For many people, the most dreaded part of getting a colonoscopy is the pre-screening prep. Patients do not like having to drink nearly a gallon of bad-tasting laxative solution the night before the procedure. But times have changed and so have colonoscopy preps.

The gastroenterologists at PA GI are continually evaluating new prep solutions. There’s been a big improvement in taste, along with options that allow for drinking two smaller doses of the solution over two days, rather than one large dose. In addition, a new pill form has received approval from the FDA.

The goal of any prep is to clean as much waste as possible from the large intestine (colon). Having a clear colon is crucial to a successful colonoscopy screening. Poor colonoscopy preparation may prevent the gastroenterologist from finding polyps, tumors and other problems. It may also increase the length of the exam and cause possible complications.

The type of prep that is prescribed for you depends on several important factors. Be sure to provide your gastroenterologist with details of any medical conditions (e.g., diabetes, high blood pressure, heart, kidney or liver disease), allergies you have or medications that you are taking. If you have had difficulty with a bowel prep in the past, be sure to mention this as well. Other factors in choosing the type of prep are the time of the colonoscopy appointment, individual preferences (taste and amount of medication), and out-of-pocket costs.

SUTAB, a sulfate-based tablet, is the first colonoscopy preparation to receive approval from the FDA in over 10 years. With the tablet, you still have to drink plenty of liquids during prep, but you can drink any clear liquid that you prefer. The tablet prep is done in two stages of 12 tablets each.

Another advantage of the new pill form is that it does not contain any sodium phosphate. Earlier pill preps contained sodium phosphate, which could result in a buildup of phosphate and calcium in some patient’s kidneys and cause damage. The SUTAB prep pill contains sodium sulphate, which does not get absorbed as readily by the kidneys.

Whether or not you take the prep pill, many gastroenterologists prescribe a split-dose bowel preparation solution. The split regimen makes bowel prep more tolerable and improves outcomes. Studies have shown that the split-dose approach not only is more tolerable but also does a better job of cleaning the colon. Better cleaning will lead to better results. One study found that doctors detected more benign polyps in people who prepared with split doses than in people who prepared with single doses.

If you have questions about which colonoscopy prep is best for you, talk with your gastroenterologist about the options that are best for you.