How to make colonoscopy prep less awful
May 8, 2015 11:21 AM   Subscribe

Should I deviate from the prep procedure my doctor gave me?

I have read several Asks about colonoscopy prep, all of which have sufficiently turned me off from the idea of Golytely.

My doctor prescribed clear fluids for a full 24 hours beforehand, with bisocodyl pills, plus Golytely the afternoon before and at 3 am the morning of the procedure.

I am pretty emetophobic and am terrified of vomiting. I also have very bad reflux that is worse when drinking a lot of cold liquid, and causes me to have trouble swallowing sometimes and makes my gag reflex very sensitive.

The mere thought of drinking "salty, flat ginger ale" (which is how the nurse described it) makes me gag a little.

I've seen the Miralax prep online, which sounds much more palatable.

I know I could call my doctor, but I don't really have a relationship with him (this is the first time I've seen him), and if he insists on the Golytely prep my ruler-following self won't be able to deviate.

Is it a bad idea to do the Miralax prep instead?
posted by raspberrE to Health & Fitness (26 answers total) 2 users marked this as a favorite
The best way to build a relationship with your doctor is to call them to discuss any questions you might have. Unless you do that, stick to what he or she told you to do. A bunch of strangers on the internet cannot advise you to go against your doctor's recommendations.

Well, they can, but they shouldn't, and if they do you should not listen to them.
posted by bondcliff at 11:24 AM on May 8, 2015 [44 favorites]

N-thing that you need to ask your doctor about this, not strangers on the internet.

If cold liquid is a problem, would warming it up slightly help? Only after calling your doctor and checking whether that is okay first, of course.
posted by kinddieserzeit at 11:29 AM on May 8, 2015

Call your doctor or your doctor's office and explain your concerns. I'm sure you're not the first emetophobic patient they've had.
posted by jessamyn at 11:29 AM on May 8, 2015 [2 favorites]

Don't deviate from the prep; call your doctor, explain to them your issues and see what happens. Worst case scenario you have to cancel and find a different gastro.
posted by griphus at 11:29 AM on May 8, 2015 [1 favorite]

Not that it will help much but I believe they have flavors of Golytely. Also, Golytely is the most misnamed product of all time.

It's not as bad tasting as you imagine it to be.
posted by cjorgensen at 11:34 AM on May 8, 2015 [3 favorites]

Some ideas

- ask your doctor if they'd be OK with prescribing an alternative prep solution. They exist, and you only have to drink 0,5 l of prep and approximately 3.5 l of water.
- refrigerate the fluid - it makes the taste less awful
- ask your doctor if you can dilute the prep with apple juice (the prep used in my country is often drunk with apple juice, but we do not use Golytely)
- you can drink the prep through a straw - it sometimes helps
- you can make breaks and drink water or tea

Disclaimer: I have plenty of experience with prepping patients for colonoscopy but am in another country where the solutions are slightly different.
posted by M. at 11:42 AM on May 8, 2015 [3 favorites]

My concern when I prepped was also the amount of liquid I was going to have to drink. I practiced for a few weeks before hand. I would get up in the morning and drink 8 oz of water every 30 minutes until I could do it without feeling like ugh. It helped tons when it came time to do it with the pills.

Don't know how far out your colonoscopy is but its worth a shot!
posted by chainsofreedom at 11:46 AM on May 8, 2015

I have severe emetophobia. I did not throw up during the prep. (Although the chemical taste was something from hell for me. I dunno, maybe I have weird taste buds.) I took small sips and followed with some candy or sports drink.

Definitely though, call your doctor and talk to them about your concerns about the prep and stand up for yourself with them.They do offer a pill prep at most places. See if you can get some anti-nausea pills as well. If I were to do it again, I'd do the pills.
posted by Crystalinne at 11:46 AM on May 8, 2015

whatever it takes, do the prep. the worst-case scenario is having to do it all over again because your system wasn't cleared out enough. do the prep.

if it makes you feel better, i had to do two rounds because my system is so sluggish. for four days, that's all i could eat/drink. even my GI - who was a dick - thought i a bad ass for being able to do it. (i had no choice.)

i have a severe phobia of throwing up too and gag at the thought of everything. but i just had to keep telling myself to keep my eye on the prize. i did two different types - the first was the big gallon of stuff. i drank it with lemonade and it was fine. not good, but fine. for the next round, i did the smaller bottle that gets mixed with water. it was awful. awful. awful.

i highly recommend the gallon jug version. BUT neither had me gaggy. just miserable.
posted by crankyrogalsky at 11:56 AM on May 8, 2015 [1 favorite]

I found using a straw helped a lot.
posted by mareli at 11:59 AM on May 8, 2015 [2 favorites]

It's not as bad tasting as you imagine it to be.

