Recent Colonoscopy UPDATE (2024)
I found a better and easier prep for my semi-colon!
I’m going to preface this article with this: If you are not a colorectal cancer survivor, PLEASE go get your colonoscopies while you are still healthy! Start at age 45 (earlier if you have a family history) and never ignore any symptoms! Push your doctor if you have to, especially if you have intuition that says, “It’s more than hemorrhoids.” Trust me when I tell you that the process of getting a colonoscopy is easy when you are healthy and it’s the best way to stay that way! I’m including the video compilation here of all of the social media posts from Colonoscopy Week including a message from my doc about why it’s so important and why Cologuard is not enough.
Last Friday I had my first post-treatment/surveillance colonoscopy. This will now be an annual occurrence for at least 5 years to ensure I stay cancer free.
I’ll cut straight to the good news first, it was 100% clean and clear! Happy Dance 💃🏼 My semicolon, “Solinita” (Spanish for little sun ☀️) was clean, pink, healthy and beautiful and my anastomosis was almost invisible it was healing so well!
Normally a colonoscopy prep, while not the most fun thing ever, isn’t so bad. A day of discomfort including a liquid diet, a bowel prep and yes, many visits to the toilet (I suggest butt cream), but more than manageable for most people. Plus you get that awesome nap out of the deal! 😴
My first, post-treatment colonoscopy brought some unexpected challenges due to my ULAR (ultra-low anterior resection). If you are in a similar situation — sporting a semicolon — you can be prepared and mitigate. Many of the suggestions below apply to ALL colonoscopy prep’s but in the case of a semicolon, I highly recommend following these suggestions to limit your discomfort.
The Process
5–7 days before (depending on your instructions), I stopped taking anything that would potentially be a blood thinning agent. This includes supplements like fish oil, turmeric and even CBD. Essential prescription meds like blood thinners should be discussed with your doctor. For the most part, you can continue taking other medications as usual. Following your prep instructions.
2 days before, I went on what we call “The Toddler Diet” for a day. This includes bland, mostly non-greasy, low acid, low fiber and stool “thickening” foods such as:
The Toddler Diet
White Rice
Apple Sauce
Yogurt (especially Greek for more protein
Eggs
Cheese (grilled cheese)
White or non-whole grain bread
Low fiber cereals
Cream of Wheat
Peanut Butter (PBJ)
Boost high protein shakes
Plain Chicken
Fish (cooked with little to no oil)
Dairy (if you’re not lactose intolerant)
Crackers
Cooked veggies with no skins or seeds (cooked carrots are a great choice)
Marshmallows and Rice Krispie Treats (in moderation due to sugar — marshmallow is soothing and thickening)
The Toddler Diet eliminates an abundance of fiber flowing through the colon and increases the effectiveness of your prep. It also is loaded with comfort foods! Bonus!
The Bowel Prep
There are many different preps with the goal to clean you out completely the day before your procedure. This is so that the scope can move through your colon and see all there is to see. Residue and feces left in your colon can hide things like small polyps or lesions and you do not want that!
Some preps require a prescription (Suprep and Sutab). Others are the OTC (over-the-counter) variety. I was given a slightly different OTC prep than in my previous colonoscopies. This one required me to take 4 Dulcolax tablets 2 nights before my colonoscopy to begin the cleanout. EX.) My colonoscopy was on Friday morning, I took these Wednesday night. Then, I was to take 4 more Duculax on Thursday AM along with 238 mg (14-dose) bottle of Miralax mixed into 64 oz of Gatorade starting at Noon. Plus an all-liquid diet with only clear liquids to stay hydrated (water, broth, juice, jello, etc. — nothing red or purple). See our homemade chicken broth recipe HERE!
Shout Out To Doc
I have to brag on Doc/Amy here for a moment. She fasted the entire time with me and did everything I did, ate everything I ate, except the prep! I protested and told her she didn't have to do it (I'm not sure I would have done it for her 🤣 ) but she did it out of solidarity! She was so amazing during the whole of my cancer treatment and I realize that this is why. She is just so willing to be there with me for every step along this journey, even the shitty ones! Thankfully she didn't do the bowel-prep part! We don't have enough toilets for that! 💩 🚽 🧻 I hope everyone going through cancer treatment is blessed to have a care-partner this dedicated! 💙
First, Lessons Learned
Keeping in mind because of my semicolon, I don’t eat normal portions of food anymore. I eat 5–6 small meals a day including snacks which could just be a handful of something. I also chew everything to puree. That said, I didn’t start out with a ton of food in my colon.
It never occurred to me that my bowel prep experience would be different because of my BadASS Eating and because of my semicolon. I no longer have a sigmoid colon (10–15”) and my rectum is only 1” (vs 6–8”), so I have NO storage and everything goes right through, unlike someone with a complete colon. That’s why I want my fellow semicolonist badasses to be prepared! I share the following not to scare anyone, but rather to help you have a plan!
