I had a colonoscopy this week, so I thought I would share my paleo colonoscopy prep experience with you and give you tips on how to make the procedure more comfortable.  Most people cringe at the thought of having a colonoscopy, but they are vital for diagnostic and preventative medicine purposes.  This is my fifth colonoscopy, and I promise they are not horrible (lots of people are babies and complain about them).  The worst part for me is not being able to eat the day before the procedure.  Yes, you do go to the bathroom a lot during the prep, but if you have any kind of gastrointestinal condition or a bad stomach virus, the prep is nothing compared to that.  There is urgency but it is not the extremely painful, crampy diarrhea that many of us have experienced.

Why should I get a colonoscopy?

According to the American Cancer Society, colon cancer is the third most common type of cancer diagnosed in both men and women in the United States, excluding skin cancer and the third leading cause of cancer-related death.  On average throughout a lifetime, 1 in every 21 men and 1 in every 23 women are diagnosed with colon cancer, but this number is steadily decreasing with more and more people receiving colonoscopy screenings starting at age 50.  These screenings may start at a younger age if you have a family history of colon cancer or polyps.  

During the procedure, gastroenterologists remove polyps, which are often pre-cancerous growths, and pathologists analyze these polyps for abnormalities.  Early detection is key for cancer treatment, so be sure to see your primary care physician regularly and schedule your mammograms, colonoscopies, pap smears, and other recommended exams.     

 

Besides screening for cancer, colonoscopies with biopsies are the gold standard for diagnosing inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis.  In IBD patients, colonoscopies are also used to monitor disease activity, response to medication, and screen for cancer, as having IBD raises your chances of developing intestinal cancers by five times.  That being said, 90% of IBD patients will not develop cancer (source: WebMD). 

How to Prepare for Your Colonoscopy

• Purchase your prep, clear liquids, and baby wipes

I have only done the MiraLax and magnesium citrate preps and prefer the MiraLax prep.  It is very gentle on the bowels and easier on the stomach when it comes to nausea.  I vomited from magnesium citrate and have heard horror stories about other foul tasting preps.  Talk to your doctor about the MiraLax prep if you have had a bad experience with a different prep.  You can also buy the generics of these medications.  

• Make bone broth, gelatin gummies, and any easy to digest meals you may want to eat after the procedure
  

• Arrange for someone to drive you to and from the hospital

• Plan something to do the morning of your prep

You may want to do something to do in the morning before you start your prep so you do not think about food as much.  Plan a morning in the city, go for a long walk with friends, or shop till you drop.  I like to stay busy because oftentimes, sitting around on the couch watching TV, seeing food commercials, and boredom make me even hungrier (so much hanger).

• Plan your Netflix Prepare to relax during the prep

Once you start the prep in the afternoon, you will be so full of liquids and running to the bathroom that you will no longer be hungry.  You may want to go to the library and borrow a good book to read or find a series on Netflix you want to binge. Don’t plan on leaving the house for the rest of the night.  And feel free to yell at your sister for making a delicious smelling bagel when you can’t eat (jk love you Michelle).

• Prepare snacks for after your colonoscopy.

Typically, I’m not that hungry right after a scope but will usually bring a banana and a Larabar or coconut milk yogurt with fruit to eat.

5 Day Low Fiber Diet:

Five days before the procedure, you need to follow a low fiber diet.  Fiber is the indigestible part of plants that creates the bulk in stool.  You want your colon to be completely clear for the procedure, so it is important to limit your waste production.  Seeds and undigested waste left in the bowels can get stuck in the scope, so you should avoid high fiber foods.

Low Fiber Paleo Foods:

Protein (ground meat is preferred)	Lean meat (fish, chicken, turkey, lamb, veal), eggs
Fruit (ripe, seedless, peeled)	Applesauce, bananas, melon, pear, avocado, 100% fruit juice, canned fruit except pineapple
Vegetables/starches	Canned vegetables (green beans), heavily steamed vegetables (carrots), baked skinless white/sweet potatoes, squash, pumpkin, cauliflower mash, peeled zucchini, peeled cucumber
Non-dairy products	Coconut milk/coconut milk yogurt, almond milk/almond milk yogurt, non-dairy ice cream
Fats	Olive oil, coconut oil, avocado oil, smooth almond butter

Meal Ideas:

