Diarrhea during colonoscopy prep 

Colonoscopy is a procedure that helps to detect and prevent gastrointestinal conditions. In fact, colonoscopies decrease the risk of death from colorectal cancer by 88%. Around 15 million colonoscopies are performed in the US annually.

To prepare for colonoscopy patients need to clean out the colon to ensure clear visibility during the examination. For some, this process can be more uncomfortable than the colonoscopy itself. In most cases, it causes diarrhea, which in turn leads to rectal irritation, soreness, itching, and burning of the anus and the skin around it.

What exactly causes diarrhea? To clean the colon you need to keep a diet, that includes primarily liquids: water, clear broth, fruit juices without pulp, plain gelatin, and sports drinks. 

You may also need to drink a bowel preparation solution, commonly referred to as a “prep.” The colonoscopy prep solutions usually include polyethylene glycol (PEG) or sodium phosphate. These laxatives work by causing water to be retained in the stool. This increases the number of bowel movements and softens the stool so it is easier to pass.

Naturally, with a diet like this, you’re going to have frequent bowel movements or diarrhea and will have to use the bathroom multiple times a day which can lead to the following:

• Frequent passage of stool irritates the sensitive tissues of the anus, leading to itching, pain, and common discomfort.
• Frequent bowel movements and straining during diarrhea put pressure on the blood vessels in your anus, causing hemorrhoids.
• The continuous irritation and pressure from loose and frequent stools create (or make worse) small tears in the skin around the anus (anal fissures). 

By the way, diarrhea can be a symptom of other medical conditions, such as inflammatory bowel disease (IBD), which includes  Crohn’s Disease and Ulcerative Colitis, that primarily affect the gastrointestinal tract. If you have one of these, keep reading to find some useful insights for yourself.

Taking Care of Your Bottom During Colonoscopy Preparation

Wiping

Let’s start with the obvious. With diarrhea, you go to the bathroom several times a day and you need to wipe. Your irritated sore bottom can’t handle dry toilet paper, which feels like sand on the skin. It’s even worse when you also have anal fissures or hemorrhoids.

Wet wipes and colonoscopy prep – is this a good idea?

If you consider using colonoscopy prep wipes or colostomy wipes, here are three reasons why you shouldn’t:

1. Wet wipes are made of synthetic material. Using polyester fibers causes irritation, sensitivity, inflammation, and chafing around the anus. Rubbing your skin with polyester wipes creates the effect of physical exfoliation – it’s like using a loofah or a scrab. You can expect soreness and pain on already damaged by colonoscopy prep skin. Besides, exfoliation makes the skin more vulnerable to infections from fecal particles, especially when you already have small cracks on the anus. 
2. Flushable wipes for colonoscopy are a myth! If they were truly flushable, they would dissolve in the package. But what about wet wipes labeled as “flushable”? First of all, read the labels closely, it will probably say that it takes at least 30 minutes to start falling apart. And secondly, they are not moist enough, so it will be like wiping your butt with an almost dry synthetic wipe. 
3. Wet wipes contain chemicals – preservatives, fragrances, and even alcohol. Imagine the amount of bacteria that could grow on that moist tissue in a plastic package. To prevent contamination manufacturers add preservatives to the liquid they use in the wipes. Certain types of preservatives and fragrances can trigger allergies. The allergic reaction may not show up right away, and the symptoms (burning, stinging, itching, redness) may appear 12 to 72 hours after using wet wipes. If you’re already dealing with an irritated butt from diarrhea, you can notice these symptoms way faster.
   If you’re curious to know more about wet wipes check this post. 

Wet wipes alternative

If you decide to stick with wet wipes anyway, look for something fragrance-free, alcohol-free, with natural preservatives, and, preferably, witch hazel.

Alternatively, try WipeGel to refresh and soothe the inflamed anus. Its gel consistency provides a cooling effect, plus, WipeGel is 30% alcohol-free witch hazel.
Witch hazel is a powerful astringent and you can often find it in hemorrhoidal or medicated wipes, as it helps with swelling. This ingredient cures skin injury, itching, redness, and pain due to its anti-inflammatory effect.
WipeGel also contains a prebiotic blend, which supports healthy bacteria. So you will clean the perianal skin and support its microbiome, preventing infections. 

To use WipeGel apply a drop of it to your toilet paper and wipe with it. You can also use WipeGel as a leave-on. 

WipeGel bottle is rather big, so it’s great to use at home. However, if you have to go through colonoscopy prep away from home, we have Mini WipeGel which fits in any bag and makes up to 50 wipes, so you will have enough for after-colonoscopy care too.

