Slag-free diet before colonoscopy: what can and cannot be eaten?

Sometimes, to recognize a pathology hidden somewhere deep in the human body, there is no other way than to look at it from the inside. For example, fibrogastroscopy allows you to see in great detail the pathological processes occurring inside the stomach, and with the help of colonoscopy, which is, for obvious reasons, a less popular procedure, you can identify pathologies hidden from the human eye behind the intestinal walls. Both procedures require certain preparation for their high-quality implementation. And the diet before colonoscopy is an important part of such preparation.

Since failure to follow a dietary regimen negatively affects the results of a bowel examination using a probe, this issue deserves special attention, which is what we will do.

General information

Before moving directly to the question of diet before colonoscopy, let's try to figure out what kind of procedure it is, why and in what cases it is carried out and what dangers it allows to avoid.

Colonoscopy is a diagnostic procedure identical to FGDES. Only its purpose is not the upper, but the lower sections of the gastrointestinal tract, i.e. the intestines. An endoscopic examination called colonoscopy allows you to carefully examine the inner surface of the large intestine and rectum using a probe, where many pathogenic microorganisms nest, capable of causing various diseases that are dangerous to human life and health when immunity is reduced.

Ideally, this procedure should be performed regularly, because it helps prevent many diseases of the large intestine (colitis, including ulcerative colitis, diverticulosis, the appearance of polyps and neoplasms on the intestinal walls, Crohn's disease, etc.).

Indications for colonoscopy are the appearance of the following symptoms:

• pain and discomfort in the lower abdomen,
• flatulence, or bloating, as people call it,
• bowel movements that manifest as constipation or diarrhea (sometimes these two phenomena can alternate, which also requires a thorough examination of the causes of this condition),
• "unreasonable" weight loss despite normal nutrition over the past 5-6 months,
• low hemoglobin levels in the blood, confirmed by appropriate tests,
• change in the color and nature of stool (feces are colored black, although the person has not taken iron supplements or activated carbon, there are blood streaks in the stool, etc.),

Such examination may be prescribed to women in connection with planned gynecological operations, especially if they are related to oncology.

Colonoscopy should be done regularly by those who have already turned 45 years old, because during this time the immune system has already weakened significantly, and pathogenic microorganisms have accumulated in the intestines in abundance. In addition, endoscopic examination helps to identify oncological processes and perforation damage to the intestinal wall in the bud, which pose a threat to the patient's life at any age, especially if he is no longer so young and healthy.

By analogy with fibrogastroscopy, a high-quality procedure requires complete cleaning of the intestines from feces. This will allow the probe to move freely and unimpeded along the intestines, reducing discomfort from, frankly, an unpleasant procedure, and the doctor conducting the endoscopic examination will receive the maximum amount of information of interest to him about the condition of the patient's large intestine.

Preparation for a colonoscopy is more labor-intensive than for FGDS and takes more than one day. Usually it takes 3-5 days, during which the patient must adhere to a special slag-free diet and fast on the last day of preparation, as well as carry out manipulations and take medications that promote high-quality bowel cleansing.

Low-residue diet before colonoscopy

Prescribing a low-residue diet is an important step in preparing for a colonoscopy. It is indicated to prevent fecal retention in the intestines and to prevent gas formation during the procedure.

It is important to understand that endoscopy is performed using a long flexible tube with a built-in mini-camera at the end, and any obstacle in its path can distort the information sent to the monitor. And the products we consume in everyday life often contain substances and toxins that are unnecessary for the body, which subsequently settle as slag on the intestinal walls.

It is the slags that can create an obstacle to the advancement of the probe, cause undesirable effects and painful sensations during the procedure, and also slightly "correct" the information about the state of the intestinal tissues. All this is considered unacceptable, therefore, before the colonoscopy, the doctor prescribes a special diet designed to prevent the formation of slags within 3 days before the date of the procedure, and the existing unnecessary layers are removed by high-quality cleansing of the intestines using an enema or medications.

