PART ONE
On my Facebook page, I said I had some
tips for colonoscopy prep. So I will start with the tips in Part
One. But, in Part Two, I want to give you info on an easy,
inexpensive and effective alternative - the FIT fecal-test.
For context, the last time I did a
colonoscopy, I used Moviprep and had to drink it all in one day.
I became very bloated and got worried that it would NEVER work. It
did, finally, but it was a pain, physically and mentally.
I changed to Kaiser this time, and
their prep is longer, but way easier - WITH ALTERATIONS. (Their
instructions are here if you want to read the full thing.)
The idea is that you switch to low-fiber - aka low-residue - foods
three days before the procedure. You have a liquid diet the day
before and drink half a gallon - Gavilyte-g was the stuff I used -
starting at 6 pm. Then, the next morning, you drink the rest of the
half-gallon.
I think preparing over three days
really made it much easier, but I wasn't looking forward to the
all-liquid diet for a full day (though I did know that as soon as I
drank the stuff, my appetite would be gone...)
Tip One:
Screw the all-liquid diet on the day before.
You can eat low-residue food in small amounts. There
are a whole lot of scientific studies about this that have come out
in the last few years, and they all agree: the all-liquid diet is
not necessary, and absolutely not better. Here is an article about one
of those studies. Therefore, I
ignored Kaiser, and ate two eggs and some toast in the morning the day before the procedure. That
was enough for me to feel good until I drank the stuff. Basically,
medical organizations haven't caught up to the science on this one.
Here is an article on low-residue diets - though there are abundant articles about them on the internet.
Tip Two:
Do your own timing of when to drink the
stuff. I used their timing on the day before - that is to
drink it at 6 pm - but that is a stupid time for me. It took until about
midnight to get rid of the first wave. I would have liked to gone to
bed earlier. Clearly, I should have started at 4pm - and would have
been ready for bed by 10PM.
Similarly, the next day they wanted me
to start 5 hours before, have the second gallon done by 3 hours
before - and take no more liquids after. I totally ignored that and
started about 7 hours before, and drank about half the remaining
stuff. Within three hours, I was "piss-pooping" clear (and
slightly yellow, which is what they expect) and threw the remaining
prep down the drain. Yes! If it hadn't been clear, I still had
another hour to drink more. I then drank clear liquids until the three hour mark.
If you have an early morning
colonoscopy, they expect you to wake up in the middle of the night to
do this. If you are a rule follower and want sleep - truly you
should get a mid-afternoon appointment with this regime (as I had).
Or, decide to make changes based on the time...
Tip Three. Drink
it down fast and make sure it is chilled! This
is one that most people know - and manufacturers of the stuff advise. I didn't flavor it - but lots of people
swear by that. But whatever you do, have a chaser. The taste
(which isn't all that bad) only lasts as long as it takes to drink
your chaser. I used tea sometimes and chicken broth other times.
But anything you like will work that is in the ok-liquid column.
Others
can feel free to put other tips below in the comments. You can do so
anonymously if you like.
PART TWO
In the United States - unlike any other
place in the world - colonoscopies are the go-to for colon cancer
screening beginning at the age of 50. The rest of the world uses
much less expensive but, perhaps, just as effective screening techniques such as the fecal-test FIT. This test must be done every year to be effective.
The fact is that colonoscopies - as yet
- haven't been proven to be more effective (or as effective, for that matter) than this test in
detecting cancer or reducing mortality. Now, the logic is that colonoscopies should be the most effective - after all, you get rid of the polyps
before they have time to become cancerous. But, the fact is there
has never been a randomized controlled trial - the most rigorous type
of study - of colonoscopies to see if they, in fact, reduce colon
cancer mortality more than other methods. (Though there are three studies in process, and in about seven years we might know for sure!) That
does not mean there haven't been other types of studies that are very
encouraging about them, such as Baxter et al. and
Nishihara et al 2013, which
certainly indicate a colonoscopy
is pretty darn good, though it has risks such as perforation of the
colon, infection, and bleeding.
But,
there is no proof, as yet, that it is better - or as good as - a simple,
inexpensive fecal test.
So, if they haven't been proven to be better, scientifically, than the alternatives, why are we so colonoscopy-crazy in the United States? Could it be $$$$? Check out this NY Times article on this.
Bottomline: you don't have to get a routine colonoscopy for cancer screening - unless the fecal test shows a problem. For most people,
it's probably the best way to go. Kaiser, for instance, emphasizes FIT tests
as the basic screening test, and colonoscopies are only recommended
for people in a higher-risk group, such as people who always get
polyps - like me!
Anyway,
as they say - ask your doctor if the FIT test is right for you
instead of doing this rigmarole. Colon cancer is the second leading
cause of cancer death in the United States. So whichever screening
method you use - don't skip it!
