Failed prep for colonoscopy: What can I do?

Hi @robbinr, welcome to Connect.
Also, here is some info on how Mayo Clinic suggests prepping for a colonoscopy- http://www.mayoclinic.org/tests-procedures/colonoscopy/basics/how-you-prepare/prc-20013624.

I'm also tagging @JimPurcell on this discussion. I don't like the phrase "failure to prepare". That's sounds so chastising. Were you simply not able to drink all the preparation? It is horrible. I've done it. But I'm sure glad I did because they found a pre-cancerous polyp and were able to remove it right away.

Hi again @robbinr. I took your questions to a pharmacist here at Mayo Clinic. She offers the following information:

"There are a few colonoscopy preps available. Each provider tends to have a preference as to what he or she feels works the best. While the standard preps tend to have an icky taste, there are some available that are more palatable. Some people have the option of using Miralax (which has little to no taste) and mixing it with Gatorade. The patient must still drink a large volume, but it’s usually much less than 4 liters, which can be the volume of some of the common preparations. This option tends to taste quite a bit better for many people. Another option to bypass the taste issue is called OsmoPrep. This option includes taking tablets and drinking clear liquids (2 quarts). Again, the amount of liquid is much less than a standard prep, and the liquids can be chosen by the patient, so taste isn’t so much of an issue. Based on a person’s medical history, the tablets may not be an option as there have been reports of side effects and damage to the kidneys. When a bowel prep has not worked for a patient, it could be due to a number of reasons. It is sometimes helpful to have a longer period of “liquid-only” diet (sometimes two days or more leading up to the start of the preparation).

As far as the heartburn goes, it is difficult to know if there is an underlying issue when the medications are not working. If the proton pump inhibitor (esomeprazole) seems to work for a while and then stop working, some providers will have patients split the dose and take half in the morning and half at night. This would require a new prescription for a different strength capsule. This should only be done if the provider has agreed to the new dosing regimen."

I hope this information helps your next conversation with your doctor. How are you feeling today?

re: prep failure: yuck, what a bummer. 50% of our over-50 population <br />
has NOT had a colonoscopy. Many are sensitive to the prep materials, or <br />
are allergic to the anesthetics.<br />
DEMAND an alternative test, as the FIRST step instead, so that your <br />
testing CAN be successful. Even if doctors whine that you have risk <br />
factors, blah-blah-blah, DEMAND an Rx for one or both of these new NO <br />
PREP simple, but accurate, tests. THEN, IF, it's positive, you and your <br />
doctor could discuss further options, with the prep being in a hospital <br />
setting. If it's negative, your doctor could run lab tests for other <br />
causes, and refer you to a nutritionist and/or allergist, and monitor <br />
your symptoms, and re-test ColoVantage after a few months if necessary.<br />
<br />
1) ColoVantage simple (arm) blood test, NO prep, not even fasting, go <br />
to lab any time of day. My PCP wrote the Rx right after I called her.<br />
Cost me $400 at Quest Lab, WORTH IT!!! Look it up online, is VERY <br />
accurate, and the test looks for trace of colorectal cancer's DNA cells <br />
(pre-polyp even!) in your bloodstream. A DNA specialist processes your <br />
test and writes the report, sends it to your doctor.<br />
(Or there may be cheaper ColoVantage at different lab in your area. Shop <br />
around. )<br />
<br />
2) ColoGuard "mail-away" kit. From home. You've seen the TV ads. <br />
Needs Rx too. NO prep. I don't know cost.<br />
I think even Medicare covers these tests, both are FDA-approved. <br />
Unfortunately most insurance companies don't cover them...yet.<br />
<br />
GOOD LUCK!<br />
<br />

I am 73 years old and had my first colonoscopy at age 40. I had a maternal aunt and uncle diagnosed with colon cancer a few years before I had some rectal bleeding. My doctor suggested colonoscopy. I had polyps removed that would have become malignant over time so had to have another in a year and several since then. I was hoping this would be my last but a polyp was found.
Yes, the prep is awful but symptoms are over in 24 hours or less. I think the prep is well worth the possiblity of preventing colon cancer. People have to buck up and just do it. I have had IBS since i was a teenager. The prep for lower GI xrays back then upset my colon for days. Colonoscopy prep has not. Unflavored Go lightly which I did until my last prep in February was less of a problem than the Miralax and Gatorade split that I in February.
Propofol has greatly improved my post anesthetic problems I had with other anesthetics.

