Since that time, I’ve done more scopes than I can count. Luckily, since my diagnosis — there are now several prep kits on the market, with the goal of “easing” the experience for patients. Here’s what I can tell you about my experience and what I think are their pros and cons of different kinds of bowel preps.
The Usual Suspects
When I had my very first colonoscopy, I wasn’t given a choice for the prep, and did Suprep. This is a split-dose (two-day) regimen that involves drinking 6 ounces (oz) of a salty, disgusting drink at night, and another 6 oz in the morning, along with water. I personally don’t enjoy this one — even though it doesn’t seem like a lot to drink, it’s gross, and I can still remember what it was like nearly 20 years later. For a number of preps after that first one, I chose to do the Gatorade-Miralax-Dulcolax mix, which is a favorite among patients. While the drink isn’t terrible to get down, it’s a lot of volume: It requires mixing a half a bottle of Miralax (119 grams; 4.1 oz) in two 32-oz bottles of Gatorade. (Pro tip: It’s best to mix this early in the day and keep it in the fridge, so it’s cold.) The evening before my colonoscopy, I had to take four Dulcolax laxative tablets. An hour after that, I started on the Gatorade and Miralax mixture. It’s recommended to drink four 8-oz glasses of this mixture every 15 minutes plus another 16-oz of water. Then in the morning, prior to my colonoscopy, I drank the other 32-oz of the Miralax and Gatorade concoction, followed by water. My gastroenterologist requires patients to also drink two bottles of magnesium citrate, regardless of what prep you choose. She claims it’s necessary to ensure all the mucus is out of the colon. Personally, the magnesium citrate is the hardest part for me. It tastes horrible and causes me to vomit. I’ve learned to take a Zofran for nausea, prior to prep. This medication is not over the counter, so I would advise getting a script from your gastroenterologist ahead of time if you have issues with keeping the prep down.
Bowel Prep in Pill Form
Last year, I tried something different. I wanted to try out a new pill prep option called Sutab. This prep involves 24 pills taken over two days. You take 12 pills along with water the day before the colonoscopy and 12 pills the morning of the procedure. While the pills are large, I found going this route was a lot easier than drinking a ton of liquid. Initially, I took the pills too fast and threw up. For my next dose, I timed the pills and took one every three minutes. This was a game changer! Once again, the magnesium citrate made me ill and I was only able to get half of it down. Regardless, I was told by my doctor that I was perfectly cleaned out. In general, to help me ease the prep process, I do a self-imposed liquid diet that starts the Monday before my Friday scope. I find it’s much easier to be cleaned out and it takes the pressure off if I have issues getting all the prep down. One of my secret tricks: gummy bears! The chewy candy is considered a clear liquid — just steer clear of red, purple, and orange the day before. (Being able to chew something helps when you’re on a liquid diet.) In December 2022 I opted to use Sutab again for my bowel prep. Unfortunately, magnesium citrate saline was recalled in the summer of 2022 so my GI came up with a different regimen in its place that involves magnesium citrate pills, additional water, milk of magnesia, and an enema.
What Else Is Out There in the Way of Colonoscopy Prep?
While there are several different types of bowel prep kits on the market, in general they all include osmotic laxatives, which make you poop and trigger your bowels to draw in more water to force the substances out. That water softens the stool and increases the overall volume in the colon. Preps also have electrolytes since the purging of the bowels can be extremely dehydrating. Here are some of the most common: Polymer-based formulas are the most prescribed bowel prep, and involve a laxative known as polyethylene glycol 3350 (PEG). This large molecule is unable to be absorbed through your colon, causing you to go to the bathroom. This type of formula is usually in powder form and mixed with large amounts of water, such as in the Miralax-Dulcolax-Gatorade concoction mentioned above. Other PEG preps include:
Golytely is commonly given to patients in the hospital. When you think about the jug of prep, this is it!Colyte is known to have a mildly salty taste and comes with flavor packs. You can choose orange, lemon-lime, or cherry. You need to get a gallon of this down.Nulytely and Trilyte are sulfate-free to make them less salty.Halflytely comes in a kit containing two delayed-release tablets and a bottle of Halflytely in powder form. You take the tablets first and wait to have a bowel movement, then you drink the solution in 90 minutes.Gavilyte comes in a lemon-flavored powder mix and involves drinking 4 liters (slightly more than 1 gallon).Moviprep is another combination formula that uses PEG with ascorbic acid as a secondary laxative.Plenvu is the first and only 1-liter PEG bowel cleansing prep, and it claims to be the most palatable.Happy Colon Foods is a unique prep in that you take laxatives along with three meals, three snacks, and flavored drinks that serve as electrolyte drink mixes, all of which are part of the kit you order. This includes tasteless PEG laxative powder, senna tablets, and magnesium citrate. With each meal and snack you drink 20 oz of water, so this still involves drinking a large volume of liquid.
Saline-based laxatives utilize sodium phosphate as a primary osmotic agent, and usually involve mineral salts such as potassium and magnesium:
Clenpiq involves drinking two bottles of solution and a total of 80 oz of water.Suprep (detailed above) is another split dose (two-day) regimen. You drink a 6-oz bottle of Suprep in the evening and the second 6-oz bottle in the morning along with water.Prepopik this powder or oral solution comes in orange or cranberry flavor and is mixed with water.Osmoprep is a prep that involves taking four tablets with at least 8 oz of clear liquid every 15 minutes and then repeating the dose every 15 minutes until you have taken five doses (20 tablets). The next day you take another 12 tablets.
Choosing the Right Prep for You
We all have preferences when it comes to stomaching things like bowel preps. If you prefer to chug your prep and get it down as fast as possible, despite the taste, then you’ll want to take that into consideration. If you’d prefer mixing your prep with a drink like Crystal Lite or Gatorade to help mask the taste and don’t mind the volume of liquid, that’s something to think about. If you don’t mind swallowing pills and don’t enjoy drinking a large amount, then there’s something out there for you. This is a conversation to have with your gastroenterologist and care provider. See what prep your care team recommends due to your health status and preferences. Prior to ordering your prep, make sure to look up coupons on the manufacturer website to get the full discount with your insurance. Find what works for you and do your best to get as much down as possible. Colonoscopies aren’t fun, but they are vital in preventing and catching cancer early, while also managing IBDs like Crohn’s disease and ulcerative colitis.
