Each year, gastroenterologists in the U.S. perform nearly 20 million colonoscopies.

Yet that number should be higher. An estimated 40% of people who should get colonoscopies don’t, primarily out of fear of the preparation. But there are misconceptions about the prep that we’ll get to in a minute.

Did you know that a screening colonoscopy can actually prevent colon and rectal cancers from developing? Recent research shows that people who have had polyps removed during a routine colonoscopy were 50% less likely to die of colorectal cancer than the general population – even 15 years later.

The Reason to Prep for a Colonoscopy

Thanks to colonoscopy screenings, the number of people diagnosed with colorectal cancer has declined since the 1980s. The American Cancer Society predicts 150,000 new cases will be diagnosed in 2021.

But the screening only works if the colon is clean. A colonoscopy is performed with a flexible tube equipped with a lighted camera. The camera works as the gastroenterologist’s eyes, examining the intestinal lining for inflammation, ulcers, and polyps (slow-growing clusters of cells).

Any waste in the intestine can block these growths from view, making the multi-step preparation of fasting and cleansing crucial.

Misconceptions About Colonoscopy Prep

Thanks to innovations in medicine, colonoscopy preparation has vastly improved in recent years. Here are five myth-based (and outdated) fears that I can dispel now:

1. Myth: You can’t eat anything the day before. While it’s true patients must fast on the day before the procedure, some foods are OK. These foods include Jell-O, popsicles, black coffee, and clear broths (think chicken broth). Just avoid anything that is orange, red, or purple, which can change the color of the colon.
   Prep tip: Drink lots of fluids, including clear fruit juice. This will prevent dehydration and help you feel somewhat satisfied. Bonus: hard candy and lollipops are OK, too.
2. Myth: I’ll have to drink a gallon of prep medicine. Thanks to developments in the prep solution, patients only need to drink a fraction of what used to be required – some prep kits involve just two doses of six ounces each (diluted in water), followed by 32 ounces of water to be taken over the following hour. Your gastroenterologist will prescribe the prep that’s right for your case.
   Prep tip: Drink the solution at room temperature. Very cold liquids slow down the stomach’s ability to empty, so skip ice and refrigeration.
3. Myth: The laxative tastes bad. In recent years, prep solutions have gotten better tasting and some come with flavor packets. Further, new solutions, including food bars and lower-volume liquids, are being tested.
   Prep tip: Add ginger ale, Gatorade, or a bit of powdered drink mix such as Crystal Lite (even lime Margarita mix!) – as long as the solution remains pale in color. Also, if the solution is taken with a straw, much of it can bypass the taste buds.
4. Myth: I won’t “clean out” in time for the procedure. Your doctor will advise when to take the laxative solution, depending on the time of your colonoscopy, so you will have plenty of time to get the “pipes” clean.
   Prep tip: Walk around between trips to the bathroom; the exercise will keep waste in the body moving. The prep is complete when bowel movements become clear liquid, without cloudiness.
5. Myth: I’m too young and healthy to need to do this. Patients are generally advised to get their first colonoscopy at the age of 45, but one may be prescribed sooner for patients whose personal or family history includes colon cancer, gastrointestinal bleeding, or other lower-GI issues. If you don’t have any risk factors and no polyps are found during your colonoscopy, you’ll likely not have to repeat the procedure for up to 10 years.
   Prep tip: Talk to your gastroenterologist, because lifestyle habits involving diet, exercise, smoking, and alcohol consumption can increase your cancer risk. The incidence of colorectal cancer among people younger than 50 had risen by 2% each year from 2012 to 2016.

What to Expect on Colonoscopy Day

On the day of your colonoscopy, you will be given time to relax before the procedure. An intravenous sedative will be administered, and you will slip into a “twilight sleep.” The actual screening usually takes 15 to 20 minutes.

Afterward, you will remain in the care of Cincinnati GI’s medical staff until the sedative wears off. Your doctor will then go over the initial results. If polyps were removed for biopsy, those results typically arrive within a week.

So, let’s put fear in its place. Getting your colonoscopy is the best proactive step you can take to steer clear of colorectal cancer.