November 28, 2022
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Photography by Stefania Pelfini/La Waziya Photography
HygiPrep is a new option that doesn’t involve drinking a gallon of foul-tasting solution or enduring multiple trips to the bathroom. Is it right for you?
For more than a decade, I’ve been living with Crohn’s disease — a chronic illness that is both diagnosed and monitored via colonoscopy. Because of that, I’ve had so many colonoscopies it’s genuinely hard to keep count. And if you’ve ever had this particular procedure before (or heard horror stories from friends and family), you probably know: The worst part of the whole process is the prep.
Traditionally, colonoscopy prep involves fasting for a day before your procedure and drinking a gallon of liquid laxative and water to clear your system for the scope camera. While traditional prep is safe — and I’ve done it myself many times — it’s not without side effects like diarrhea, severe dehydration, vomiting, dizziness, and more. In addition, the process is often painful and time consuming, and if we’re being honest, it can be really gross.
I’ve personally experienced severe nausea and vomiting using traditional colonoscopy prep. That’s not just unpleasant. If you vomit the prep after you drink it, you run the risk of voiding the laxative’s purpose and having to start all over. Suffice it to say I was eager for another colonoscopy prep option.
When I saw a poster in my doctor’s office waiting room for a new service called HygiPrep, billed by the poster as “quicker and easier” bowel prep, I was skeptical. Living with a chronic illness for 12-plus years means that I have been sold a lot of products that sounded too good to be true. But given my issues with traditional bowel prep, I was willing to give it a try.
I reached out to my doctor for her take ahead of scheduling my next maintenance colonoscopy. I needed a few answers before I jumped on the HygiPrep wagon. Was it safe? Was there any reason I shouldn’t do it? My doctor quickly assured me that while it was fairly new, there was nothing in my chart, like fistulas, rectal cancer, or other contraindications to prevent moving forward. There was one catch: The prep procedure wouldn’t be covered by my insurance, and I’d have to pay the $245 out of my own pocket.
Because I have a tax-free health savings account — and because I have had issues with traditional prep in the past — I decided to “splurge” on the new prep procedure.
The piece of the HygiPrep experience that I immediately loved was not having to do much of anything in preparation the day before my colonoscopy. Anyone else who has had many scopes knows that the day before the procedure is often chaotic. Because of the number of times you have to drink the laxative and the effects of those laxatives, you are often up throughout the night, your sleep disrupted by painful trips to the bathroom or drinking more bitter liquid. With HygiPrep, I had to follow a clear liquid diet for 24 hours before the procedure, but otherwise just went to bed, hungry but undisturbed from my normal day-to-day routine.
Because HygiPrep is still a fairly new technology, it wasn’t available in the same facility as my actual colonoscopy. My designated driver had to take me that morning to Rockville, Maryland (about an hour away from my home in Washington, DC) to get the HygiPrep procedure. When I arrived, I was brought into the room with the HygiPrep machine and given a gown to change into and detailed instructions from the tech. Throughout the experience, the staffers were very attentive and helpful. They seemed to know this wasn’t a process many people had done before and were eager to answer any questions I had.
The piece of the HygiPrep experience that I immediately loved was not having to do much of anything in preparation the day before my colonoscopy.
As for the nuts-and-bolts: HygiPrep involves lubricating your rectum and positioning yourself, in a reclined seated position, over a hose with a turkey-baster-sized nozzle connected to a large chair, like the kind you might see in the pedicure section of a nail salon. Once you’re seated, you put a blanket over your waist and call the tech back in — so unless you’re having trouble navigating the hose and need assistance, you can do the whole procedure with some amount of privacy.
When the tech returned, they turned on the machine, and it started a steady, gentle stream of water up through the hose and into my body. I’d be lying if I said that part was comfortable, but it wasn’t painful. It lasted less than an hour, and my favorite part was that I could watch a screen at the base of the chair to track the water level throughout the process, so I knew roughly how much time I had left.
About 40 minutes in, I felt a sudden and strong wave of nausea and pressed the call button for the tech, who very quickly brought me a bag to throw up in. She said that vomiting is an infrequent but not unheard-of side effect. She paused the water flow for 10 minutes until my nausea faded, and then we continued the process.
When all was said and done, I was in and out in about an hour. From there, my designated driver took me to the endoscopy center 30 minutes away from the HygiPrep facility — but on our way back to DC — for my actual colonoscopy procedure.
Like all new medical tech, HygiPrep isn’t a silver bullet for bowel prep difficulties, but I did leave with the overall feeling that I’d do it again next time.
For me, it comes down to weighing the pros and cons. If you’re totally fine with liquid bowel prep and don’t find it to be gross and time consuming, I’d say save your pennies and a trip to a second location — HygiPrep probably isn’t necessary for you. But if you’re like me and so many of my friends who struggle to (literally) stomach traditional prep options, HygiPrep is a welcome alternative.
Two things need to happen to see real adoption of HygiPrep as a common choice for patients: Insurers need to cover the procedure, and endoscopy centers need to start offering it on-site. Currently, HygiPrep centers are only available in Texas, Ohio, Mississippi, Florida, Virginia, and Maryland. Until that list grows, HygiPrep will remain a helpful — but not entirely accessible — tool in our progress toward a better quality of life for people with gastrointestinal disease.
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