This. Although, by about half way through it, you will be very tired of it. But it's not that bad. Compared to what prep used to be like, golytely is freakin awesome. Suffer through. You don't want to have to repeat because the sewer wasn't clean enough.

It needs to be refrigerated because reasons. But you can totally heat it up before consuming. Microwave it, or warm it up like a baby bottle. Works the same. Careful, that you don't scald yourself, though.
posted by Pogo_Fuzzybutt at 12:17 PM on May 8, 2015 [3 favorites]

After every 3 gulps of the devil's elixir, allow yourself to lick a lemon lollipop or jolly ranger as reward. I'm also emetophobic and it didn't make me throw up. Also, think of how goooood the colonoscopy drugs will be. You can do it!
posted by oxisos at 12:24 PM on May 8, 2015 [1 favorite]

Start eating a low residue diet a week before your prep. You will clear out more quickly and easily if you don't have bits of spinach and the like clinging on for dear life inside your colon.

You didn't hear this from me, but if you have been following a low residue diet and your bowel movements are completely liquid and clear after the first half of your prep, you will probably be safe with not finishing the 3 AM dose. It's a numbers game as noted above and you do run the risk of not clearing out enough.

I had a tendency to get nauseated during past preps because all of the suggested clear liquids are sweet. Clear chicken broth with solids strained out (or the cans/cartons are generally totally liquid) is a clear! It even has a tiny bit of protein! You can heat it up and have a "hot meal" during your prep day.
posted by telegraph at 1:01 PM on May 8, 2015 [1 favorite]

I've had a couple of colonoscopies. I am also a world-class, champion, No. 1 ranked, Rock 'n Roll Hall of Fame vomiter and I have never felt sick once during prep. Didn't like the taste at all, but it didn't make me nauseous. I would also ring your doc if you're feeling concerned, and I personally would not change the prep without running it by the doctor - maybe there are Reasons for that particular regime?

Hope it goes well for you.
posted by Martha My Dear Prudence at 1:20 PM on May 8, 2015 [1 favorite]

Drink through a big straw if you want to -- then you won't have to taste it anyway.
posted by vickyverky at 1:46 PM on May 8, 2015

Thanks for encouragement to call my doctor. I did, and although the nurse said he won't let his patients use the Miralax prep, if I am willing to pay out of pocket, I can use Suprep, which the Internet tells me is much more tolerable. It's only 32 oz total of gross liquid instead of a gallon.

Has anyone used Suprep? (thanks for the tips, by the way... I'll be getting a big straw!)
posted by raspberrE at 2:10 PM on May 8, 2015 [2 favorites]

I have Crohn's, and am intimately acquainted with all manner of prep procedures. They all suck, but they're essential. Don't deviate without permission or you may end up having to redo your procedure. Miralax might be fine, but you won't know unless you ask.

This may not be tha answer you want to hear, but it's the answer that's gotten me through the last 20 years of gastroenterological prep: hella weed. I have access to high CBD strains that are less mind-foggy and provide some measure of relief from the cramping and discomfort that are (unfortunately) a requisite part of the prep process.

Be well!
posted by late afternoon dreaming hotel at 3:00 PM on May 8, 2015 [1 favorite]

I hesitate to mention this... but given that you have the option and you want to make an informed decision... I vomited during my Suprep prep. I did not vomit during GoLytely.

That said, Suprep was my first prep ever and I tried to be a hero and chug chug chug to get it over with. With that in mind, I sipped GoLytely as instructed and had no problems whatsoever (crippling diarrhea being the intended effect and therefore unclassifiable as a 'problem').
posted by telegraph at 5:00 PM on May 8, 2015

Highly second the advice about eating lightly/low-residue for a few days before. It definitely makes it easier if you have less to clear. I did not have any nausea or vomiting with Golytely, and it was not as bad as I'd feared at all.
posted by judith at 5:39 PM on May 8, 2015

I have ulcerative colitis, currently well controlled with medication. I've been on the colonoscopy-a-year program for the past ten years or so, and I've done both NuLytely (similar to GoLytely but with more flavor options and less salt) and, the last two times, Suprep.

I personally prefer the latter because it's less liquid to ingest (also, I am not allergic to sulfates, which Suprep contains). It too is a two-step process like you described. My gastroenterologist gave me a coupon so that the cost would be less--if your doctor did not, you can get a savings voucher by going to the Suprep website.
posted by apartment dweller at 6:30 PM on May 8, 2015

I had a prep similar to this a few months back. My body is not yours, but here's my experience...