First, if you take Imodium daily to reduce your bathroom visits due to LARS (lower anterior resection syndrome), if possible, stop taking it at least two days before the cleanout (three days before colonoscopy)! Imodium works by slowing motility (movement) of your stool through your colon. Forcing it to absorb more water on the way through and out. Which is why it works so well for stopping diarrhea. It can also conflict with the bowel prep by creating a push-pull sort of effect with the prep laxatives.
Second, The Yucky Stuff!
Dulcolax (a laxative) works by causing your stool to become loose and your colon to spasm, thus moving stool through the colon and out quicker. In my case, because I had extreme radiation side effects that included spasms, cramping and tenesmus, I seem to be more prone to spasming now — or it could be that my new-ish connections are still learning to perform and sometimes get lazy and tired of doing their new jobs! Who could blame them? Plus, I stopped taking my Imodium the day before cleanout (WED), but realized I should have stopped it as early as TUES. Needless to say, after four Dulcolax, I was in the bathroom early morning on Thursday feeling pretty miserable. I had already cleaned out most of the solid stool that was in my body and I was already at liquid stage at only part 1 out of 3 of my bowel prep! My body continued to feel like it needed to go (spasms) but nothing more was yet forthcoming. YIKES!
I immediately called my doctor who modified the prep for me. I am so lucky to have a GI (Gastroenterologist) that is responsive and who listens!
He removed the remaining Dulcolax from the prep — leaving me with just the Miralax portion to complete. I also still had my prescription for anti-spasmodics on hand from radiation and my Dr. told me I could take them as prescribed that day — I only needed 1. Once the spasms stopped it was much more like a normal prep, aside from my lack of storage, which I address below in #3 (Third).
The moral of this story is to TALK TO YOUR DOCTOR about this article and your body before your prep! Ask for adjustments to the prep — What is the most gentle prep for you? And/or ask for a prophylactic prescription for an antispasmodic should you need it. My GI and I are already discussing changing my prep for next year to something more gentle for my body but equally effective. I've heard a lot of good things about Su Tabs so I'm hoping to try it next year!
It’s never made sense to me that a 230-pound hot dog eating contest competitor uses the same prep as a 125-pound vegetarian! While doctors do their best and there is surely research showing what preps work best and why, it’s OK to TALK TO YOUR DOCTOR to make sure yours is right for you. Like I always say, be your own best advocate and ask for what you want. If you don’t feel comfortable with your doctor, I’ll loan you mine! 😉 You should never feel like you’re just another number or like you are part of a cookie-cutter process when it comes to your own health and well-being.
Third and finally, Diaper Up!
Another rectal cancer survivor gave me a bit of warning that day about how little control she had to hold it to get to the bathroom on time the day of her prep. I mistakenly thought my 6 months of pelvic-floor physical therapy would save my ass. WRONG! There is no stopping the torrent of liquid feces during a colonoscopy prep with and without a semicolon. But without a place for poop storage, no amount of kegel exercises are going to keep a raging, gas-propelled waterfall of poo inside you! I’m just saying! 🙈 I made myself a nice little bed on the floor in the bathroom. 😂 🛌 It was definitely different from having a whole in-tact colon! Did I fair better than someone who hasn’t been doing 100 kegels a day for six months? Maybe. I still highly recommend wearing your doody diapers for the day! I also have a great pad left over from after surgeries called a PeaPod. I LOVE IT and I carried it around everywhere that day!
Two other items worth mentioning here are Butt cream and Bidets! Butt cream is essential for this day! Apply it after every single go, even when you’re tired and don’t want to. Trust me! Aquaphor Baby Healing Ointment is my favorite. We also now have two bidets at home, which are game changers on so many levels (one of these days I WILL get around to that series of LARS posts to explain why). The brand we like best is Brondell Bidet. (Secret: We called Brondell before we ordered bidet #2 😂 and told them of my diagnosis and they gave us a nice discount on our second one.) It has several adjustable features such as water pressure and spray width as well as temperature and a dryer! Believe me there is nothing better than a warm water gentle butt wash after going 100 times in a day! In lieu of a bidet, sitz baths can be very soothing.
Follow the rest of your instructions for pre-op protocols such as removing all jewelry, makeup and showering with antibacterial soap (I use Hibaclens) before the procedure.
Post-Colonoscopy
I learned some lessons here, too! Your instructions will likely tell you to go back to your regular diet. I used to do that. Things were different this time! 😬
Last year in August as a part of rectal cancer treatment, I had an anastomosis/ULAR surgery and a temporary ileostomy for 10 weeks (to allow the ULAR to heal) then, I had a second surgery to close the ileostomy and reconnect my small intestine to my large so I could poop through my colon again. During and after both surgeries it is necessary to be super gentle to your gut because you want to avoid blockages but also because you have to rebuild your gut’s beneficial bacteria and equilibrium — Microbiome (all of the microbes in your intestines which are essential to good health and act together as another organ).
