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 and improve outcomes, many doctors recommend splitting the dose of bowel preparation solution. This regimen may not be possible if your colonoscopy is scheduled for early in the morning, because you should consume the morning dose three hours before leaving home for the procedure.
If your procedure is scheduled at a time that allows you to split the dose, follow the instructions provided by your doctor. 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 cleansing 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 polyps 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 prevent 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.
April 02, 2019
- A-Rahim YI. Bowel preparation before colonoscopy in adults. https://www.uptodate.com/contents/search. Accessed Jan. 31, 2019.
- Horton N, et al. Impact of single- vs. split-dose low-volume bowel preparations on bowel movement kinetics, patient inconvenience, and polyp detection: A prospective trial. The American Journal of Gastroenterology. 2016;111:1330.
- Perreault G, et al. Split- versus single-dose preparation tolerability in a multiethnic population: Decreased side effects but greater social barriers. Annals of Gastroenterology. 2018;31:356.
- 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. Overview of colonoscopy in adults. https://www.uptodate.com/contents/search. Accessed Jan. 31, 2019.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Feb. 7, 2019.
- AskMayoExpert. Importance of bowel preparation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.