Harvard Health Letter

The prep is worse than the procedure

Split dosing and some new liquids may make the bowel cleansing needed for colonoscopy a bit easier and perhaps more palatable.

For many people, the main problem with colonoscopy is not the procedure itself, which is experienced in sedative-induced oblivion, but what comes beforehand. Bowel preparation — or, simply, "the prep" — typically involves drinking about a gallon of a foul-tasting solution that provokes diarrhea and then a marathon session on the toilet.

And, currently, there's no getting around it for colonoscopy. Virtual colonoscopy takes the "scope" out of colonoscopy by using CT scans to visualize the colon, but the six-foot length of the colon and rectum still needs to be emptied. Researchers have had some success with prepless colonoscopy that involves tagging fecal matter with iodine and barium so it can be subtracted from CT scan and MRI images. But so far, that's an experimental technique that hasn't made its way into clinical practice.

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