When I wrote about my first colonoscopy, back in 2022, I was both eager and sheepish: I so desperately wanted to talk to others about the entire experience, but I also realized I was talking about a lot of pooping on the internet. Since then, I’ve had two more colonoscopies, including one this past week. I’ve learned a lot about the process — and how to make it better and less exhausting for myself —
I'm so grateful you wrote this and demystified it. One thing I want to emphasize: the prep part is not nearly as big of a deal as people think because it's not painful and you don't feel sick. We associate diarrhea with feeling sick, perhaps nauseous, but you don't feel any of those queasy symptoms with prep for a colonoscopy. You just sit on the toilet and go.
My brother-in-law—my husband's only sibling, who's a year younger than I—died of advanced colon cancer at 51. After he died, I got a colonoscopy mainly because my husband wanted me to. I have zero risks and honestly thought it was a bit unnecessary. But when I came out of anesthesia, the GI doc told me it's a good thing I went in because I had numerous polyps, one of which was a pre-cancerous kind that's most worrisome (I'm forgetting at the moment what it's called). He said to make sure all my sibs have been screened, since it has a genetic component, and my kids should start getting screened a decade earlier than recommended. I have to have one every three years now.
Finally, I'm inspired by my OBGYN, a young woman who's a kick-ass ultrarunner in addition to being a doctor, who had "poop problems" at age 30 she first wrote off as inflammatory bowel disease. Turns out, she had advanced rectal cancer with a massive tumor blocking her lower end. She endured two years of chemo and recovery, had all her lower plumbing removed, had her eggs retrieved and went through IVF because she no longer can carry a pregnancy due to her radiation treatment—and ultimately, she healed, and is now a long-distance runner again. But that is what can happen to a supposedly healthy person. Prevention and scanning are SO IMPORTANT. (I invite you to read a story I wrote about her if interested, https://www.trailrunnermag.com/people/live-through-this/).
Wanted to share my family's favorite colonoscopy prep advice. My family has a history of colon cancer so my father considers himself an expert on colonoscopies since he has them so regularly. At some point he learned about prepping with Miralax dissolved in Gatorade and then taking Dulcolax and it changed his life because it's so much easier to get down than standard prep. A lot of doctor's use this prep but of course check with your doctor first.
Hi there - 51 y/o woman here, 2 colonoscopies under my belt. My greatest fear, approaching the first one, was being knocked out. I'm a single mom of a kid with medical issues, and being unconscious for a few hours, the kid being sort of extra vulnerable during that time, scared me far more than the prep. At the hospital, I was asked, Are you going to be sedated? I said, Do I have a choice? Why, yes, the nurse said. Great! I said. No sedation for me. In the room, the doc recommended a little sedation, "to take the edge off." Right on, I said. It was glorious. Yes, glorious. Because a) I stayed conscious, b) I am many years sober and opportunities to be a little high are few and far between, and c) how often do you get to look up your own ass? Fast forward to colonoscopy #2, this past January, when I thought I didn't even need that little bit to take off the edge. Utter misery. My recommendation: do the "conscious sedation" (that's the official term) if you have any concerns about being knocked out. My only consolation was that somehow, through my thrashing about, my hair acquired this wonderful tousled look, and the nurse bringing me ginger ale said, "Girl, how did you come out of a colonoscopy looking like you got a blow-out?" Still cracks me up.
I’m only 31 so have yet to have my first colonoscopy but it’s likely not far away as my mom was diagnosed with Stage 3 rectal cancer at age 66. She’s now doing great, but one thing the whole process has created is…a family devoted to bidets. Like, I cannot IMAGINE inevitably doing this process without a bidet.
As a person whose CR tumor was diagnosed at the beginning of the pandemic, my encouraging words are these: the discomfort of a colonoscopy is infinitely more bearable than radiation, a year of chemotherapy, and an 8-hour stint on an OR table. As for prep, the Miralax option is decidedly less unpleasant than that prescription ICKY stuff from Walgreens!! This piece is much-needed, Anne, thank you! If anyone ever needs to talk about poop or is on a CR cancer journey, I’m willing to hold your hand (virtually) and hold space. I was healthy before I was diagnosed, but had no clue about family health history (my family prides itself on their secrets). All the good health habits in the world don’t necessarily override the genes you inherit.
