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Johns Hopkins Health Alert

Colonoscopy Prep Advice

Comments (2)

Before you have a colonoscopy, it's essential to get your colon completely clean. But a recent study published in Clinical Gastroenterology and Hepatology (Volume 7, page 670) finds that standard bowel preparation doesn't work as well in people who are overweight. This is a concern because any residue in the colon can mask polyps and cancers during colonoscopy. 

Researchers evaluated bowel preparation in 1,588 colonoscopy procedures and found residue in the bowel about 25 percent of the time. The heavier the person, the more likely the researchers were to find residue. Inadequate colonoscopy bowel preparation was seen in more than 43 percent of the people who were obese, compared with 33 percent of those who were of normal weight. Other factors that increased the risk of inadequate bowel preparation were being male, smoking, drinking alcohol, using antidepressants or other drugs and having diabetes. 

Bottom line: If you are overweight, ask your doctor before your next colonoscopy whether you would benefit from starting a liquid diet a day earlier than is typically recommended. Another possibility might be to take additional laxatives. 

Posted in Colon Cancer on January 18, 2012


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


Having had five colonoscopys between age 67 and age 77, I feel qualified, at age 79, to comment on the question of bowel preparation for the procedure although I was not then, nor now, overweight/obese. No surgery was called for by any of the exams. My first one disclosed a "precancerous" polyp which was removed but required a sooner-than-usual followup (negative). My third exam revealed a "too-small-to be-biopsied" lesion at the intersection of the small and large intestines; requiring a sooner-than-usual followup (negative). Fourth exam was negative and 5th one was done by a different gastroenterologist. For the first two exams I was told only to drink a gallon of a prescribed electolyte solution the night before the exam. After that experience, I also ate only low-residue foods for two days before the next two exams. In each case I was barely able to down the electrolyte solution w/o vomiting. For my recent-most exam I was advised by my new doctor to take 3 TBSPs of Milk of Magnesia at 6:00 PM two days prior to the procedure and no solid food or dairy products thereafter. On the day before the procedure I was instructed to take only a clear liquid diet (nothing red) until 4 PM and thereafter drink the gallon of CHILLED electrolyte, 8 ounces at a time until it was all gone, then nothing to eat or drink. I had absolutely no trouble downing the chilled electrolyte solution and wish that that had been recommended to me at my first four experiences.

Posted by: clearair | January 19, 2012 7:49 PM

People who smoke better take note of this advice here. Being a smoker already puts them in plenty of health risks, but if it obstructs the ability of the colonoscopy to detect dangerous cancer cells, then they would be defeating the purpose of a scan. Going on a liquid diet could be hard for people who are overweight, but it is important that their colons are as clean as possible.

Gordon - Green Smoke Discount Code

Posted by: BlueBierd | April 26, 2012 3:57 AM

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