Archive March 2019 XX, No. 3

Ideas That Work: Half-and-Half

Tell Patients to Split Their Colonoscopy Prep

Frank Kim, MD
BOTTOMS UP Drinking half the colonoscopy prep the night before a screening and the other half 5 hours before the examination flushes out the colon and gives physicians the best shot at seeing all potentially cancerous polyps.

If your patient drinks all her prep the night before her colonoscopy screening, her colon will be fully cleaned out when she goes to bed. But the digestive system never sleeps. Come morning, the patient’s right colon will be coated with the bile and mucus the small intestine emptied into it while she slept. Your physician will have an obscured view of the colon that makes it difficult — if not impossible — for him to see all of the polyps during the screening.

The solution: Instruct your patients to split their colonoscopy prep. They’ll take half of the dosage the night before the procedure. They’ll take the other half just 5 hours before the screening. This ensures the right colon is completely flushed out. The split prep cleans out the colon and then polishes it for a sparkling, clean-as-a-whistle view.

Of course, that second phase of the prep can be difficult for patients — especially those with early-morning appointments who have to set their alarms for 3 a.m. or earlier. But when we explain to them that a little extra discomfort during the prep phase can help us catch a life-threatening cancer in the early stages, they’re usually onboard.

And most patients heed our advice to split their prep because they don’t want to chance what happens in the event of an insufficient prep: a repeat screening the very next year.

Frank Kim, MD
Center for Digestive Health & Nutrition
Moon Township, Pa.

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