I had two failed preps for follow-up colonoscopies, as part of on going follow-up for colorectal cancer (resection removed tumor, and now involved in extended follow-up). Followed the prep directions to the letter (PEG and one other); both failed and there was initial blame on me for not following directions. Believe me, since I did have a very large, malignant tumor removed, the LAST thing I would do is compromise the bowel prep process. Am set to have my 3rd colonoscopy in 24 hours, and am worried if this one also fails, what options are there for screening?
I am 67 yo, 165lbs, 5'11"; ride a bicycle at 120-150 miles per week at about 16-18 mph. I eat very healthy; was treated for GERD that eventually resulted in a subtotal gastrectomy with roun-y (?spelling?)--ie, stomach has been removed except for a small pouch about the size of a tangerine. What options are available to continue my follow up if this upcoming colonoscopy also fails?
Thank you.

@azcyclist2018 I see you are new member of Connect! Welcome.
Can I ask which prep brand or formula you been prescribed? Is the issue throwing it up?
I agree the prep for a colonoscopy is awful . I feel for you. I had colon cancer as well, and have had my fair share of colonoscopies. I have so far been doing ok with the gallon of horrible liquid to drink. I generally wash it down with coconut milk.
Once a Dr had given me Prepopik that was easier to drink than the Gallon Jug. Is that prep a possibly? You may want to ask your Dr. if you can try that brand?
Please let us know how you manage.
Best of luck..
Jackie

hello @robbinr
sorry to hear about your experience, but for me it is of interest that others have experienced the same thing as me. My first prep was PEG, 2 day prep period-nothing happened the first day...nothing. The second day was not much better, but had the procedure anyway. My "failed prep" sort of seemed as though it was my fault- that chastising thing reported by Colleen. Not a nice feeling to leave the center with that hanging over my head! No excuses; yes it does not taste like that latte supremo, but I am not in this for joy and grins- I want answers, and will do what it takes. The second prep was Supreprep (excuse the spelling please) and this was supposed to be the answer. Again, not so much worked, and failed prep, except this time the GI doc said OK to wait for a year and do it again. As I learned only too recently, if you do not advocate for yourself, nobody will! I said that result of the second procedure was totally unacceptable, and as cancer patient, I wanted answers. A few phone calls and I did get the reschedule. This prep was 7 days on low residue foods....not much eating there!, and then 2 full days on PEG again. Seems to be working now, and I will know in the morning (Tuesday) if it did in fact work. More details as I finish this round--but not too much of TMI-- take care,

Tuesday 5.22.18; 2:47 PM Procedure went as well as could be expected. the prep was listed as "fair"; had not completely emptied. However did find another polyp and removed it. Will see if any pathology comes back.
Finally the GI do allowed that since I had a gastrectomy with roun-y (spelling?) and resection of a significant portion of the colon, preps will be complicated.--I will know for next time.
Someone asked if the prep was compromised due to nausea from drinking the "kool-aid"-- no, drank it all! Guess mine will be a plumbing issue from now on, but at least I will know in advance for next time. Thank for the comments!
bill

@azcyclist2018 Glad to hear they were able to do the procedure. Maybe next time you will have better luck with the prep? When are scheduled for your next colonoscopy? I had a resection 2 1/2 yrs ago. I go every 3 years now. Thank God.. I do not like having to get this done. My stomach is always a mess afterwards. Takes a few months to get back to normal.
Will pray your Path report comes back good.
Wish you the Best..
Jackie

Next colo set for 3 years; however will work with primary care with more questions: if the polyp was 6mm after one year (my last full colo was clean!), in 3 years that could be 18mm or almost 3/4 "--if my math metrics are right- not sure that 3 years is in my plan but will see what the primary says.
thank for your kind words; best to you.
bill