD, an assistant professor of gastroenterology at the University of Manitoba Winnipeg. This is especially key for women: Dr. Singh and fellow researchers concluded that women are 31percent more likely to have their cancers missed than men, in part because cancerous lesions in women usually occur in the upper colon, where it's harder for the camera to reach.
Ask for Prep Pills If you just can't tolerate the taste of the liquid, the prep is available as a pill. Think of this as a last resort: "You have to take thirty-two tablets in one and a half hours," says Carol Burke, MD, director of the Center for Colon Polyp and Cancer Prevention at the Cleveland Clinic, and the sodium phosphates in the pills have been associated with rare but potential kidney damage. But because the risk of kidney damage is smaller than the lifetime risk of colon cancer, in very few cases (less than 1percent), Dr. Burke offers the pills to prepresistant patients, with informed consent.
Are There Any Alternatives?
In a virtual colonoscopy, an MRI or CAT scan takes several cross-sectional x-rays of your colon. It's fast and noninvasive-- though you still have to do the full prep. But while some private insurance companies cover this alternative, it's not covered by Medicare unless there's a medical reason the patient can't undergo traditional colonoscopy (if there's excessive twisting or scarring of the colon, for example, or the patient can't tolerate anesthesia). Also, if the doctor spots a polyp, you'll need a regular colonoscopy to remove it anyway, says Dr. Burke. Upon FDA approval, which could happen as soon as 2012, those at low risk (no family history of colon cancer or personal history of polyps) may have a new screening option. The Cologuard test is an at-home kit that allows a patient to collect a small amount of stool and mail it to a lab for analysis. The test will look for DNA changes associated with precancerous and cancerous polyps. You'll need a traditional colonoscopy only if the test shows DNA change.
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