I had my first one about a year ago, at age 40. I think it's worth adding here that there's a prep in pill format available. You swallow a bunch of tablets with water and that's it. No prep liquid that may or may not taste very gross. It was really the part I was most dreading, and the pills were totally fine. The gummy bears info is key - I am keeping this in mind for next time because all I wanted to do was chew, all day.
I’ve had dozens of colonoscopies, and the only thing I would add to the excellent advice here is that, if your ride falls through (like the time my husband woke up with food poisoning at 6 am when I had a colonoscopy scheduled for 8 am), there are often medical transport services you can use to get taken home (since you can’t drive yourself, or take a Lyft/public transit without supervision). I got the info from my doctor’s office that morning, and I think it cost me ~$40, which was totally worth it to not have to reschedule my appointment and go through all the prep again.
Thanks for sharing this! Aren't we so lucky to be able to have these life-saving procedures?
I am in the UK (for context) and have had a colonoscopy and a sigmoidoscopy (where they just look at the last section of your bowel) at the age of 28, which got me my Crohn's diagnosis. The colonoscopy involved prep (as brilliantly described by AHP) and sedation. I was conscious but super relaxed and enjoyed seeing the inside of my colon on the screen. For the sigmoidoscopy there was no prep to drink - I had to fast and then was given an enema just before (they squirt laxative up your bum to make you poo). I was told I would not need sedation. It was very painful - they decided to look around the corner of my colon and even with gas and air, it hurt a lot and I was in pain for days afterwards. So I would always encourage people to ask for sedation if you can. But there's a lovely 90 year old guy in my choir who happily has full colonoscopies without sedation so maybe just know your body and think about what will make the process the least stressful for you, because chances are you will have more in the future. Also in the UK they give you 'dignity shorts' to wear - shorts with a little flap at the back, hilarious but not at all dignified...
Some people get a real sore anus with all the wiping. Highly recommend a bidet. Next best is a package of disposable wipes with dimethicone which protects skin from liquid poop. You won’t find these in stores and have to order them from a medical supply source Most places make you buy a case but here’s a link where you can order 1 or 2 packs.
Former incontinence nurse and colonoscopy veteran.
Thank you again for sharing this! I know I’m going to reread it before getting my first colonoscopy in a few years.
I would love to read something similarly demystifying/preparatory about mammograms. Is anyone else terrified by the idea of them? All I’ve seen on the internet is that they’re incredibly painful. I know I need to get one but I’m honestly so scared that I’m putting it off.
I just started a substack called Anxiety Party based on my experience getting diagnosed with rectal cancer (and subsequently, Lynch Syndrome, which puts me at a much higher risk of developing colorectal cancer among others) at age 40 after a mass was found during a colonoscopy. I ended up having rectal surgery to remove the mass, which was cancerous, but at such an early stage they considered it cured with surgery. I will never forget the anesthesiologist assistant coming by my gurney just before surgery and, upon hearing why I was there, saying, "Good! This is exactly why we screen – to catch things like this." Highly encourage anyone reading this to talk to their doctor about getting a colonoscopy if they have a family history or any symptoms, and this was a GREAT summation of the process. I've had two colonoscopies in two years and will have one every year for the rest of my life. It's not that bad – I pretend I'm doing a cleanse – and Yes! to Vietnamese broth. Great tip. Lucy's in Brooklyn is my go to for clear liquids day. Thank you Anne for writing about this!
I had my first colonoscopy last summer at 37 due to persistent GI problems. The prep took me out—my whole body felt very cold, shaking uncontrollably, and throwing up. I managed to drink enough to be “running clear” so they let me do the procedure. The prep was hard for me, but I’m so glad I did it. I was convinced I had cancer; the symptoms, some of the things doctors said at other appointments—I was so sure. I was really anxious and the kind anesthesiologist gave me some anti-anxiety meds in my IV. If you are scared, tell them!! They can help.
