COLONOSCOPY PREPARATION — SPLIT DOSE BOWEL PREP

FOR PRINTED INSTRUCTION:



Split dose bowel preparation consists of splitting your colon cleanse over a period of time, as close to your procedure as possible. Split dosing has been shown to be superior to same day preparation in clinical studies and decreases the likelihood that the procedure will need to be canceled and rescheduled because of a poor cleansing. Note, this may require you to either awaken early in the morning or remain awake later in the evening, in order to complete the prep process. Although inconvenient, the correct timing of drinking the prep is critical to obtaining a good colon preparation.

Remember you must have someone to drive you home - this can not be a taxi or bus unless there is a known responsible adult to accompany you.

DIET

7 days before your colonoscopy

  • Stop eating seeds, nuts, popcorn, and whole grains (brown/wild rice, oatmeal, granola, whole wheat/grain bread/pasta/crackers etc.)

1 day before your colonoscopy

  • Stop eating solid food, milk, and dairy products
  • Consume clear liquids only. These include: Water, plain tea and coffee, broth or bouillon, clear juices such as apple, white grape or white cranberry, fruit flavored drinks such as Crystal Light, Italian ices, Jell-O, sports drinks such as Gatorade, Powerade, or Propel, clear carbonated beverages, and popsicles.

What are clear liquids:

Liquids that you can see through at room temperature liquids which are transparent (you can see through them when held up to the light are considered clear liquids. This includes clear juices, broths, ices and gelatin.

SHOPPING LIST (ALL ARE OVER THE COUNTER):

(2)   64 oz. bottles of Gatorade (any flavor or color/see alternatives below for diabetics)

(2)   8.3 oz. bottles of Miralax powder (238 gram/14 dose)

The way in which you take the bowel preparation depends on the time your colonoscopy is scheduled, please follow the instructions below:

On day prior to procedure follow the instructions below. 

NO solid foods, clear liquids only.

In the morning, mix (1) 8.3 oz. bottle of Miralax with (1) 64 oz. bottle of Gatorade in one pitcher and other Miralax/Gatorade bottles in another.  You may use other clear liquids (Crystal Light, Propel, etc.) if unable to tolerate Gatorade. Place in refrigerator to chill if desired, after powder dissolves.

Prep Instructions

FOR MORNING COLONOSCOPY (BEFORE 12PM)

At 6pm the night prior, begin drinking the first Miralax/Gatorade solution. You will need to drink an 8-ounce glass of the preparation every 15 minutes until the entire 64 oz. is gone.  Nausea can be side effect of this preparation.  If you become nauseated stop, wait 30 minutes, and then continue.  You need to finish the solution within 2 hours.

At 10pm, begin drinking the second Miralax/Gatorade solution. You will need to drink an 8-ounce glass of the preparation every 15 minutes until the entire 64 oz. is gone.

ON DAY OF PROCEDURE do NOT eat or drink anything 4 hours prior to your procedure arrival time this includes:

  • NO chewing gum or hard candy
  • No smoking
  • Leave valuable at home, including jewelry and watches
  • Bring your insurance card(s) and photo identification with you to the facility
  • Wear comfortable, warm loose fitting clothing
  • Bring a list of your medications
  • Be sure to have an adult present to drive you home and be with you for 24 hours following procedure.

FOR AFTERNOON COLONOSCOPY (AFTER 12PM)

At 6pm the night prior, begin drinking the first Miralax/Gatorade solution. You will need to drink an 8-ounce glass of the preparation every 15 minutes until the entire 64 oz. is gone.  Nausea can be side effect of this preparation.  If you become nauseated stop, wait 30 minutes, and then continue.  You need to finish the solution within 2 hours.

At 5am day of procedure, begin drinking the second Miralax/Gatorade solution. You will need to drink an 8-ounce glass of the preparation every 15 minutes until the entire 64 oz. is gone.  You will need to finish the solution within 2 hours.

