colonoscopy confidential: the sugar-free bowel prep your doctor might not know about
sharing a more holistic way to prep for a colonoscopy
reviewed by Joseph Tito, MD, General Surgeon
This newsletter is meant as a guide to share how I prep for a colonoscopy and is not meant as medical advice. Always consult with your own doctor for information pertaining to your unique circumstances.
I shared on Instagram recently that I had my second colonoscopy. I carry a gene for colon cancer (Monoallelic mutation of MUTYH gene), so I get regular colonoscopy screenings.
The official colonoscopy recommendations advise beginning at age 45, but there has been a rise in colon cancer in younger people, so you may need to start at a younger age if you have a family history of colon cancer or if you carry the gene for colon cancer like I do, or if you have symptoms.
Preparing for a colonoscopy is crucial for ensuring accurate results, but traditional prep methods often include sugar-loaded ingredients that may not align with a holistic, health-focused approach to achieving blood sugar balance and good metabolic health.
This guide will provide you with practical tips for a sugar-free, more natural approach to colonoscopy prep. It will support your digestive health with fewer processed additives and a focus on nourishing choices. In addition, it will provide you with the steps I took to “recover” from the colonoscopy procedure.
Why consider a sugar-free, more holistic prep?
Standard colonoscopy preparations usually involve liquid solutions high in artificial sugars or additives that can spike blood sugar levels and disrupt gut health. Most recommendations include Gatorade, Jell-O, popsicles, soda, and things I don’t consume in my everyday life, so I will not consume them now!
A holistic, sugar-free approach aims to reduce exposure to these ingredients, support stable blood sugar balance, and minimize digestive discomfort before and after the procedure. Some benefits of this approach include:
Better blood sugar balance: Avoiding sugar and artificial sweeteners can help prevent blood sugar spikes and crashes.
Enhanced gut health: A natural, whole-food approach can reduce inflammation, support beneficial gut bacteria, and get your gut “back to normal” quicker after the procedure.
Reduced side effects: Many experience fewer cramps, bloating, and dehydration symptoms when using natural ingredients and reduced additives.
Do Check with Your Doctor
While these steps can offer a healthier prep alternative, always discuss any changes to your prep routine with your healthcare provider. A colonoscopy requires a clean colon, so ensure any modifications align with medical guidelines.
5 days before your procedure, prepare your digestive system by eating low-residue, low-fiber foods
Many health practitioners recommend switching to low-fiber foods in the last few days before your official prep to reduce residue in the colon. Begin eating easy-to-digest foods and reducing your fiber intake 5 days before your scheduled procedure.
Enjoy:
cooked vegetables
pureed soups
fruit without seeds or peel
tender meat like braised meats, skinless chicken or fish
bone broth
eggs
Avoid:
seeds
nuts
popcorn
fatty or fried foods
tough meat
whole grains
raw vegetables
fruit seeds and peel
corn
broccoli
cabbage
beans
peas
Hydration: the foundation of a successful prep
One of the most important aspects of colonoscopy prep is staying hydrated. Dehydration can make the process uncomfortable and difficult. Aim to drink plenty of water every day leading up to the prep. A good rule of thumb is half your body weight in ounces daily. This includes teas, sparkling water, no sugar electrolytes, and filtered water.
Infuse water with electrolytes naturally
Electrolytes are essential for maintaining hydration levels, especially when consuming less food, such as during a fast. While commercially available electrolyte drinks often contain loads of sugar, you can create your own by adding a pinch of Himalayan salt and a squeeze of lemon or lime juice to your water. You can also use coconut water-based electrolytes like CURE or sugar-free LMNT electrolytes.
Sip on bone broth
Bone broth is a nutrient-dense, gut-supportive option that can help keep you nourished and hydrated. It provides amino acids, collagen, and trace minerals, supporting gut lining health while keeping you fuller and reducing hunger pangs. Make your own bone broth, or look for one with good ingredients like Olla Bone Broth, Bonafide Provisions, or Kettle and Fire.
24 hours before your procedure: a sugar-free, clear liquid diet
The day before a colonoscopy is typically limited to clear liquids. Here’s how to maintain a clear liquid diet while keeping it free from added sugars:
Clear bone broths and herbal teas
Choose clear vegetable, chicken, or beef broths. Look for options without added sugar, Make your own bone broth, or look for one with good ingredients like Olla Bone Broth, Bonafide Provisions, or Kettle and Fire. Herbal teas like peppermint or ginger can also help soothe your tummy.
Coconut water
Clear coconut water, known for its electrolyte content, can also be a great choice. To ensure clarity, avoid anything with pulp.
Instructions for a one-day prep for a morning appointment
One bottle of Miralax powder 8.3oz (238 grams)
4 Dulcolax laxative tablets (bisacodyl tablets) 5 mg
64 ounces of coconut water
Day Before Procedure:
In the morning, using an empty pitcher, mix 4 ounces of the Miralax powder with 32 ounces of coconut water until dissolved. Repeat with the other bottle of coconut water and 4 ounces of Miralax powder. Keep cold in the refrigerator.
11:00 am, take 2 of the Dulcolax tablets with water.
12:00 pm, take the remaining 2 Dulcolax tablets.
1:00 pm, begin drinking the first pitcher of Miralax/Coconut water solution; pour it into 4 glasses and drink one glass every 15 minutes (done in an hour). Plan to stay home.
If the prep causes nausea, try sipping it through a straw. Making sure that the prep mixture is very cold can also help.
2:00 pm drink the second bottle of Miralax/Coconut water solution—again, one glass every 15 minutes.