The wonderful nurses and doctor made sure that as soon as I was with it, the first thing I heard was that there was no cancer. It was worth every chill and shake and puke and poop the night before!
I had my first colonoscopy last year, after I started seeing blood in my poop. It's turned out to be a bit of wear & tear around a diverticular pocket, and it's still going on, so I'll probably have another one this year plus some repair work. So - if you are seeing blood, as Anne says, it really can be *all number* of things, and not The Worst - but it is also really, really important to get checked, and do it regularly.
What I found most fascinating was the procedure itself, because I got to watch it in realtime. I was so nervous beforehand that the sedative failed to knock me out, and I suddenly felt so chill about it that I decided to not ask for more of it. So - I watched the screen as it happened. IT WAS FASCINATING. Honestly, I have rarely been so enthralled by anything on a TV. I can still remember the whole thing too - my initial anxiety must have been sky-high to override the meds like that. But at that point, all my nervousness utterly disappeared (the doctors and nurses were really lovely too - Scottish healthcare for the win). Couldn't feel anything, felt the most relaxed I'd been in years, and I got to see firsthand where the problem was, and listen to them say it was nothing to be too worried about.
10/10 would colonoscopize again (and will be doing soon).
I have a slow moving colon so I once had a colonoscopy that was unsuccessful meaning that I hadn't been properly cleansed so I had to do it over. That was such awful news upon waking.
So, ever since I've had a two day prep and I think a much better GI doctor. I schedule mine first thing in the morning, say a Wednesday) and then do a two day clear liquid diet after breakfast on say Monday.
My really big tip is this: to drink the obnoxious fluid twice the night before I mix it with white grape juice and just before I drink it I assault my mouth with Dentine Ice gum. If I then hold my nose I can drink the whole thing in thirty seconds and not taste anything.
I strongly recommend restoring your gut biome after the procedure with eating yogurt or another food with similar qualities. After my first colonoscopy with an excessive older prep my gut did not normalize for six months. Not farting was nice for six months but my bowels were definitely not normal.
I'm so grateful you wrote this and demystified it. One thing I want to emphasize: the prep part is not nearly as big of a deal as people think because it's not painful and you don't feel sick. We associate diarrhea with feeling sick, perhaps nauseous, but you don't feel any of those queasy symptoms with prep for a colonoscopy. You just sit on the toilet and go.
My brother-in-law—my husband's only sibling, who's a year younger than I—died of advanced colon cancer at 51. After he died, I got a colonoscopy mainly because my husband wanted me to. I have zero risks and honestly thought it was a bit unnecessary. But when I came out of anesthesia, the GI doc told me it's a good thing I went in because I had numerous polyps, one of which was a pre-cancerous kind that's most worrisome (I'm forgetting at the moment what it's called). He said to make sure all my sibs have been screened, since it has a genetic component, and my kids should start getting screened a decade earlier than recommended. I have to have one every three years now.
Finally, I'm inspired by my OBGYN, a young woman who's a kick-ass ultrarunner in addition to being a doctor, who had "poop problems" at age 30 she first wrote off as inflammatory bowel disease. Turns out, she had advanced rectal cancer with a massive tumor blocking her lower end. She endured two years of chemo and recovery, had all her lower plumbing removed, had her eggs retrieved and went through IVF because she no longer can carry a pregnancy due to her radiation treatment—and ultimately, she healed, and is now a long-distance runner again. But that is what can happen to a supposedly healthy person. Prevention and scanning are SO IMPORTANT. (I invite you to read a story I wrote about her if interested, https://www.trailrunnermag.com/people/live-through-this/).
Wanted to share my family's favorite colonoscopy prep advice. My family has a history of colon cancer so my father considers himself an expert on colonoscopies since he has them so regularly. At some point he learned about prepping with Miralax dissolved in Gatorade and then taking Dulcolax and it changed his life because it's so much easier to get down than standard prep. A lot of doctor's use this prep but of course check with your doctor first.
