Bowel Prep, Honestly: What It's Really Like Before A Colonoscopy

Bowel prep is the clear-out you do at home before a colonoscopy: a low-fibre diet beforehand, then a laxative drink that empties your bowel so the consultant can see it clearly. It isn't glamorous, and nobody here will pretend it is. But it's temporary, and following the instructions provided closely is the best way to make sure your colonoscopy can go ahead as planned.

If you're dreading it, you're in good company. Colonoscopies are an important test used to investigate bowel symptoms and can help diagnose conditions such as bowel cancer. Around 48,200 people are diagnosed with bowel cancer in the UK each year [1]. If you're still deciding whether to book at all, our article Why People Avoid Colonoscopies - And Why That Needs to Change covers that side of things. This one is about getting through the prep.

What Is Bowel Prep And Why Does It Matter?

A colonoscopy is an examination of your large bowel using a long, thin, flexible tube with a camera on the end. For the consultant to see the lining properly, your bowel needs to be empty. The NHS says that without the laxative, the specialist may not be able to do your colonoscopy [2], and LivingCare's own instructions say the same: if they are not followed correctly, you may not be able to go ahead with your appointment.

Prep comes in two parts: a low-fibre diet in the days beforehand, then the laxative preparation itself. You'll be prescribed your preparation, with instructions, and the timings depend on which product you're given and whether your appointment is in the morning or the afternoon. So the one rule that runs through this whole article is simple. Follow the instructions you're given. Where anything here differs from them, theirs win.

What Can You Eat Before A Colonoscopy?

You'll switch to a low-fibre diet for the days leading up to your colonoscopy. Your instructions will tell you exactly when to start, which is typically 3-5 days before. All of this will be confirmed on your pre-assessment call.

Foods to avoid:

• Wholegrains and high-fibre foods such as popcorn
• Raw fruit and vegetables, skins, seeds and nuts
• Sweetcorn and beans
• Any food with red colouring added
• Red meat

Foods you can choose:

• White bread, white rice and pasta
• Peeled potato
• Chicken and fish
• Eggs and dairy

Think plain and pale. It won't be the most exciting menu you've ever had, but it doesn't last long.

Your instructions will give you a time to stop eating. From then on, it's clear fluids only. LivingCare's instructions ask for plenty of still water, with no fizzy drinks and nothing dark, red or purple in colour.

How Do You Take The Bowel Prep?

The preparation is a powder you mix with water and drink in stages, at the times set out in your instructions. If you're prescribed Plenvu, for example, there are two doses, and each one is 500ml of the mixed solution plus 500ml of clear fluid, taken over about 60 minutes [3]. It's important to drink it slowly, as it can make you feel slightly sick.

The second dose matters as much as the first. It's tempting to think you're finished once you've been to the toilet a few times, but LivingCare's instructions are clear: take the second dose even if you have already been to the toilet.

Keep drinking between and after doses, as your instructions describe. The prep can leave you dehydrated, which the Plenvu leaflet lists as a common side effect [3].

More information on how to take the preparation is available on the LivingCare YouTube channel.

What Should You Do About Your Medicines?

Tell us about every medicine you take and any long-term health condition when you book. LivingCare discusses all your medications at the pre-assessment stage, as some medication may need to be stopped or adjusted temporarily.

Don't stop any medicine on your own unless you've been told to. LivingCare's instructions ask you to stop iron supplements 5-7 days before a colonoscopy. And with some preps, tablets taken around a dose may not be absorbed properly - the Plenvu leaflet mentions the hour before, during and the hour after [3] - so ask about the timing of your usual medicines too. If you take a weight-loss injection, our article On A Weight-Loss Jab And Booked For A Scope? explains why it matters.

What Does Bowel Prep Feel Like?

Here's what to expect, plainly:

• Lots of trips to the toilet. The prep gives you frequent, watery bowel movements, sometimes with little warning. The NHS advises staying at home and near a toilet once you start drinking it [2].
• Cramping and bloating. Cramping is normal, and you may feel bloated before your first bowel movement [3].
• Feeling sick. The Plenvu leaflet lists nausea and vomiting as common side effects, affecting up to 1 in 10 people [3]. The second dose can feel sickly, so take it steadily over the time your instructions allow.
• A clear finish. By the end, what you're passing should be a clear, yellow liquid. That's the sign the prep has done its job.