Washing

If you’re lucky to go through colonoscopy prep at home you can wash your anus with warm water after bowel movements. Make sure the water stream pressure is minimal to avoid additional discomfort or damage to the mucosa and anal sphincter.  

Plain water is enough, but if you decide to use an intimate wash, make sure it doesn’t contain harsh surfactants, preservatives, or fragrances. Some surfactants will leave your already irritated skin feeling dry, and certain preservatives and fragrances are known to cause allergies. Harsh types of these ingredients should not be used in intimate areas. You can find out more about how to choose a wash in this post. 

Sitz baths

To calm soreness from diarrhea you can also take sitz baths. Fill a bathtub with warm water and sit in it for 10-15 minutes. Just make sure the water covers the affected area.

And if your colonoscopy prep caused hemorrhoids, make it cold, or even make a cold compress. It will reduce blood supply to the swollen part, and hemorrhoids will shrink.

Can colonoscopy irritate hemorrhoids?

Colonoscopy prep often involves taking a bowel preparation solution to cleanse the colon. These solutions contain laxatives and cause diarrhea. You may need to push or strain a little bit during diarrhea to pass the stool. The straining puts pressure on the veins in your anus, causing them to swell up. These swollen blood vessels are what we call hemorrhoids.

Hemorrhoids can get worse after a colonoscopy too. It happens because the instruments used during the procedure stretch the anus, which also puts pressure on blood vessels in the anus.

How to take care of hemorrhoids before and after colonoscopy?

Pre- and post-colonoscopy hemorrhoids typically resolve on their own within a few days or weeks. But you can speed up this process, prevent hemorrhoids from getting worse, and ensure more comfort for yourself.

1. Keep the anus clean. It’s difficult to wipe clean with hemorrhoids. Instead of using dry toilet paper, doctors recommend washing the perianal after a bowel movement or gently tapping the anus and the sensitive skin around it with soft, moist toilet paper or a wet towel. You can wet it with a toilet paper gel, like WipeGel, containing witch hazel, which will properly clean the skin, and help to shrink the hemorrhoids.
2. Soothe the skin. You can do sitz baths, cold compresses (or even put an ice cube wrapped in a towel on your hemorrhoids), or use WipeGel as a leave-on. WipeGel will calm the skin, and won’t leave any stains or anything sticky behind. 
3. Heal the tears. If you have anal fissures or small cracks after a colonoscopy or from diarrhea, you need to help them heal. First of all, it’s important to keep them clean too. When you use dry toilet paper fecal particles are left behind, and dry toilet paper is a great tool for spreading bacteria, which can potentially cause inflammation and infection in the tears.
   To heal anal fissures your doctor will probably suggest some over-the-counter ointment or petroleum jelly to moisturize and calm the skin. But you can also try SALVE with natural vitamin E and Gorgonian extract. It will soothe the skin and help with the healing process.
4. Keep a fiber-rich diet after the colonoscopy and add probiotics to your diet. Probiotics will help restore the balance of gut flora and improve digestive health. Discuss with your doctor whether probiotic supplements or probiotic-rich foods are appropriate for you.

What else can you expect after a colonoscopy?

You will most likely feel tenderness and soreness in the rectal area after a colonoscopy. This happens due to the manipulation of the colon and rectum during the procedure. 

You may also experience irritation in the rectal or anus area because of the instruments used during the procedure, the colonoscopy preparation process, or sensitivity to certain materials used during the examination.

Anus itching and rash around the anus can occur after a colonoscopy due to the use of cleansing agents during the procedure.

What should I do for after-colonoscopy care?

To manage the consequences of colonoscopy procedure, consider the measures described above, in particular:

• Replacing dry toilet paper and wet wipes with WipeGel or a soft wet towel,
• Avoiding soaps and washes with harsh chemicals,
• Practicing sitz baths,
• Applying cold compresses to the anus.

Additionally, if you have itching after a colonoscopy, do your best not to scratch the anus and the skin around it. Otherwise, the effect will be similar to using dry toilet paper – more irritation and potential infection spread. 

If your symptoms are persistent and are getting worse, consult with your doctor for further evaluation and treatment.

Summary:

1. Colonoscopy prep always comes with frequent bowel movements or even diarrhea.
2. You will most likely feel sore after colonoscopy too.
3. Colonoscopy prep and colonoscopy itself can irritate hemorrhoids and anal fissures.
4. To take care of your perianal area during colonoscopy prep and after colonoscopy, you should:
   • Wipe with a soft wet towel or use WipeGel,
   • Do sitz baths,
   • Avoid using wet wipes,
   • Avoid washing with harsh soaps, use plain water.