Hi there - 51 y/o woman here, 2 colonoscopies under my belt. My greatest fear, approaching the first one, was being knocked out. I'm a single mom of a kid with medical issues, and being unconscious for a few hours, the kid being sort of extra vulnerable during that time, scared me far more than the prep. At the hospital, I was asked, Are you going to be sedated? I said, Do I have a choice? Why, yes, the nurse said. Great! I said. No sedation for me. In the room, the doc recommended a little sedation, "to take the edge off." Right on, I said. It was glorious. Yes, glorious. Because a) I stayed conscious, b) I am many years sober and opportunities to be a little high are few and far between, and c) how often do you get to look up your own ass? Fast forward to colonoscopy #2, this past January, when I thought I didn't even need that little bit to take off the edge. Utter misery. My recommendation: do the "conscious sedation" (that's the official term) if you have any concerns about being knocked out. My only consolation was that somehow, through my thrashing about, my hair acquired this wonderful tousled look, and the nurse bringing me ginger ale said, "Girl, how did you come out of a colonoscopy looking like you got a blow-out?" Still cracks me up.
I’m only 31 so have yet to have my first colonoscopy but it’s likely not far away as my mom was diagnosed with Stage 3 rectal cancer at age 66. She’s now doing great, but one thing the whole process has created is…a family devoted to bidets. Like, I cannot IMAGINE inevitably doing this process without a bidet.
As a person whose CR tumor was diagnosed at the beginning of the pandemic, my encouraging words are these: the discomfort of a colonoscopy is infinitely more bearable than radiation, a year of chemotherapy, and an 8-hour stint on an OR table. As for prep, the Miralax option is decidedly less unpleasant than that prescription ICKY stuff from Walgreens!! This piece is much-needed, Anne, thank you! If anyone ever needs to talk about poop or is on a CR cancer journey, I’m willing to hold your hand (virtually) and hold space. I was healthy before I was diagnosed, but had no clue about family health history (my family prides itself on their secrets). All the good health habits in the world don’t necessarily override the genes you inherit.
My husband named the colonoscopy prep “Poople Drank.” Laughter is the best medicine!
I had my first one about a year ago, at age 40. I think it's worth adding here that there's a prep in pill format available. You swallow a bunch of tablets with water and that's it. No prep liquid that may or may not taste very gross. It was really the part I was most dreading, and the pills were totally fine. The gummy bears info is key - I am keeping this in mind for next time because all I wanted to do was chew, all day.
I’ve had dozens of colonoscopies, and the only thing I would add to the excellent advice here is that, if your ride falls through (like the time my husband woke up with food poisoning at 6 am when I had a colonoscopy scheduled for 8 am), there are often medical transport services you can use to get taken home (since you can’t drive yourself, or take a Lyft/public transit without supervision). I got the info from my doctor’s office that morning, and I think it cost me ~$40, which was totally worth it to not have to reschedule my appointment and go through all the prep again.
Thanks for sharing this! Aren't we so lucky to be able to have these life-saving procedures?
I am in the UK (for context) and have had a colonoscopy and a sigmoidoscopy (where they just look at the last section of your bowel) at the age of 28, which got me my Crohn's diagnosis. The colonoscopy involved prep (as brilliantly described by AHP) and sedation. I was conscious but super relaxed and enjoyed seeing the inside of my colon on the screen. For the sigmoidoscopy there was no prep to drink - I had to fast and then was given an enema just before (they squirt laxative up your bum to make you poo). I was told I would not need sedation. It was very painful - they decided to look around the corner of my colon and even with gas and air, it hurt a lot and I was in pain for days afterwards. So I would always encourage people to ask for sedation if you can. But there's a lovely 90 year old guy in my choir who happily has full colonoscopies without sedation so maybe just know your body and think about what will make the process the least stressful for you, because chances are you will have more in the future. Also in the UK they give you 'dignity shorts' to wear - shorts with a little flap at the back, hilarious but not at all dignified...
Some people get a real sore anus with all the wiping. Highly recommend a bidet. Next best is a package of disposable wipes with dimethicone which protects skin from liquid poop. You won’t find these in stores and have to order them from a medical supply source Most places make you buy a case but here’s a link where you can order 1 or 2 packs.