Continue with clear liquids throughout the day and evening so you don’t get dehydrated. Sugar free electrolytes, herbal teas, sparkling water, and clear bone broth.
My fellow substack writer Celia Chen of In the Pink just completed her first colonoscopy a few weeks before mine. I was curious to hear how she approached her prep as a health optimization coach and biohacker. Celia chose to do what Dr. Joseph Tito calls “split prep”. This is what Celia offered:
Anyone health conscious will want to revise the hospital’s colonoscopy prep. It might be effective for your doctor who wants a clean colon for the procedure, but the dietary recommendations are dreadful. Fasting can be challenging enough for some so spiking your blood sugar all day long does not help with mood, energy or cravings!
Below are ways I optimized the two rounds of prep while 100% ensuring my sleep was not disrupted by urgent bathroom visits.
Pro-tip #1: Select an afternoon appointment. The two rounds of prep can be split between the night before and the morning of the procedure. It gives your body time to rest from “clearing out.”
Pre-prep/Low-Residue options: I mostly ate scrambled eggs or made warm bowls for lunch and dinner. Options like salmon, avocado and bone broth rice or shredded chicken and mashed potatoes with coconut milk.These lean proteins paired with healthy fats and easy-to-digest carbs kept me nourished and satiated.
Prep mixture: Gatorade was a no-go for me, so I created a homemade electrolyte drink from 32 oz of filtered water, 2 tsp of maple syrup, 2 tbsp of fresh lemon juice, and ¼ tsp of Himalayan pink salt. Mix with 4 oz of Miralax. Repeat this recipe to make two bottles. Drink at room temperature because you are already in a caloric deficit so you may feel more cold.
Timeline:
3pm 4 Dulcolax with 8oz warm water, wait one hour
4pm Bottle #1 of Miralax, slowly over 1 hour
5pm 16oz of warm decaffeinated tea and water over 2 hours
7pm small cup of clear bone broth
9pm hot shower + bed
6am Bottle #2 of Miralax, slowly over 1 hour
8am warm green tea and coconut water
11am stop all liquids
3pm procedure
Pro-tip: Many people feel hungry after the procedure and are offered apple juice and graham crackers in recovery. I recommend bringing your own snack. I packed a banana and warm bone broth in a thermos just in case. Although I fast often and wasn’t ravenous, it was comforting to have a healthy option.
Supporting gut health during prep
A colonoscopy prep clears out most of the contents in the gut, including beneficial bacteria. To help support a balanced gut microbiome before and after your procedure:
Probiotic foods (until the last few days)
Leading up to your low-fiber diet, enjoy probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi. These foods can help support beneficial bacteria and maintain a healthy gut lining. Stop consuming these foods in the final days to limit any residual bulk in the colon.
Post-procedure: probiotic-rich foods
After your colonoscopy, reintroduce probiotic foods to help repopulate the gut with beneficial bacteria. Fermented foods and probiotic supplements can support a quicker microbiome recovery. I started taking Metabolic Daily probiotics twice a day on an empty stomach after my colonoscopy, and I found them to be very helpful.
Planning for the day of the procedure
After completing the prep, prioritize rest and hydration. You may feel fatigued or experience minor digestive upset, so it’s best to stay comfortably at home before heading to the clinic.
Consider packing the following for after your colonoscopy:
Gut comfort foods: bone broth, light soups, and soft, bland foods like avocado and fish
Electrolyte-rich drinks: Coconut water, homemade electrolytes, or sugar-free electrolytes (CURE or LMNT) will help replenish lost fluids.
Post-colonoscopy: supporting a gentle recovery
Returning to a regular diet gradually can help restore the digestive system to normal function.
Start slowly with simple foods
Stick to light, easily digestible foods like cooked vegetables, fish, bone broth, and lean proteins. Avoid anything too fibrous, spicy, or acidic immediately after the procedure. It took me three days to feel like my gut and digestive system were back to normal and feeling good again. I did take Metabolic Daily probiotics on an empty stomach in the morning and again before bed in the week after my colonoscopy.
Rehydrate and restore electrolytes
Due to fluid loss after the procedure, you may feel depleted, so rehydration is key. Along with water, consider bone broth, electrolytes, or lightly salted water for natural electrolyte replacement.
Reintroduce fiber and probiotics gradually
Once your gut feels stable, start reintroducing fiber slowly to avoid discomfort. Gradually add vegetables and fiber-rich foods over the next few days to promote regular digestion.
A holistic, sugar-free approach to colonoscopy prep supports digestive health while avoiding unnecessary additives, artificial sweeteners, and blood sugar spikes. Focusing on hydration, natural ingredients, and gentle gut-supportive foods can make the prep process more comfortable and more aligned with your wellness goals. Remember, always consult with your healthcare provider to ensure these modifications fit within your medical guidelines for a successful colonoscopy.
I am happy to share that I had a negative colonoscopy, and I won’t have to do it again for five years- when I am 63.
Now, go schedule your colonoscopy!
I have created a downloadable PDF of this post so that you can print it and share it with your doctor:
Thank you🧡
This newsletter wouldn’t be possible without YOU! A huge THANK YOU to all who support my work here on Substack.
I have been sharing blood sugar-friendly, whole-food recipes (gluten-free, refined sugar-free, and mostly dairy-free) on my blog and Instagram for four years now, and I love this longer format here on Substack!
🧡P.S.
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🧡Beth
This is so helpful! Thank you for sharing.
Glad I stumbled upon this. I am aware of alternatives to Gatorade but didn't even think of coconut water so I added it to my prep. Your article reinforced all my decisions for a healthy approach and gave me some comfort to deal with this process. Thank you!