The goal of the diet is to help the intestines cleanse themselves as much as possible and not accumulate new harmful substances, which are commonly called slags. That is why such a diet is called slag-free.

Indications

A slag-free diet is prescribed by doctors in cases where a thorough cleansing of the body from harmful or simply unnecessary substances accumulated in it is required. When examining the intestines from the inside, it is necessary for it to be completely emptied of its contents, therefore a diet before a colonoscopy is usually prescribed to all patients who are preparing for this somewhat intimate procedure.

In parallel with the diet, bowel cleansing is prescribed, which is carried out in the evening of the last day of the diet and in the morning 3-4 hours before the colonoscopy.

It remains to figure out when is the best time to start a diet before a colonoscopy? Usually, doctors advise starting preparation for the procedure 3 days before it is performed. However, if a person has certain digestive problems, which often result in stool disorders in the form of constipation, it will be necessary to take care of a high-quality colonoscopy in advance (5-7 days). This will help to some extent to normalize the stool and facilitate the passage of feces.

If the intestines do not want to cleanse themselves, you will have to help them by taking the usual laxatives (for example, Senadexin).

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General information colonoscopy diets

As we have already said, a low-slag diet is necessary for the best bowel cleansing before a colonoscopy. But what is its peculiarity, we still have to figure out.

So, a lacquer-free diet involves eating only healthy foods that do not contain slag, which means they will be maximally absorbed and will not leave traces on the walls of the small and large intestines. It is clear that dishes prepared from such products should not be high in calories, which will make them difficult to digest.

The main requirement of the diet is to exclude from the diet foods rich in fiber, which is not completely digested, and those that can cause fermentation and gas formation in the intestines.

Despite the fact that the foods allowed in the diet are low in calories, you can prepare a lot of tasty and healthy dishes from them that will provide the body with all the nutrients it needs and will not lead to the formation of a large amount of feces.

As with most diets that make the gastrointestinal tract easier to work on, it is better to stick to the principle: more often and little by little. It is better to eat 5 or 6 times a day in small portions than to eat so much that it is difficult to even breathe 3 times. Nutrition on the last day of the diet before the colonoscopy should be especially light with a predominance of liquid transparent dishes, and the last meal is recommended to be no later than 2 pm.

A low-residue diet prepares the intestines for the final cleansing before a colonoscopy, no matter what it is performed with.

What can and what can not?

So, we have figured out what a low-residue diet is and why it is needed before a colonoscopy. Now it remains to find out what foods you can eat before a bowel examination and which ones you should avoid for a while.

What can you eat?

The slag-free diet allows the consumption of only light, low-fat foods. These include:

• Lean meats: poultry (chicken, turkey, quail and other types of meat without skin and internal fat), lean beef, young veal, rabbit meat. Meat dishes should be boiled or steamed.
• Low-fat varieties of sea and river fish (hake, pollock, pike perch, pike, etc.). The fish is boiled or grilled.
• Low-fat milk in limited quantities.
• Fermented milk products, low-fat cottage cheese, low-fat cheeses.
• Butter, vegetable oils and fats, and even a little mayonnaise (preferably homemade).
• Weak broths and soups prepared on their basis.
• White bread made from wholemeal flour without bran and crackers made from it.
• Pastries without added poppy seeds and nuts.
• Pasta made from white flour.
• Semi-liquid semolina porridge.
• Chicken or quail eggs (preferably soft-boiled or steamed omelette).
• Vegetable broths and vegetables (boiled, baked without skin) with the exception of white cabbage, which contains hard fibers in any processing
• Lenten (biscuit) cookies, crackers.
• Natural green or weak black tea is better without sugar.
• Fruit juice, except plum and grape juice (juices can only be drunk diluted and without pulp).
• Fruit mousses and soufflés.
• Compote or jelly made from fruits or dried fruits (transparent without dense fruit mass).
• Coffee (definitely not strong).
• Mineral still or purified drinking water.
• Natural sweets without additives and colorings: sugar, honey, syrups, jelly from fruit juice (preferably with pectin).

What shouldn't you eat?