Same with a colonoscopy. The colonoscopy prep clears out the good with the bad. So it’s like starting over again to rebuild your gut microbiome after the procedure. (Same is true after taking antibiotics btw). For healthy people, it takes about 2–4 weeks to fully rebuild your healthy gut flora. I knew this and yet I didn’t think about it as I was dreaming of seriously good comfort food post-colonoscopy! I often used certain foods as rewards for my “good behavior” when it came to cancer treatment! I’m just a big kid after all! 😂
The following post-colonoscopy eating recommendations are for EVERYONE, and especially for semicolonists!
POST COLONOSCOPY EATING
After your colonoscopy, your stomach may be growling in hunger but your colon/semicolon will be like, “WTF just happened?!” Listen to the colon, not the stomach!
Feed the stomach, but do it with gentle foods for your colon for at least a couple of days. Refer back to the Toddler Diet above. Why?
For starters, you may have a lot of gas afterward because your GI uses gas to inflate the colon to improve visibility. Eventually, it will come out in the form of farts but the last thing you need is more gas-causing food!
Back in the day (pre-cancer diagnosis) I would normally Indulge that first day as a treat then go back to my regular diet and not notice anything amiss. This time, was not like that! Solinita (my semicolon) is much more sensitive!
Right after the procedure I had a small OJ from surgery, then 30 minutes later Amy gave me ½ a PBJ and that was great (part of the Toddler Diet). We went for an easy brisk walk which really helped to get rid of some of that gas!
For my next meal, we indulged. I was still starving after not eating for over 36 hours! There is a new pizza and ice cream place in town and we hardly ever eat takeout! So I had 1 small slice of pizza (divided into two portions over 90 minutes) with mushrooms and olives (no meat), and ⅓ of a homemade ice cream sundae with pineapple soft serve (hey, bromelain is a digestive enzyme right?), strawberries and hot fudge. The pizza sauce was good but heavy on the garlic. Oy! Oh yes and Amy had a green chile pizza that looked irresistible so I had two bites of that. Double Oy!
I seemed fine, so a couple hours later we had bland chicken, white rice and cooked carrot leftovers (also Toddler Diet foods) and we also had a small side salad — also Oy!
Lettuce and I have a love/hate relationship these days. I love it but it doesn’t always love me.
Between the remaining gas from the procedure, the salad, the spicy and the treats, an hour after that I was in the bathroom with a major bout of diarrhea! (Keep those diapers on!) I thought, “OMG, poor Solinita!” I tortured her with the prep and now with food and she is rebelling! I decided I really needed to be kinder to her so for the next day and a half I stuck to The Toddler Diet and had no more issues. You can obviously do what you want, but explosive diarrhea is NOT my friend!
Tips for Rebuilding Your Gut Microbiome Post Colonoscopy
These tips can also apply to post-surgery or post-antibiotic use
After your colonoscopy if you are up to it and not woozy, take a walk to help pass that gas and get any remaining anesthesia out of your system — Anesthesia for colonoscopy is usually light and moves out of your system quickly.
After your colonoscopy, eat only bland foods (Toddler Diet) and beverages for at least one day and see how your colon adjusts.
Are you pooping normally?
Not too gassy?
Save treats for day 2 or 3!
Minimize spicy and acidic foods for 1–3 days.
Avoid caffeine for a few days.
Eliminate or limit alcohol for at least a week.
Eat Prebiotic, Probiotic and Fermented foods every day for at least two weeks or longer! I eat at least 1 serving every day.
Yogurt
Kombucha (watch sugars)
Miso
Kefir (watch sugars)
Tempeh (fermented soy — we prefer organic)
Take a probiotic supplement for at least 1–2 weeks! Normally I’m a fan of broad-spectrum probiotics (the more variety the better) — and these are fine to take, but one of the most recommended probiotics by doctors for post-surgery, post-colonoscopy or post-antibiotic use is called Florastor containing a powerful strain called Saccharomyces boulardii.
I take a probiotic regularly for semicolon health. My GI recommends taking one three times a week (ideally broad spectrum and mix it up).
Fiber is a friend to your colon and your microbiome! Just like probiotics, the more varied your fiber (plant/grain) intake, the better your microbiome. After 2–3 days begin to reincorporate fiber into your diet!
Start with soluble fiber first! Lots of fruits have great soluble fiber in including bananas and avocados.
Eventually, add back in more insoluble fiber.
The daily recommended allowance of fiber for women is 21-25 mg and for men 30–38 mg in the US. Most people get nowhere near that! Fiber is essential for colon health and a healthy microbiome to fight off disease.
You can also get fiber from whole grains, nuts and seeds! (We try to get organic grains to avoid pesticides and GMOs.)
This has been a much longer post than I intended but I enjoy proving helpful information, especially if you can learn from my experience and mistakes! 😂 Feel free to take what you like and leave the rest. May you have a happy and healthy summer and cheers to cancer-free colonoscopies! Now get out there and do something FUN! 💃🏼
What's Up Your Butt? Pick up this T to remind others 45 and over to get their butts checked!
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