My doctor had me take bowel cleansing liquid the night before my colonoscopy and then the morning of. Is this a good colonoscopy preparation?
Answer From Michael F. Picco, M.D.
To make bowel preparation more tolerable, many doctors recommend splitting the dose of bowel preparation. This regimen may not be possible if your colonoscopy is scheduled for early in the morning, because you should consume the morning dose four to six hours prior to the procedure.
If your procedure is scheduled at a time that allows you to split the dose, take the recommended amount of the bowel cleansing liquid the night before the exam, and the remainder in the morning before the test. Depending on the type of preparation, your doctor may recommend splitting the dose 1-to-1 or 3-to-1.
The biggest reason for poor colonoscopy preparation is people's distaste for having to drink large quantities of bowel cleaning solution. The most common colonoscopy preparation calls for drinking 1 gallon (4 liters) of a polyethylene glycol solution. Some studies have shown that more than a third of people don't complete the full preparation.
Studies have shown that the split-dose approach not only is more tolerable, but also does a better job of cleaning the colon. Better cleaning will lead to better results. One study found that doctors detected more benign tumors (adenomas) in people who prepared with split doses than in people who prepared with single doses.
Cleaning as much waste material as possible from your large intestine (colon) is crucial to a successful colonoscopy exam. Poor colonoscopy preparation can keep your doctor from finding polyps, tumors and other problems. It also increases the length of the exam and the risk of complications. In many cases, the exam has to be redone.
Ask your doctor about split-dose preparation for your next colonoscopy.
Feb. 05, 2016
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- A-Rahim YI, et al. Bowel preparation for flexible sigmoidoscopy and colonoscopy in adults. http://www.uptodate.com/home. Accessed Nov. 19, 2015.
- Kojecky V, et al. A single or split dose picosulphate/magnesium citrate before colonoscopy: Comparison regarding tolerance and efficacy with polyethylene glycol. A randomized trial. Journal of Gastrointestinal and Liver Diseases. 2014;23:141.
- Martel M, et al. Split-dose preparations are superior to day-before bowel cleansing regimens: A meta-analysis. Gastroenterology. 2015;149:79.
- Johnson DA, et al. Optimizing adequacy of bowel cleansing for colonoscopy: Recommendations from the US Multi-Society Task Force on Colorectal Cancer. The American Journal of Gastroenterology. 2014;147:903.
- Lee L, et al. Overview of colonoscopy in adults. http://www.uptodate.com/home. Accessed Nov. 19, 2015.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Nov. 30, 2015.