Prohibited foods in a low-residue diet are those that increase the total volume of feces and cause gas formation in the intestines:

• Fatty meats (fatty beef, pork, duck, lamb, etc.).
• Fatty fish (herring, sprat, carp, crucian carp, etc.).
• Black bread (especially with the addition of rye flour).
• Bran bread.
• Whole grains and cereals (except semolina).
• Dishes and baked goods that contain crushed grain, poppy seeds, nuts, coconut flakes and other hard-to-digest additives.
• Vegetables in fresh, dried and fried form, various root vegetables.
• Fresh fruits and berries, especially those with small seeds.
• Any fresh herbs.
• Dishes made from white cabbage, including borscht, salads, and cabbage soup.
• Soups prepared with milk.
• Dishes made from whole milk.
• Okroshka.
• Sausages, hot dogs and frankfurters, smoked meat, salted hard lard.
• Any pickles and preserves.
• Mushrooms in any form.
• Korean-style or pickled seaweed.
• Hot spices and sauces.
• Any kind of alcoholic beverages, including beer.
• Kvass.
• Mineral and especially sweet carbonated water.
• All types of legumes: beans, peas, beans, soybeans, etc.
• Seeds and any nuts, flax seeds.
• Fast food dishes.
• Candies, cakes, chocolate, Turkish delight and other sweets that are not included in the list of permitted ones.

It is better to boil, stew or bake food. It is not allowed to eat fried food, especially crusts on meat and vegetables. It is necessary to exclude very salty and spicy food. It is better not to eat old, tough and sinewy meat, even if it is lean and considered dietary.

As for white bread and pastries, you will need to give them up completely the day before the procedure. And boiled vegetables and mashed potatoes are removed from the diet 2 days before the scheduled date of the colonoscopy.

In the first days of the diet, you are allowed to eat a small amount of fresh fruit: a mashed apple, half a peach or banana, a small piece of melon. But you will also have to give up such desserts 2 days before the procedure.

As for drinking water and other types of liquids, there are no special restrictions. You can drink up to 2 liters of water, as usual. Tea should be limited to 5 cups, which is also quite usual. But with regard to broths, it is better to be careful. It is enough to drink up to ½ liter of vegetable or meat broth per day.

The slag-free diet is sometimes also called a diet consisting of transparent liquids. The fact is that broths, compotes, juices and drinks must be transparent, they are not allowed to contain solid particles. Fatty and rich broths should be excluded from the diet. On the last day of the diet, all liquid consumed should not have a rich color, especially the content of various dyes is not allowed.

3 day diet menu

As we have already figured out, the diet before colonoscopy will have to be composed of foods with a minimum content of fiber and transparent liquids. If, due to problems with the gastrointestinal tract, there is irregular bowel movements and constipation, the diet will last not 3, but 5-7 days. At the same time, the first days you can not limit yourself much in the choice of dishes, but you need to drink at least 2.5 liters of water and take laxatives, which should facilitate bowel movements.

The main thing is to start the diet by eliminating foods and dishes containing small bones and whole grains. You should also give up rye bread, grapes and tomatoes, which can cause fermentation in the intestines.

Three days before the colonoscopy procedure, the diet becomes even stricter. The diet menu for 3 days is made taking into account prohibited and permitted products.

Let's look at an example of such a menu:

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Day one

1st breakfast: thin semolina porridge, weak coffee with milk, white bread with honey

2nd breakfast: fruit jelly and cracker

Lunch: vegetable soup, boiled rice with lean steamed turkey cutlet

Afternoon snack: a glass of kefir with biscuits

Dinner: boiled beetroot and carrot salad, a piece of boiled fish, green tea

Day two

1st breakfast: a sandwich of white bread with low-fat cheese, weak tea with sugar

2nd breakfast: baked apple without peel

Lunch: pasta soup with weak chicken broth, 1-2 eggs, bun

Afternoon snack: cottage cheese with sugar or honey

Dinner: stewed vegetables (except cabbage) with a piece of dietary boiled meat, clear light compote without pulp

Day three

1st breakfast: fruit jelly (not red), tea with honey

2nd breakfast: a glass of fruit juice

Lunch: a bowl of weak meat broth, jelly, green tea with mint

The diet on the day before colonoscopy is considered the most strict, since during this period it is advisable to limit yourself to liquid transparent dishes only. This can be weak black or green tea, transparent compotes without pulp, still mineral water, transparent fruit juices (not red), jelly, light low-fat meat and vegetable broths.