• Ground turkey patty, butternut squash soup, steamed carrots
• Chicken thighs, baked butternut squash, cauliflower mash
• Chicken, baked skinless sweet potato, canned green beans
• Shredded chicken, avocado/guacamole, peeled cucumber “salad”
• Over easy eggs on top of peeled baked sweet potato/sweet potato hash
• Ground turkey, peeled zucchini & carrot stir-fry
• Bone broth soup w/ carrots, celery, starch of choice (white rice/yuca/rutabaga) & chicken
• Smoothies (Vital Proteins collagen, coconut milk, frozen banana, frozen mango, spinach)
• Coconut milk yogurt w/ peeled pear
• Smooth almond butter w/ banana
• Desserts: banana n’ice cream, ripe fruit, dark chocolate, coconut milk ice cream

Avoid: raw vegetables, raw fruits, berries, dried fruits, seeds, peels, nuts, coconut, tough meats

The meal options are endless. Below are some examples of low fiber meals from my Instagram. Be sure to peel your fruits and veggies!

Day Before the Procedure: Put on your comfiest sweats, watch a good movie, and prepare your legs to run to the bathroom

The day before the colonoscopy, you can only drink clear liquids (nothing red), and you start the prep in the afternoon.  Once you start the prep, do not leave the house!

You are supposed to mix the MiraLax with 64 oz of Gatorade, but there is no way I am willing to drink 112 grams of sugar, especially the refined sugar in Gatorade.  Thankfully, MiraLax dissolves in water and has absolutely no taste.  I usually add a little 100% apple juice for some natural sugar and flavor.  Listed below are some other clear liquids you can sip on throughout the day to stay hydrated and avoid hunger:

• ClearFast Drinks – comes in watermelon and white grape flavors. This is a clean ingredient carbohydrate drink that can be used in place of the ensure clears before surgery or as a clear liquid for colonoscopy prep
• Coconut water
• Tea (I’ve been loving Peach Mango herbal tea) 
• Warm lemon water
• Bone broth
• Gelatin gummies (I make mine with Vital Proteins Gelatin) 
• 100% juice (apple juice, white grape juice, white cranberry juice)
• Pedialyte Clear – you can buy unflavored and mix with your prep or favorite juice or one of the flavors . They also have plenty of clear liquid electrolyte powders in many flavors

Keep drinking throughout the day and night to avoid dehydration and help all the stool pass through you.  I was nauseous by 8pm after drinking so much MiraLax , but Zofran helped a lot.  Talk to your doctor about anti-nausea medication if you tend to get nauseous easily. 

The Day of the Procedure

The morning of the procedure, you cannot eat or drink anything.  By morning, you should be done going to the bathroom, but if you are not and your stool is not a clear liquid, be sure to use an enema.  Enemas are pretty unpleasant, but honestly not the worst thing in the world.  If your colon is not clean, your doctor may not be able to perform the procedure, and you will have to do the prep all over again at a later date.  So make sure your colon is clean, and do the enema if you must.  

Once you arrive at the hospital, everything is pretty simple.  You change into a hospital gown, receive an IV, talk to your gastroenterologist and anesthesiologist, and then you’re wheeled into the procedure room.  You lie on your left side, the doctor injects sedatives, and the next thing you know, the procedure is over.  I do not remember much about any of my colonoscopies, but if you are concerned about sedation, talk to your doctor about different medication options.  

Once the colonoscopy is over, you will sleep for a little while in recovery.  The doctor will usually tell you how everything looked inside before you leave the hospital.  Typically, you schedule a follow-up appointment with your gastroenterologist one to two weeks later when the biopsy results are back.    

Colonoscopy Recovery

Many colonoscopy preps strip your colon of your good and bad bacteria, so load up on your prebiotics and probiotics, bone broth, and avoid sugar in order to repopulate the good bacteria and not allow the bad bacteria to overpopulate.  Yogurt, fermented foods (kombucha, sauerkraut), and dark chocolate are good sources of prebiotics and probiotics.  Yes you read that right, dark chocolate is full of healthy flavenoids (antioxidants), B-vitamins, minerals and more.   

My past two colonoscopies, I have been very sore, crampy, and bleeding for a few days after, most likely from all the biopsies.  However, most people do not experience this bleeding and discomfort after the procedure, especially if the doctor does not take biopsies.  I must have been pretty tired, because I essentially slept from 9am-6:30pm, then 10pm-7am the next morning.  And I had some crazy dreams.  Additionally, the doctor pumps your intestines full of air during the procedure, and this air gets trapped.  It is helpful to walk, roll around on an exercise ball, use a heating pad, and drink activated charcoal (capsules or powder) to pass the gas.    

I hope these tips on keeping your colonoscopy prep paleo are helpful for you. How do you survive your colonoscopies?

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