This post originally appeared early in 2015. At the time, I had just been through my third colonoscopy procedure in three years. (For the uninitiated, three colonoscopies in three years indicates issues.) This third procedure netted a squeaky-clean result; so much so that I was given a three-year break in colonoscopies!
Fast forward three years and I’ve now completed my fourth procedure. And for me, the news is great – so much so that my next colonoscopy is not for five years. [insert happy dance here]
Given the prevalence of bowel cancer in Australia and New Zealand, I think an update is in order…
“Healing is a matter of time, but it is sometimes also a matter of opportunity.” – Hippocrates
So… if you’re of a delicate disposition, look away now.
No, seriously. Maybe you should read this one.
Because this one is about preparing for a colonoscopy, which is an important health procedure. While on the Autoimmune Protocol (AIP), no less. Although, this preparation could just as easily be for anyone having a colonoscopy who is concerned about what they eat.
And, while it’s not for the squeamish, I promise I won’t get too down and dirty on you.
What is a colonoscopy, anyway?
Colonoscopy: A procedure allowing a Gastroenterologist to comprehensively examine your large intestine (colon). An endoscope equipped with a video camera is passed via the rectum through the full length of the colon. Biopsies (tissue samples) can be taken for pathology testing and polyps can also be removed during the procedure.
Many of us will experience the indignity of a colonoscopy at some point in our lives.
In Australia, bowel cancer is the second biggest cancer killer. It affects 1 in 12 Australians in their lifetime. And, New Zealand is no better. In fact, between them, New Zealand and Australia have the highest rates of bowel cancer in the world. So chances are that you, or someone you know, will be affected in some way by the disease. In my family, it’s rampant. This is my third colonoscopy. And, I have yet to reach the standard screening age of 50.
And, if you have unidentified digestive complaints – common in many autoimmune diseases – a colonoscopy will often be scheduled to ‘check things out’.
See why a colonoscopy can be so important?
Frankly, the worst part of the colonoscopy isn’t the procedure. You’re sedated for that bit. No. The worst part is the 48 or so hours leading up to the procedure. The bit where you’re clearing out your colon so that it’s squeaky clean for the camera… smile!
And this bit can be broken into 3 stages.
Stage 1: two-to-three days before your procedure. Otherwise known as the ‘You-know-it’s-coming-but-if-you’re-prepared-it-isn’t-so-bad-stage’
During this stage, you are limited to a low residue or low fibre diet (Frankly – they are very similar). Do you know what has lots of fibre? Vegetables. So, this is almost the antithesis of what you normally eat on the Autoimmune Protocol. Forget about filling your plate with greens today.
In bright RED letters on your patient information form, you are instructed to avoid foods that contain nuts, whole grains, skins, seeds or fibre…
You are also instructed to drink at least 12 glasses of liquids per day – things like strained broths, water (at least 8 glasses) or clear apple juice.
The following foods are some examples of recommended foods for stage I:
- corn flakes
- plain white bread or toast with margarine and Vegemite
- tinned fruit without the skin (low fibre only)
- plain white bread sandwiches with chicken, beef, fish, eggs or white cheese
- Ginger ale
- White pasta
- Plain biscuits or sponge cake
- all milks, yogurt, cheese, sour cream, plain ice cream
Lots of AIP-friendly options, then…
Stage II: the day before your procedure Also known as ‘The-stage-where-you-are-housebound’. Really.
And then the real fun begins. PicoPrep or MoviPrep fun…
PicoPrep (also known as sodium picosulfate) and MoviPrep, are powders dissolved into liquid and taken orally with the aim of producing a watery bowel motion that empties and cleans your bowel prior to examination. (still with me?) It causes you to frequently and urgently make a mad dash to your bathroom. In my family, we call it ‘squirt juice’. I probably don’t need to say any more about it except that when I went to purchase my PicoPrep for this procedure, the pharmacist asked me if I needed any super-soft loo paper and Sorbolene…
This is the worst stage of the procedure. By far.
Stage III: the day of your procedure. ‘Sleepy-Time’.
Assuming your procedure is in the morning, and frankly – the earlier the better, after enjoying a hearty breakfast of… well, nothing. Not even any water. And, of course, having a slightly tender nether region from all those trips to the loo. Then, today is pretty painless. No, really – it is.
