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PREP INSTRUCTIONS

COLONOSCOPY

MANAGE YOUR BLOOD THINNERS AND GLP-1 MEDICATIONS

DO NOT STOP ASPIRIN.

Get clearance from your Primary Care Physician / Cardiologist to stop the following medications:

1) Plavix / Effient - stop 7 days prior to your procedure.

2) Coumadin (Warfarin) / Pradaxa - stop 5 days prior to your procedure.

3) Xarelto - stop 1 day prior to your procedure.

4) Ozempic / Wegovy / Zepbound -- hold one dose before the procedure.

THREE DAYS BEFORE THE PROCEDURE

1) Do not eat fruits & vegetable peels, leafy greens and salads.

2) Do not eat nuts and seeds.

3) Stop fiber supplements such as Metamucil, Citrucel etc.

4) Drink plenty of fluids daily

ONE DAY BEFORE THE PROCEDURE

DO NOT TAKE ANY SOLID FOOD ALL DAY

EAT ONLY CLEAR LIQUIDS ALL DAY

1) Clear broth -- chicken, beef or vegetable -- without noodles

2) Plain Jello -- no red or purple

3) Tea and coffee -- no milk or cream

4) Sprite, 7-UP and ginger ale

5) Apple juice and lemonade

6) Gatorade, Powerade, Kool-Aid and Crystal Light -- no red or purple

7) Popsicles and Italian ice -- no red or purple and no added fruit pieces

DRINK PLENTY OF FLUIDS ALL DAY -- nothing red or purple.

3:30 PM : PREPARE YOUR PREP -- follow the instructions provided by your Pharmacist. Take four (4) Dulcolax pills.

4:00 PM : DRINK THE FIRST HALF OF THE PREP - drink 8 oz every 10-15 minutes until you finish half of the prep. You may prefer to drink it on ice.

THE DAY OF THE PROCEDURE

4:00 AM : DRINK THE SECOND HALF OF THE PREP -- drink 8 oz every 10-15 minutes until the entire prep is gone. This step must be completed by 6:00 am or at least 2 hours before your procedure time.

DO NOT EAT OR DRINK ANYTHING ELSE & DO NOT SMOKE

DIABETIC PATIENTS -- DO NOT TAKE insulin or oral diabetes medications the day of your procedure. Insulin pump – follow the off-pump plan given by your prescribing physician on the day of your procedure. You can resume these medications after the procedure is finished.

TAKE ALL YOUR OTHER MORNING / AFTERNOON MEDICATIONS THAT YOU TOOK YESTERDAY

Please bring your insurance cards and a list of your medications and allergies.

SOMEONE MUST ACCOMPANY YOU TO DRIVE YOU HOME -- if you do not have someone to drive you home, your procedure will be rescheduled.

NO HURRIES AND NO WORRIES -- although the actual procedure may take a short time, the time spent in the Endoscopy Center could be longer. Time is spent on interviews with nursing personnel, preparation with medications, and recovery after the procedure. We appreciate your patience and understanding.

FREQUENTLY ASKED QUESTIONS ABOUT THE 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. It usually takes the entire dose of the prep to completely clean out the colon.

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. It usually takes the entire dose of the prep to clean our the entire colon.

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?

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.

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 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. 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.

Can I drive home after my procedure?

You should NOT drive until the next day. You will need a ride home with a responsible adult. You will not be allowed to drive, walk or take public transportation after the procedure. Please make appropriate arrangements.