Colonoscopy Bowel Preparation Instructions

 

 

  • 7 days prior to your colonoscopy buy 1 container of CoLyte/PegLyte/GoLytely from the drug store.  (NO SUBSTITUTIONS).  No prescription is needed.

 

The procedure takes 30 minutes to 1 hour. You will need to stay 30 minutes to 1 hour after it is over. Plan to be at the hospital 1 ½ to 3 hours from start to finish.  Make sure the nurse knows how to contact the person taking you home. 

 

What is a colonoscopy? 

  • The colon and rectum make up the large intestine, which is sometimes called the bowel. Colonoscopy is an examination of the lining of the rectum and colon using a colonoscope. 
  • The scope is a long flexible tube with a camera and a light at the end. The scope is inserted into the anus and advanced into the rectum and the large bowel. This allows the doctor to carefully examine the lining of the large bowel and take samples of tissue if needed. 
  • Before the exam, most patient are given medication to help them relax. This medication will be given through an intravenous (IV).
  • The doctor will tell you what he or she is doing. There is a nurse in the room helping you and the doctor. You will be lying in a comfortable position on your left side while the scope is inserted. Air will be put through the tube to expand the colon. The exam may feel uncomfortable. There can be a feeling of pressure or cramping at various times during the exam. This will pass quickly. 
  • Small tissue samples (biopsies) may be taken. These biopsies are sent to the lab for testing. Polyps (small growths of tissue inside the colon), if found, may be removed as well. This is called a polypectomy. Most polyps are not cancerous. 
  • The scope will be removed once the exam is done and samples are taken.

 

Be sure to tell your surgeon well before the exam if you have: 

  • Allergies or sensitivities to medications, 
  • Glaucoma, diabetes or are pregnant, or 
  • An implantable device e.g. ICD, pacemaker, implantable pain pumps a total joint (hip, knee, ankle, shoulder) or heart valve replacement.

 

Are there any risks with these exams? 

Your surgeon will discuss the risk, benefits, and alternatives of the colonoscopy with you. Colonoscopy has a 1/250 risk of a complication.

These can include: 

  • Reaction to the medication or redness or soreness at the IV site 
  • Bleeding or infection. Risk is less than 1 in 1000. 
  • Perforation of the bowel. Risk is less than 1 in 2,000. 
  • Aspiration of stomach contents into the lungs due to the sedation. 
  • Possibility of missing a polyp or small tumor.

 

 

How do I get ready for the exam?

          

At least 10 days before

Ask your doctor for directions if you take any of the following medications:     

                                                               

      Blood thinners e.g.                          Take your usual amount        

      Warfarin (Coumadin®),                 Stop___days before

      Dabigatran, rivaroxaban

 

     clopidogrel (Plavix®),                     Take your usual amount

     prasugrel, ticlidine                           Stop___days before

 

Continue all other medications unless specifically told not to by your doctor.

Diabetics

If you are on insulin (or oral hypoglycemics) please make an appointment to see your family doctor regarding decreasing or with-holding medication the day prior to and the morning of your colonoscopy.

 

5-7 days before colonoscopy:

  • Stop taking iron pills or supplements containing iron. 
  • Stop eating foods that contain seeds and nuts including whole flax, sesame seeds, berries and popcorn.

 

3 days before colonoscopy:

  • Confirm your ride to and from the hospital. 

 

The day before your colonoscopy:

  • Stop eating any solid food, milk, milk products, non-dairy creamers, protein beverages or alcoholic beverages. Add 4 liters of water to your CoLyte/PegLyte container, and store it in the fridge until you are ready to drink it.
  • Start drinking only clear fluids from now until 3 hours before the exam. It is best to avoid fluids that are red or purple in color.

Clear fluids can include: 

  • Water                        
  • Popsicles 
  • Jell-O (with no added toppings or fruit)
  • Clear tea & black coffee
  • Carbonated drinks (pop), Gatorade, Power aid
  • Fruit juices without pulp (apple juice, lemonade)
  • Clear broth
  • Coconut water- no pulp

A typical adult loses 3-4 liters of fluid during a bowel cleanse.  It is important to drink lots (3-4 liters) of clear fluids the day before your procedure and up until 3 hours before the exam. This will help replace the fluids lost from your body. 

Diabetics: Try to maintain your normal caloric intake in liquid form. Test your blood sugar before meals, at bedtime, other times as needed during the day.

 

At 3:00PM on the day prior to the colonoscopy

(You can take 1 tablet of Gravol if you need to).  Start drinking the CoLyte/PegLyte Preparation.  You need to drink 2 liters.  The best way to do this is to drink at least 8 oz every 15 minutes until you have finished ½ the container (2 liters) 

At 6 hours before you are to arrive at the hospital

Drink the remaining 2 litres of the CoLyte/PegLyte Prep solution.   It is best to drink it rapidly, rather than sipping it over a longer period.  Drink 8 oz. at least, every 15 minutes until you have finished the remainder of the container.

What can I expect after taking the CoLyte/PegLyte preparation? 

  • Remain close to a toilet. You will have frequent diarrhea type bowel movements. The 1st 2 litres of CoLyte/PegLyte usually starts working within 1-3 hours, but may take longer. (For some people it may take up to 6-8 hours or more).  Subsequent doses will take less time to work. Keep this in mind if you are travelling the day before your procedure. 
  • Cramping can occur and is considered normal. 
  • Your bowels are considered clear when you are passing only liquid. The liquid may be clear, yellow or colored with flecks of stool. 
  • The exam can only be done if your bowel is properly cleaned out.

 

Day of the Exam

  • Continue drinking clear fluids until 3 hours before the exam, then nothing at all.
  • Take your normal medications with a sip of water except for blood thinners and diabetic medications (you should have specific instructions for these drugs).
  • You can take Tylenol/migraine medication until 3 hours prior to your procedure.

 

Checklist for coming to the hospital

  • If you have an ostomy you should bring your supplies with you in case you need to change it. 
  • Do not wear jewelry, body piercings, make-up, perfume, aftershave or other scented products. 
  • If you have diabetes, check your glucose as usual and bring the results with you to the hospital. You may need to have your glucose checked at the hospital. 
  • Bring your CPAP, Bi-level machines or dental device if you use one for sleep and you are having IV sedation during the exam. 
  • Bring a translator, if you do not understand English. 
  • Bring your BC Care Card or proof of substitute Medical Insurance Plan. If you do not have these, bring another form of personal ID. 

 

After the exam

  • You will be given a handout describing the findings of your procedure 
  • You must have a responsible person meet you and drive you home, even if you go by taxi or bus, or your exam may be cancelled. The person that picks you up must come directly to the Endoscopy Unit. 
  • Sedation drugs can stay in the body for up to 24 hours afterwards. You may be considered impaired for up to 24 hours after your exam, we recommend that someone stay with you during this time.  You should plan not to: 
    • Make important decisions, sign documents, go to work or do business 
    • Drive a car or work with machinery 
    • Do any strenuous activities like bike riding, swimming, or climbing ladders 
    • Travel alone by public transport e.g. bus, taxi 
    • Drink alcohol, take sleeping pills or anti-anxiety medication 
    • Be responsible for the care of another person e.g. baby, small child, person in poor health 

 

The information in this handout is intended only for the person it was given to by the health care team. It does not replace the advice or directions given to you by your doctor.