ON THE DAY OF PROCEDURE do NOT Eat or drink anything 4 hours prior to your procedure arrival time this includes:

  • NO chewing gum or hard candy
  • No smoking
  • Leave valuable at home, including jewelry and watches
  • Bring your insurance card(s) and photo identification with you to the facility
  • Wear comfortable, warm loose fitting clothing
  • Bring a list of your medications
  • Be sure to have an adult present to drive you home and be with you for 24 hours following procedure.

**Please note if you drink any liquids within the 4 hour window your procedure will be cancelled or delayed. If procedure is at Gulfcoast Hospital or the Sanctuary you cannot eat or drink anything after midnight the night before procedure. **

This preparation is safe for those who have a history of congestive heart failure, kidney failure, or dehydration.

Pre-Procedure Medication Instructions

TAKE YOUR BLOOD PRESSURE AND HEART MEDICATIONS DAY BEFORE AND DAY OF PROCEDURE! 

Do not take oral diabetic agents, insulin, diuretics (Lasix, HCTZ), vitamins or supplements the morning of your procedure.

BLOOD THINNERS

If you take blood thinners you may be at an increased risk of bleeding if tissue is removed.  

You may continue aspirin unless instructed by your doctor. 

The risk of stopping your blood thinner must be individualized for each patient. 

If you had a stent placement within the past 12 months or have a history of TIA's, talk to your physician before stopping these medications.  

Please remind staff at the Endoscopy unit that you are taking blood thinners.

Stop taking:   Coumadin  Plavix  Xarelto  Pradaxa  Eliquis  per your doctor instructions.

Please resume your medication after the procedure is completed or as directed by the doctor.

Diabetic Instructions (oral or insulin) Recommend Gatorade G2, Powerade Zero, or Crystal Light in place of regular Gatorade

On day prior to your procedure you will need to only take one half (1/2) of your morning and evening dose.  

DO NOT take your diabetic medications the morning of the procedure. 

Once the procedure has been completed and you have eaten a meal you will need to take one half (1/2) of your morning dosage. Resume your normal dosage regime after this.

Monitor your blood glucose level and if becomes low take glucose tablet.

What to Expect For Your Colonoscopy

Colonoscopy utilizes a long flexible tube camera to evaluate the large intestine. This test is commonly performed to investigate the cause of blood in the stool, diarrhea, abdominal pain, a change in bowel habits, or personal/family history of polyps/cancer.

An intravenous (IV) will be started in your arm and you will be sedated to make you drowsy and relaxed. The examination is performed with you lying on your left side and the colonoscope will be gently guided through the colon. If any abnormalities are found such as polyps, biopsies (removal of small pieces of tissue) may be taken for examination. This is a very safe procedure and in many cases, eliminates the need for surgery.

Your stay at the facility will be approximately two hours long, depending on how long it takes to pass the scope around the colon.

Please bring with you to the center glasses, hearing aids,  dentures (no Fixodent or glue), insurance card and photo ID, medication list.  Do not bring jewelry or any valuables. Do not use lotion, sprays, perfume/cologne.

Wear warm loose-fitting clothing.

AFTER THE PROCEDURE

You will be observed for about thirty minutes before going home. You will not be allowed to drive for 24 hours after the procedure since you will be drowsy several hours afterward.

Following the procedure, your doctor will inform you of the preliminary results of the test. A follow-up visit may be scheduled so the final test results (biopsies) can be explained to you when you are fully awake.

RISKS

This is a very safe examination, but there is a small risk of complications, which occur in less than 1% of patients which could include bleeding, infection, or perforation of the bowel.

We find 95% of polyps and usually, but not always, they can be completely removed during the procedure.

Reactions to medications may rarely occur such as allergic reactions or difficulty breathing.  If you experience severe pain, bleeding, or any serious problems after the test, please contact our office immediately at (239) 772-ENDO (3636).

MAKE SURE YOU TAKE YOUR BLOOD PRESSURE AND HEART MEDICATIONS DAY BEFORE AND DAY OF PROCEDURE!