 Hi, I'm Dr. Rosario LaGresti, I'm the Chief of Gastroenterology at Hackensack University Medical Center and welcome to our segment on This Is Not Your Parents Colonoscopy Prep. So since 2008, we've noticed a dramatic and alarming increase in colonoscopy cancer rates in younger patients. We've seen this increase in the patients age 20 to 29 at the highest rate, but we've seen these increases going up until the age of 45, much, much higher than it used to be. So it is critical that younger patients are considered for colonoscopy. Like I said, if you have a colon, you need a colonoscopy. You know, your typical preparation is generally starting a few days before the colonoscopy. What do I mean? So a few days before the colonoscopy, people should kind of reduce their amount of roughage in their diet. So a little less veggies, a little less fibrous things. And then a day before the colonoscopy, they really want to stick with a liquid diet. Things like broths, juices, jellos, you know, light teas, those are all perfectly acceptable. And you want to just stay really hydrated during the entire day before. And why is that? Because you want these preps to actually do their job. When you get to a colonoscopy, you really want your colon to be as clean as possible so the gastroenterologist can see every nook and cranny. You know, this prep we still use fairly commonly. It's a gold lightly prep. It's the old-fashioned prep. What's good about this prep these days and why we still use it is that it doesn't taste too terrible. It's, again, it's a large volume of fluids, so it's fairly dilute. It's got a lemon-lime type of a flavor. We still use it not infrequently in patients that are older because it's a little bit less harsh on patients, kidneys and intestines. Again, the downside is, as you can see, after the first few glasses of this, people feel like they're going to float away. So we went from a gallon of fluid down to fluid this amount in size. And so what's the difference between these two? This is a lot more salt products within it and a little less fluid. That doesn't mean you still need to have less fluid to make the prep work well. You still need to drink a lot of fluid. You still need to take a lot of broths during the day. But you can have less of a nasty prep to drink. And the taste is actually not too bad. When I had my colonoscopy a year ago, I used Plenview and I was quite happy with it. It wasn't as terrible as I thought. Sometimes the biggest complaint people have is the consistency. It feels a little bit gritty as you're drinking it. But the taste is actually on the citrusy side and it's actually pretty good. The next invention that came along is Clenpic. Why is Clenpic better than Plenview? Well, they're kind of not better. They're kind of very similar. But as you can see here, two smaller bottles as opposed to one larger bottle. And both of these bottles are part of that split-dose prep I was talking about. So one half of the prep the day before, the other half the day of. My other caveat to patients is make these ice cold if you can and try to get them down or chug them down as fast as you can. Interestingly enough, you could actually probably sweeten these a little bit. So if you wanted to put in a little bit of Nutrisweet, you wanted to put in, you know, other flavoring agents you certainly can't. For example, a lot of patients swear by crystallite. So you can certainly mix in some crystallite and that'll be a much better tasting prep. And finally, we come down to what everyone asks about. What about pills? Is there a pill prep? And the answer is absolutely. There is a pill prep. So when people think of a pill prep, they figured, I'll take two pills ready to go. The colonoscopy is going to be clean as a whistle. But instead, there are 24 pills and each two of these pills has to be taken with eight ounces of water or other clear of liquid. So needless to say, there's a lot of pills, but again, it's a split dose prep. You're taking 12 the night before the procedure and 12 the day of the procedure. And you're taking two of these pills every 20 minutes. The pills themselves tend to be on the larger side, but needless to say, it's a pill prep. It kind of avoids that very, very salty taste that patients are otherwise kind of fearing. So, preps aren't as bad as they used to be. The preps have gotten smaller in volume. They've gotten a little bit more palatable. There is a pill prep nowadays. And in general, my take home message is it's still a prep. It's not something you want to drink every day of the week. But needless to say, it's something that you can drink sometimes as infrequently as every 10 years because colonoscopies, if they're negative, in the average risk patient can be done every 10 years. So March is a colon cancer awareness month. This is a good time for you to think about getting your colonoscopy. So call us. Our office is always available.