Dr Nick Burr, Consultant Gastroenterologist and Endoscopist at LivingCare, explained: "The quality of the preparation has a big impact on the quality of the colonoscopy. A clear bowel means I can examine the lining properly and give you a reliable answer. Being nervous before the procedure is normal, and my advice is simple: follow your instructions closely, don't skip the second dose, and ring the team with any questions you may have. We are all here to support you."

What Actually Helps With Bowel Prep?

Three things help, and all of them are in line with LivingCare's own instructions:

• Chill it. The Plenvu leaflet says the mixed solution may be stored in the fridge, and should be drunk within 24 hours [3].
• Use a straw. The LivingCare leaflet for Plenvu notes it may be easier to drink through a straw.
• Go slow. Drink the solution slowly. If it takes longer than 60 minutes, that's fine: it's better to finish the drink.

Beyond that, keep it practical. Clear your diary, stay close to a toilet from your first dose [2], and expect to go to the loo many times.

What Should You Avoid?

Search for "bowel prep hacks" and you'll find plenty. Some of them break the rules that make prep work. Please don't:

• Drink anything red or purple, such as blackcurrant juice, or eat red jelly. The Plenvu leaflet rules out anything coloured red or purple [3], and LivingCare asks for nothing dark.
• Use fizzy drinks as a chaser. LivingCare's instructions rule them out.
• Add squash or anything else to your prep unless your instructions say you can.
• Drink alcohol, milk or anything with pulp. The Plenvu leaflet rules these out [3].
• Skip or cut down the second dose because you think you're already clear.
• Follow a routine from a social media video. Preps and rules differ between products and countries. Yours is the one in your LivingCare instructions.
• Stop a medicine on your own. Raise it at booking instead.

When Should You Call Us?

Contact LivingCare's Pre-Assessment and Admin team, using the details in your instructions, if:

• you are sick and bring up the preparation
• you feel unwell or dizzy
• you have not had a bowel motion after starting your second dose
• what you're passing is still dark or solid, or you're not sure
• you do not understand your instructions
• you have any questions about the procedure or your medication

If you feel very unwell and can't reach us, call NHS 111, or 999 in an emergency.

Frequently Asked Questions

Does bowel prep hurt? You'll spend a lot of time on the toilet. If you feel unwell or dizzy, call us.

Can I go to work while taking bowel prep? Plan not to. The NHS advises staying at home and near a toilet once you start the laxatives [2]. Your instructions will show when your doses fall, so you can plan around them.

What if I can't finish the prep? Call us rather than stopping or trying a different routine. The team can tell you what to do next.

How do I know my prep has worked? What you're passing should be a clear, yellow liquid. If it's dark or solid, or you're unsure, call us before you come in.

How much does a colonoscopy cost at LivingCare? A colonoscopy at LivingCare costs £2,250, including your initial consultation and referral. Self-pay, no GP referral needed.

Book Your Colonoscopy In Leeds

LivingCare's Gastroenterology service offers Colonoscopy at Thorpe Park Clinic, Leeds. A colonoscopy costs £2,250, including your initial consultation and referral - self-pay, no GP referral needed. You'll be prescribed your preparation, with instructions, and the team is there if you have questions along the way. If you'd like to talk it through first, start with a Gastroenterology Consultation (£200). Exceptional care, without the wait.

References

1. Cancer Research UK - Bowel cancer incidence statistics: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/incidence
2. NHS - Colonoscopy: getting ready: https://www.nhs.uk/tests-and-treatments/colonoscopy/getting-ready/
3. Norgine (emc) - Plenvu patient information leaflet: https://www.medicines.org.uk/emc/product/8578/pil

Medically reviewed by: Dr Nick Burr, Consultant Gastroenterologist and Endoscopist

This article is for general information and is not sponsored content.