Such a diet does not contribute to the formation of feces, which means nothing will interfere with the examination of the intestines. But even if for some reason a person could not resist eating semi-liquid or thick food from the permitted products, it is okay, because in the evening of this day and in the morning before the procedure the intestines will still need to be cleaned with an enema or special preparations. If a person has difficulty tolerating a slag-free diet and constantly wants to eat, then you can have small snacks of biscuits, which are easy to digest.

To help the intestines get rid of food residues, on the day before the colonoscopy, you can drink 3 liters of salted water within 2-3 hours, which will act as a cleansing enema.

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Diet before colonoscopy in combination with "Fortrans"

People who have a negative attitude towards cleansing the intestines with an enema (it is clear that the procedure is not pleasant, and not everyone has an Esmarch mug, which is the most suitable in this case), can be advised to use such medications as Fortrans and Duphalac for these purposes.

Diet before colonoscopy with "Fortrans" is an ideal and relatively comfortable way to prepare for the procedure of endoscopic examination of the intestine. However, this method is only suitable for adults and adolescents over 15 years old.

A packet of the preparation is designed for 1 liter of water, in turn, 1 liter of solution is used for every 15-20 kg of weight. It turns out that with a body weight of 50-60 kg, 3 packets of the preparation diluted in 3 liters of water will be required, and with a weight of more than 100 kg - 5 or more packets, which must be diluted in the appropriate volume of liquid.

The drug is taken on the last day before the procedure. At 2 p.m., the last meal is taken according to the requirements of the low-slag diet before colonoscopy, and in the evening, a drug is taken to facilitate bowel movements.

The powder from the Fortrans sachets should be poured into the prepared water and mixed thoroughly. After that, either drink the entire composition in the evening (you can start after lunch, little by little, since it is simply impossible to drink such a quantity of liquid at once), or divide it in half (drink one part in the evening, and the second in the morning no later than 4 hours before the scheduled time of the colonoscopy). You can improve the taste of the prepared solution by adding freshly squeezed lemon juice without pulp to it. The effect of Fortrans begins somewhere 1.5 hours after taking the entire dose.

For high-quality bowel cleansing, you can use only Fortrans, or use both recommended drugs. In the second case, take Dufalac in the evening, diluting 250 ml of the drug in 2 liters of water, and in the morning - Fortrans, dissolving a packet of powder in 1 liter of liquid. In the evening, the medicine should be taken no later than 7 p.m., in the morning - before 7 a.m.

After two o'clock in the afternoon the day before and while taking the medication, you can drink only clean water without any special restrictions.

The colonoscopy procedure can be performed both under anesthesia and without it. In the first case, the amount of liquid drunk in the morning will have to be limited. After the morning intake of "Fortrans", do not eat or drink anything else. If you need to take any other oral medications, you can wash them down with a small amount of clean water. But this must be done no later than 2 hours before the examination.

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Possible risks

A slag-free diet, which can be used both for preventive purposes to cleanse the body of harmful substances, and before a colonoscopy for complete cleansing of the intestines, does not cause any harm to human health. And even on the contrary, it helps him get rid of unnecessary ballast in the form of slags and toxic substances that do not represent the slightest value.

There are practically no contraindications to the diet. The only point is that in case of diabetes, the diet before colonoscopy may pose some danger, and this should be discussed with the doctor. In addition, with this pathology, sugar-lowering and insulin-containing drugs are prescribed, the intake of which should be carried out at a strictly allotted time, which should also be reported to the doctor conducting the colonoscopy in advance, even before the start of preparation for the procedure with the help of a diet.