I've had plenty of colonoscopies over the years (long story) and this was probably the least obnoxious prep I've had. You drink just enough of the stuff to reach the point where you're like, GOD, I HATE THIS STUFF. Right then, you stop drinking it. (Normally with prep you reach that point and then have to keep drinking and drinking, until every fiber of your being is telling you to STOP DRINKING. Then you drink some more.)

So you drink the yucky stuff, you stop drinking, then you poop a lot for a few hours. In the middle of the night, you repeat the process. It helps that I'm a night owl and being up at 3 AM comes naturally to me.

Other preps require drinking LOTS of toxic awfulness, or drinking stuff that's like this gross, slimy-sweet, cough-syrupy-y mess. This is more like a few quick shots of stale, vaguely salty water. Nasty, but bearable.

Ask you doctor's office about mixing in some Crystal Light. I think that's allowed, sometimes. In my experience a big problem with any prep is that you get so sick of that same taste, and your system is like NO MORE OF THAT TASTE. Next time I may try having some Golytley with CL and some without, just to mix up the taste a little.

I have GERD and a major puke phobia too, but I've never puked taking prep or even come close to it. Again, my body is not yours. But prep should mostly just be an annoyance, it's not a scary, traumatic thing. You'll get it done, and you'll be fine.

I'm going in for yet another colonoscopy myself on Wednesday. Let's wish each other happy butt-scoping!
posted by Ursula Hitler at 1:38 AM on May 9, 2015

I've had to do colon cleanouts a couple of times. I was terrified of drinking the gunk. I didn't know what the gunk was, what it would taste like, what the consistency would be, nothing. But I was terrified of drinking the gunk.

It was nowhere near as bad as I'd built it up in my mind to be.

I'm also emetophobic. I had a little bit of nausea, but that was all.

Wiggling your toes helps with the gag reflex. Don't know why. A dental tech told me about it when she was shoving all kinds of metal plates into my mouth to do full x-rays. Worked like a charm.
posted by The Almighty Mommy Goddess at 10:54 AM on May 10, 2015

I don't know if you've already done the prep ny now, but I'd go with Golytely over Suprep every single time. I've done both (and a couple of others) thanks to Crohn's Disease.

My problem with the Suprep was that it was pre-flavored and pre-sweetened. So as opposed to the Golytely, which I could mix with Crystal Light to my tastes, it was already a specific (awful, to me) fruity flavor and had a specific amount of sweetness built in. It's sweetened with Splenda, which I personally have a very hard time with, as it always tastes like manufacturers put 50% more in than they need to, and everything Splenda ends up overly sweet.

Seconding the advice for several low-residue days beforehand. I just couldn't do the second dose of Suprep (the gagging and weeping were something to behold), and I was still able to get that colonoscopy done.
posted by themissy at 11:51 AM on May 10, 2015

FWIW, I did the prep last night and it was a lot harder on me than the last one. I developed a pretty spectacular headache, which I'm assuming was a dehydration thing. Talk to your doc or pharmacist about staying properly hydrated. Even if you feel like you cannot sip one more bit of liquid, you are actually LOSING a ton of liquid and dehydration can be its own kind of hell.

Also FWIW, I just did one of these damn things a few months ago, and had to do another today. So it may well be that my first one was more like these things are supposed to go, and today's was my body saying NOPE NOPE NOPE.
posted by Ursula Hitler at 4:14 PM on May 13, 2015

Thanks everyone for the encouragement!

My doctor did send me a coupon for Suprep, and now I just have to avoid anxiety until the prep... which unfortunately, due to conflicts between my schedule and the doctor's, isn't until 6 weeks from now!

Everyone's answers were great, but I appreciated specific tips about making the liquid less awful, and how to quell the gag reflex.
posted by raspberrE at 9:13 AM on May 14, 2015

Update for anyone reading this in the future...

I went with the Suprep and it was NOWHERE near as terrible as I thought it would be. So, anxious person googling this in the future - rest easy! You can do it!

I tried using a straw but that made it too hard to drink fast... I ended up just holding my nose and chugging, and then sucking on a lemon to kill the taste whenever I needed to take a breath. The TASTE itself wasn't so bad, as the saltiness... shudder. But again - not as bad as I imagined!

Also, tips: it works WAY FASTER than I thought (I was basically cleaned out after the bisacodyl) so DO NOT stray far from a toilet; and wear a sweatshirt because all that cold fluid coursing through your body really chills you.
posted by raspberrE at 1:30 AM on June 25, 2015 [1 favorite]

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