STEP 1: Three (3) days prior to the procedure:

• Begin a low fiber diet and continue until 12PM the day prior to procedure.
• Avoid fruits and vegetables with peels or leafy greens including salads. Avoid nuts and seeds.
• Discontinue fiber supplements such as Metamucil, Citrucel, Fiberall, etc.
• Drink plenty of fluids to hydrate prior to beginning colonoscopy prep.

STEP 2: One (1) day prior to the procedure:

• Eat only clear liquid diet starting at 12PM.You may only have:
• Clear broth – chicken, beef or vegetable (no noodles)
• Plain Jell-O (no red or purple)
• Tea or coffee (no milk or cream)
• Clear pop such as Sprite, 7-UP and ginger ale
• Clear juices such as white grape, apple, lemonade
• Sports Drinks such as Gatorade or Powerade, Kool-Aid, Crystal Light (no red or purple)
• Popsicles, Italian Ice (no red or purple and no added fruit pieces)
• NO SOLID FOOD
• Be sure to drink plenty of fluids all day (nothing colored red or purple)
• Prepare the bowel prep as instructed on the container. You may refrigerate to make more tolerable.
• At 3:30 pm, take four (4) Dulcolax pills.
• At 4:00 pm start to drink 8 oz from the jug every 10-15 minutes until half of the prep is gone. You may prefer to drink it on ice. Other tips to make the prep easier:
• Drinking through a straw may help avoid contact of the salty fluid with your taste buds.
• Rinse your mouth with water, clear soda or mouthwash after drinking.
• If you feel nauseated, slow down to 8 oz every 30 min for 2-3 cups, sip peppermint tea, or suck on a lemon.
• If you experience abdominal fullness and/or bloating, slow down to 8 oz every 30 min until these symptoms subside. This is normal and will subside when bowel movements start.
• If your pharmacy did not supply you with a flavor packet, you may substitute powdered Gatorade or Crystal Light. Follow the instructions on the Gatorade or Crystal Light Container for reconstituting one (1) gallon. No red or purple.

STEP 3: The day of the procedure:

• At 4:00 am the morning of the procedure begin to drink the remainder of the prep. Again, 1 cup every 10-15 minutes until it is empty. This step must be completed by 6:00 am or 2 hours before your procedure time. To allow optimal results with your colonoscopy, make sure the jug is completely gone.

DIABETIC PATIENTS:

• No insulin or oral diabetes medications the day of your procedure.
• Insulin pump patients – follow the off-pump plan given by your prescribing physician on the day of your procedure.

PATIENTS ON BLOOD THINNERS:

• If you take Coumadin (warfarin) or Pradaxa, please obtain clarification from your prescribing physician to stop taking the medication 5 days prior to your procedure.
• If you take Plavix, Effient or any other similar blood thinning medications, please obtain clarification from your prescribing physician to stop taking the medication 7 days prior to your procedure.
• If you take, Xarelto, please obtain clarification from your prescribing physician to hold medication for 1 day prior to your procedure.

FREQUENTLY ASKED QUESTIONS ABOUT YOUR BOWEL PREP

Is there any way to make the prep taste any better? Try sucking on hard candy. Add the flavor packs that come with the gallon prep or you can add Crystal Light or Gatorade packets to the glass. Don’t eat or drink anything other than the approved liquids while you are drinking your prep. Rinse your mouth with water or mouthwash after drinking the prep.

I feel like vomiting and do not think I can drink any more. What should I do? It is important that you continue to drink the solution if possible. Without a clean bowel, the doctor will not be able to thoroughly see inside of your colon to complete the examination. You can stop drinking for 30 minutes, then resume. If you do vomit, wait 30-60 minutes then begin drinking the solution again. You make drink the prep at a slower rate.

Why avoid red and purple liquids? The color can persist in the colon and make an accurate diagnosis more difficult.

One of the medications I was instructed to take is red. Can I take it? YES

I already have diarrhea before taking the prep. Do I still have to take the colon prep/laxative? Yes, you must take the prep as directed. Your colon is approximately 6 feet long; the entire colon must be emptied for your physician to see the colon clearly.

I am taking the prep and already have loose watery stools; do I still need to take the rest of the prep? Yes, you may have solid stool higher in the colon that needs to be eliminated.

I see yellow color in the toilet bowl and a few flecks; what do I do? If your last bowel movement was clear enough to see the bottom of the toilet; you should be fine. It is OK if you have some flecks of material. The yellow color is bile that normally colors the feces. This should not interfere with the procedure.

Can I drink alcoholic beverages? No.

My bottom is very sore. What should I do? Avoid rubbing when cleaning the area. Gently pat with a wet washcloth or wet wipes. Apply Vaseline, Preparation H, or Desitin liberally.

Can I drink alcoholic beverages? No.

Can I chew gum or suck candy? NOT on the day of the procedure.
What if I am still passing stool the morning of my test? Take a tap water enema until you run clear. If this does not work, call the office.

Can I brush my teeth? Yes. Do not swallow any water.
Can I wear my dentures? Yes, you may wear dentures to the Endoscopy Center. However, you may be asked to remove them prior to the procedure.
If you have been instructed not to take anti-inflammatory or blood thinner medicine several days before the procedure. What can you take for headaches and pain relief? You may take Tylenol (acetaminophen) as directed.

I have a headache and/or feel dizzy. Dizziness and headache could be signs of low blood pressure or dehydration. Drinking a regular carbonated beverage (not diet), Gatorade or apple juice may alleviate these symptoms. Drink plenty of fluids!

Can I have the colonoscopy done if I am having my menstrual period? Yes, the procedure can still be performed. We ask that you use a tampon if possible (not absolutely necessary).
What should I do if I believe that I am pregnant? It is very important for us to be aware of this possibility. If there is any doubt, please contact us immediately.

May I drive home? Any patient receiving sedation should not drive until the next day. A patient receiving sedation for a procedure needs a ride home with a responsible adult. Patients will not be allowed to drive, walk or take public transportation after sedation or anesthesia. Please make the appropriate arrangements.

What must I bring with me on the day of the procedure?

• Bring insurance identification cards, driver's license
• Bring your completed medication list, including over-the counter, herbals and vitamins and a list of any medications to which you are allergic
• Make sure you have a ride home and someone to care for you at home
• Wear comfortable, loose fitting clothing
• Bring case for eyeglasses or contacts
• Leave all jewelry and valuables at home