Colonoscopy preparation: drinkable solutions or colon hydrotherapy?

In short: before a colonoscopy your bowel must be completely clean, otherwise the test may need to be repeated. The most common preparation is a macrogol-based solution to drink, but many people tolerate it poorly. Here you will find the options, what specialists say about colon hydrotherapy as a preparation and why the choice must always be made with the doctor performing the test.

Why preparation matters so much

During a colonoscopy the doctor examines the colon wall with a scope. If stool residue remains, some areas cannot be seen clearly and the diagnosis may be incomplete. That is why bowel cleansing is an essential part of the test.

The standard preparation: drinkable solutions

The most widely used preparations are macrogol-based solutions, to be drunk in large amounts within a few hours, along with a low-residue diet in the days before.

Many people find this the hardest part of the test, mainly because of:

• the large amount of liquid to drink in a short time;
• nausea, a feeling of fullness and bloating;
• abdominal cramps and anal irritation.

Colon hydrotherapy as preparation: what specialists say

Colon hydrotherapy cleans the colon with water alone at controlled temperature and pressure. On its use as a colonoscopy preparation, we quote two specialists (translated from Italian):

"Colon hydrotherapy is a natural method (it uses only water, at controlled temperature and pressure), direct (it acts only where needed), quick (about 60 minutes of treatment), effective (it achieves complete cleansing of the colon) and well tolerated (it causes no abdominal pain, bloating or nausea, but rather a pleasant feeling of lightness)."

— Donella Gestri, Public Health Laboratory, Florence Health Authority; Vincenzo Mazzuca Mari, Digestive Endoscopy Service, Casa di Cura Tricarico-Rosano, Belvedere Marittimo (CS), Italy

The same authors report that, in their experience, macrogol preparations often cause discomfort and that colon hydrotherapy can also be useful for patients, such as some people with diabetes, who tolerate other preparations poorly.

Rules to always follow

1. Follow the instructions of the centre performing the test. They decide which preparation is acceptable.
2. Ask in advance whether intestinal washing is accepted instead of, or together with, the drinkable solution.
3. Stick to the diet you are given for the days before the test.
4. Never replace the prescribed preparation on your own initiative.

What about at home?

Washing with a home medical device works on the same principle: water only, on your own, in your bathroom. It can help you get used to bowel cleansing and is useful for people with constipation. As a colonoscopy preparation, use it only if the doctor performing the test agrees.

Before using it, read the contraindications. For the differences from an enema, read enema or colon hydrotherapy?.

Frequently asked questions

Can I avoid the drinkable solution altogether?

It depends on the centre and your situation. Ask the doctor performing the test before you book.

Are professional and home colon hydrotherapy the same thing?

The principle is the same: cleansing with water. Clinic treatment is carried out by specialist staff; home treatment is done on your own with a dedicated device. See the differences between professional use and home use.

Questions?

Request a consultation: we will help you understand whether the device is right for you.