Your nearest and dearest drives you to the surgery rooms where you check in. If you’re lucky, your health insurance will cover the procedure. You’re then directed to a cubicle where you strip off and pop yourself into a hospital gown and lie down on a gurney until it’s time for your procedure. You’ll be asked about your preparation process. The anaesthetist will come and have a wee chat. And then, you’ll be wheeled into the theatre. You’ll be asked to count backwards from 10…. and, before you realise it, you’ll be waking up in your cubicle again.
Unfortunately, I can’t make the PicoPrep or MoviPrep part of your procedure any easier. I wish I could. I REALLY wish I could.
What I can do, is help you a little with sticking as closely to the AIP while undergoing the process. Here’s what I do…
Low residue and/or low fibre food is the go in the lead up to your procedure. And, any seasoned AIPer knows that preparation is e v e r y t h i n g. So I plan ahead.
I poach a whole chook – I buy a pasture-raised chook, cover it with water and throw in a few bay leaves, before bringing it to the boil. I reduce it to a simmer and walk away for 60 – 90 minutes. The cooked chook is removed from its broth and set aside to cool sufficiently to handle. Once cool, I’ll remove the meat from the bones, saving both separately and discarding the bay leaves.
That poached chicken is the foundation of my Stage I eating plan.
I make bone broth from the leftover chook bones – If I’m sufficiently organised, I’ll have extra chook carcasses in the freezer. They’ll go into the pressure cooker with the leftover bones from my poached chook. I follow Simone from Zenbelly’s instructions on making pressure cooker bone broth, but if you’d like to make it conventionally, here’s a post on how to make bone broth.
That chicken bone broth is the foundation of my Stage II eating plan. (If you can call consuming liquids eating.)
I make a ‘Colonoscopy Soup’ – My low fibre, low residue, colonoscopy prep’ and AIP-friendly soup. It’s a very simple VERY well cooked and pureed pumpkin soup – heavy on the bone broth.
I also hard boil some happy eggs (and I make some mayonnaise) – I’ve successfully reintroduced eggs. They are not part of the initial elimination plan. If you tolerate eggs, hard-boiled are just about the easiest, most portable way to get a high protein snack. Pop a few room temperature eggs into a saucepan. Cover them with cold water. Bring to a simmer and cook for 8 minutes. Easy! They taste even better with a little homemade mayo’, too!
I stew some peaches (without skins) – you’re ‘allowed’ tinned peaches as part of your low fibre diet day. I can’t remember eating tinned peaches as an adult. I remember we used to have them on summer holidays as a kid. They are definitely a comfort food for me. Sadly, this option is a ‘grey area food’ for a low residue diet, so I steered clear for my latest prep’.
Of course, so much better if, rather than commercially produced peaches in syrup with extra sugar, you stew your own. It’s easy and much better for you.
Small segue – ever since reading Jo Robinson’s Eating on the Wild Side, I always opt for white peaches over yellow if I can.
“White-fleshed peaches and nectarines have twice as many bionutrients as yellow-fleshed varieties.” (Jo Robinson, ‘Eating on the Wild Side’)
To make my stewed peaches (admittedly not the prettiest dish I have ever made), I must first remove the skins. No skins allowed on a low fibre diet. I simply score a cross in the bottom of each of my peaches with a knife. I drop each peach into a pot of simmering water for about a minute. I pull them out with tongs and set aside until cool enough to handle. The skins will peel away easily. The peaches are then chopped, stones removed, before being popped back into the empty pot with a little water and brought to a simmer until soft. They taste remarkably good!
I also splash out and buy some organic, clear apple juice – and I drink it with water. Half and half. It’s my wee splurge to get over the boredom of straight water and broth, and reward to myself for going through this awfulness that is the PicoPrep.
And, that’s about it for the cooking preparation
For me, the focus is on maintaining my whole-food diet, to the limited extent that I can, and at the same time not compromising on the preparation for the procedure. I don’t want to have to do it all again!
But! The REAL work comes after the procedure…
The nature of a colonoscopy is such that your colon is cleaned out good and proper. And, it seems we are learning more every day about just how important all that bacteria in your gut actually is. So, I aim to repopulate my gut as quickly and efficiently as I can. This means a very focused and intentional period of working on making my gut happy again.
Here’s what I do:
- continue to up my bone broth consumption
- focus on eating a nutrient dense and fibre-rich diet
- Add an extra serve of liver for the next few weeks
- A large serve of fermented veggies at every meal
- get outside into direct sunlight every day
- walking barefoot in the grass or on the beach
- sleeping LOTS
- taking a good broad-spectrum multi-strain probiotic