In principle, this point should be discussed in any chronic diseases, if refusal to eat/take medications or consumption of certain types of products can cause harm to health.

Thus, with diabetes, the consumption of foods rich in carbohydrates and glucose, baked goods made from white flour, etc. is reduced to a minimum. In addition, meals should be regular. And with gastritis and many other gastrointestinal pathologies, refusal to eat on the eve of a colonoscopy can cause an exacerbation of diseases. Taking all these points into account will help various risks associated with the diet.

There are practically no contraindications to a low-slag diet before a colonoscopy (in case of illness, a dietary correction is usually carried out), but there are contraindications to the endoscopic examination of the intestine itself.

Colonoscopy is not performed:

• In a state of shock, in which muscle spasm is observed, which significantly complicates the examination.
• In case of intestinal obstruction, when it is not possible to thoroughly cleanse it.
• In case of heavy bleeding from various organs of the gastrointestinal tract or oral cavity, when blood enters the intestines and can distort the existing picture.
• In case of inflammation of the peritoneum (peritonitis) due to the risk of worsening the situation.
• In case of intestinal perforation, when ruptures form in its wall with the release of contents into the abdominal cavity.
• In case of inguinal or umbilical hernia, when colonoscopy can contribute to protrusion of the intestine through the opening of the umbilical ring.
• If the patient has recently undergone surgery on the pelvic organs and colonoscopy may cause suture divergence.
• If the preparation for colonoscopy was insufficient due to the patient ignoring the requirements of a low-residue diet or not sufficiently cleaning the intestines with an enema or special preparations. In such cases, all preparatory procedures will have to be repeated.

Colonoscopy is not performed under anesthesia if there is intolerance to anesthetics. In addition, it is better to refuse the procedure in case of exacerbation of ulcerative colitis, the presence of acute infectious diseases, blood clotting disorders, severe cases of cardiac and pulmonary insufficiency.

Possible complications after colonoscopy:

• Perforation of the intestinal wall during the procedure. Occurs in 1 in 100 people and requires immediate surgery to repair the rupture.
• Bleeding in the intestine, which most often occurs due to damage to the inner wall of the organ (1 person per 1000 patients). If bleeding is detected during the procedure or immediately after it, the procedure is stopped and measures are taken to stop it immediately (cauterization of the wound, administration of adrenaline, etc.). If the appearance of blood from the rectum is noted later (after several hours or even days), the patient must be urgently taken to the hospital for surgery related to the problem that caused the bleeding.
• Development of infectious diseases due to infection entering the intestines due to insufficient treatment of the probe or violation of the procedure technology (hepatitis, syphilis, etc.). Occasionally, colonoscopy can provoke the "awakening" of bacteria that were previously inactive.
• Irritation of the affected areas of the intestine (polyps, inflammation, tumors), accompanied by pain and fever.
• A ruptured spleen occurs in isolated cases and requires urgent measures to eliminate the problem.

Complications of varying severity can be caused by the administration of anesthesia.

All the above complications are directly related to the procedure, and not to the slag-free diet before it. An unpleasant consequence of the diet itself may be a complication of existing chronic diseases if the diet is not adjusted in accordance with the dietary requirements for the corresponding disease.

The exit from the diet should also be gradual. You should not run home immediately after the colonoscopy and sweep everything that is on the table. For 2-3 days, it is recommended to eat light food in small portions, gradually increasing the amount of food eaten to the initial indicators. Products that cause gas formation will have to be excluded from the diet for a while.

If there is some discomfort in the intestines, you can take a few tablets of activated charcoal. You cannot stimulate the process of defecation (its absence for 2-3 days after a colonoscopy is considered normal) with an enema or laxatives.

A diet before a colonoscopy is considered a mandatory and very effective procedure that helps to completely cleanse the intestines for a detailed examination with an endoscope. Thanks to it, the doctor gets the opportunity to identify the smallest pathologies of the organ mucosa and prevent the development of dangerous pathologies. It is for this reason that the issue of following a diet before an endoscopic examination of the intestines should be approached with all seriousness and responsibility.

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