TUESDAY, May 24, 2016 (HealthDay News) -- New research suggests that the grueling process of preparing for a colonoscopy may not have to be endured on an empty stomach.
Colonoscopy patients typically have to forgo all solid foods and go on a clear-liquid diet while taking laxatives the day before their procedure. However, this new study found that those who ate a limited amount of low-fiber foods were happier and didn't suffer any negative effects during their exam.
In fact, their bowels were actually better prepared for the procedure than those of the patients who stuck to traditional clear-liquid diets, the researchers said.
"The assumptions about no food on the day before colonoscopy are probably not correct. The clear-liquid diet is very restrictive, and probably too restrictive," said study author Dr. Jason Samarasena. He is an assistant clinical professor of medicine with the division of gastroenterology and hepatology-interventional endoscopy at the University of California, Irvine.
The American Cancer Society estimates that more than 134,000 cases of colorectal cancer will be diagnosed in the United States this year. But while colonoscopy screening is recommended at age 50 for most adults (and even earlier for those at high risk), many don't undergo the procedure. The required preparation is simply too much for some to bear, the researchers said.
The clear liquid is designed to keep the colon clear during a colonoscopy. "Things that are hard or fibrous like seeds can clog the scope," explained Dr. Theodore Levin, chief of gastroenterology with Kaiser Permanente Medical Center in Walnut Creek, Calif.
Enter the idea of a low-fiber diet. The concept is to allow patients to eat foods that aren't likely to stick around in the bowel and disrupt a physician's examination of the intestines.
In the new study, researchers assigned 83 patients to undergo a colonoscopy after a day on a clear-liquid diet or a day in which they were allowed to eat a small number of low-fiber foods like macaroni and cheese, yogurt, white bread, lunch meats and ice cream. The patients ate about 1,000 to 1,500 calories from a combination of fat, protein and carbohydrates.
The researchers found that more of the patients on the low-fiber diet were adequately prepared for a colonoscopy than those who took clear liquids only. And, those in the low-fiber group were less tired on the morning of the procedure. Also, 97 percent of those in the low-fiber group said they were satisfied with their diet compared to just 46 percent of those in the clear-liquid group.
Samarasena said the low-fiber food -- also known as "low-residue" food -- clears out of the colon because it easily liquefies in the digestive system. "The problem isn't food," he said. "It's specifically the type of food that you'll have on the day before. Things that liquefy quickly will get washed out easily."
By contrast, he said, high-fiber foods like vegetables, fruits, nuts, seeds and grains are often undigested when they make their way to the colon, and they can interfere with the examination of the colon.
But why would those who ate food actually have clearer bowels? Eating "probably stimulates more bowel movements the day before the procedure," Samarasena said. "You've started the colon-emptying process with the food that you've been eating."
The study was small, but Samarasena said other research has produced similar results.
Levin, the gastroenterologist, said the study is useful, but patients should talk to their physician before changing their colonoscopy prep.
"It is worth discussing, though," said Levin, who allows diabetic patients and some others to consider a low-fiber diet.
As for himself, Levin said he'd probably try a clear-liquid diet first, to maximize the chances of a "well-prepped colon," but "the low-residue diet is worth looking into."
The findings were to be presented Monday at the Digestive Disease Week conference in San Diego. Studies released at conferences should be considered preliminary until they are published in a peer-reviewed medical journal.
More information
For more on colonoscopy prep, visit the Colon Cancer Alliance.
Colonoscopy.com
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A colonoscopy is one of the best ways to spot or help prevent colon cancer. But many people who should have the procedure don’t. Often that’s because they’re afraid of what they have to go through to get ready for it.
Your colon has to be empty and clean for your doctor to get a proper look at it. To make that happen, you’ll have to fast and use strong laxatives beforehand. It’s inconvenient and somewhat unpleasant, but it’s temporary, and it might help save your life.
Here’s how to make the process as smooth as possible.
Your doctor is your best source of information about how to get ready. When you schedule the procedure, you’ll get instructions. Read them over well before your appointment, and call your doctor if you have any questions.
Clear your schedule for the evening before and the day of your colonoscopy, and make plans for someone to go with you the day of the colonoscopy.
Shop for some key supplies several days ahead, too. Your list may include:
- A prescription or over-the-counter laxative specified by your doctor
- Low-fiber food
- Sports drinks, juices, and broths
- Moist wipes
- Diaper cream
You can help the cleansing process by eating light 3 or 4 days before the procedure. Doctors recommend low-fiber foods that are easy to digest and leave your system quickly.
You can have:
- White bread, pasta, and rice
- Well-cooked vegetables without skin
- Fruit without skin or seeds
- Lean meat, chicken, or fish
- Eggs
Don’t eat:
- Seeds, nuts, or popcorn
- Fatty foods
- Tough meat
- Whole grains
- Raw vegetables
- Fruit with seeds or peel
- Corn, broccoli, cabbage, beans, or peas
At this point you should stop taking vitamins or other supplements. Ask your doctor whether and when you should stop taking any prescription medicines you use regularly, and any over-the-counter anti-inflammatory or blood thinning meds you may use.
The day before your procedure you can’t eat anything solid.you can only consume clear (see-through) liquids. It is important to stay hydrated by drinking lots of clear liquids, such as sports drinks, clear juice like apple and white grape, and clear broth. Soda is OK, and so are coffee and tea, but without cream. You can have gelatin and ice pops, but stay away from anything colored red, blue, or purple. The dyes can discolor the lining of the colon and make it harder for the doctor to see. Also avoid alcohol and drinks you can’t see through, like milk or orange juice.
Two to four hours before the procedure, be sure not to drink or eat anything (please consult your doctor on the exact time stop consuming clear liquids)..
The night before your colonoscopy you’ll take strong laxatives to clear your digestive tract. The method recommended for most people is called split dosing. You’ll drink a half-gallon of liquid laxative in the evening. Then you’ll get up about 6 hours before your appointment to drink another half-gallon.
You probably won’t enjoy the taste of the solution, but there are tricks to help get it down:
- Mix it with something flavored, like a sports drink or powdered drink mix.
- Keep it well chilled.
- Drink it through a straw placed far back on your tongue.
- Follow it with a sip of something good tasting.
- Suck on a lemon slice or piece of hard candy after drinking.
Once the laxative starts working, you’ll have frequent, forceful diarrhea. You may have cramps and bloating. If you have hemorrhoids, they may become irritated. You may also feel nauseated and even vomit. If so, your doctor may recommend you take a short break.
Try these tips to make yourself as comfortable as possible:
- Stay in the bathroom -- bring something to entertain yourself, like a book, television, or laptop.
- Apply diaper cream before the diarrhea starts.
- Use moist or medicated wipes to clean yourself.
The purge process may still be happening as you head to your appointment. If you’re worried about having an accident, consider wearing adult diapers and pack extra clothes.
Your stool should look like urine or clear water if you have completed the process appropriately and it has worked effectively.
The process isn’t easy, but remind yourself this is a smart step to protect your health. If you prepare well, your doctor will be able to see what they need, and your colonoscopy will go faster. If your results are good, it may be 10 years before you have to go through it again.