Former incontinence nurse and colonoscopy veteran.
https://www.avacaremedical.com/remedy-skin-protectant-wipes?sku=MSC092503H&fee=14&fep=106803&gad_source=1&gclid=Cj0KCQjwqdqvBhCPARIsANrmZhOmWBw6cu_8ELthT9zOYGybDSO0ithWjQ-nozfyDlBahLRtJmLxchkaAqJ5EALw_wcB
Thank you again for sharing this! I know I’m going to reread it before getting my first colonoscopy in a few years.
I would love to read something similarly demystifying/preparatory about mammograms. Is anyone else terrified by the idea of them? All I’ve seen on the internet is that they’re incredibly painful. I know I need to get one but I’m honestly so scared that I’m putting it off.
I just started a substack called Anxiety Party based on my experience getting diagnosed with rectal cancer (and subsequently, Lynch Syndrome, which puts me at a much higher risk of developing colorectal cancer among others) at age 40 after a mass was found during a colonoscopy. I ended up having rectal surgery to remove the mass, which was cancerous, but at such an early stage they considered it cured with surgery. I will never forget the anesthesiologist assistant coming by my gurney just before surgery and, upon hearing why I was there, saying, "Good! This is exactly why we screen – to catch things like this." Highly encourage anyone reading this to talk to their doctor about getting a colonoscopy if they have a family history or any symptoms, and this was a GREAT summation of the process. I've had two colonoscopies in two years and will have one every year for the rest of my life. It's not that bad – I pretend I'm doing a cleanse – and Yes! to Vietnamese broth. Great tip. Lucy's in Brooklyn is my go to for clear liquids day. Thank you Anne for writing about this!
I had my first colonoscopy last summer at 37 due to persistent GI problems. The prep took me out—my whole body felt very cold, shaking uncontrollably, and throwing up. I managed to drink enough to be “running clear” so they let me do the procedure. The prep was hard for me, but I’m so glad I did it. I was convinced I had cancer; the symptoms, some of the things doctors said at other appointments—I was so sure. I was really anxious and the kind anesthesiologist gave me some anti-anxiety meds in my IV. If you are scared, tell them!! They can help.
The wonderful nurses and doctor made sure that as soon as I was with it, the first thing I heard was that there was no cancer. It was worth every chill and shake and puke and poop the night before!
I had my first colonoscopy last year, after I started seeing blood in my poop. It's turned out to be a bit of wear & tear around a diverticular pocket, and it's still going on, so I'll probably have another one this year plus some repair work. So - if you are seeing blood, as Anne says, it really can be *all number* of things, and not The Worst - but it is also really, really important to get checked, and do it regularly.
What I found most fascinating was the procedure itself, because I got to watch it in realtime. I was so nervous beforehand that the sedative failed to knock me out, and I suddenly felt so chill about it that I decided to not ask for more of it. So - I watched the screen as it happened. IT WAS FASCINATING. Honestly, I have rarely been so enthralled by anything on a TV. I can still remember the whole thing too - my initial anxiety must have been sky-high to override the meds like that. But at that point, all my nervousness utterly disappeared (the doctors and nurses were really lovely too - Scottish healthcare for the win). Couldn't feel anything, felt the most relaxed I'd been in years, and I got to see firsthand where the problem was, and listen to them say it was nothing to be too worried about.
10/10 would colonoscopize again (and will be doing soon).
I have a slow moving colon so I once had a colonoscopy that was unsuccessful meaning that I hadn't been properly cleansed so I had to do it over. That was such awful news upon waking.
So, ever since I've had a two day prep and I think a much better GI doctor. I schedule mine first thing in the morning, say a Wednesday) and then do a two day clear liquid diet after breakfast on say Monday.
My really big tip is this: to drink the obnoxious fluid twice the night before I mix it with white grape juice and just before I drink it I assault my mouth with Dentine Ice gum. If I then hold my nose I can drink the whole thing in thirty seconds and not taste anything.
I love the sensation of being put under.
I strongly recommend restoring your gut biome after the procedure with eating yogurt or another food with similar qualities. After my first colonoscopy with an excessive older prep my gut did not normalize for six months. Not farting was nice for six months but my bowels were definitely not normal.