Procedure Preps | Pearl Health Partner

Patient instructions:

Bowel prep for colonoscopy, diet, medications and transportation

Taking the colonoscopy prep

Before your colonoscopy, you must take a laxative medication and restrict your diet to clear your colon of stool so that the doctor can clearly see any abnormal areas in your colon during the procedure. If your colon is not completely emptied, the chances your doctor will miss abnormalities increases, and you may even have to repeat the procedure.

By the day before your test, you should already have your bowel prep. Your doctor may have prescribed and sent the bowel prep medication to your pharmacy or may have instructed you to take a bowel prep that is over-the-counter. Alternatively, your doctor may have requested that the bowel prep be mailed to you.

What to expect from the colon prep

You will develop diarrhea after drinking the preparation. Plan to be near a bathroom. This is normal as it means the medication is working to clear stool from your colon. If you experience frequent constipation, it may take a number of hours to begin working. Some people also do not experience much bowel output but can still be clean.
Most people feel mild bloating and mild abdominal cramps. This is normal. If you experience nausea listen to your body and go more slowly! Drinking the prep medication more slowly and over a longer period of time can help alleviate these symptoms.
A well-prepared colon produces yellow liquid. Please finish your preparation regardless of your stool color.

Bowel prep options

One bowel prep medication type may not be right for everyone, and you should always use the bowel prep medication that your doctor has directed you to use. Colonoscopy bowel prep instructions are listed below for the following types:

Same Day preparation (Procedure >10 AM)

Split dose preparation (Procedure <10 AM)

Happy Colon "Eat Your Prep"

Constipation Add-on preparation

Upper endoscopy (EGD) preparation

Diet

Happy Colon Prep? Click here

Beginning 5 full days before your procedure, you must avoid seeds and nuts.

Beginning one full day (24 hours) before your procedure, you must begin a clear liquid diet, which means that you should NOT eat any solid foods and should ONLY drink clear liquids. For example, if your procedure is on Thursday morning, you should not eat any solid foods for Wednesday breakfast, lunch, and dinner and should only drink liquids that are clear. Aim to drink at least 12 tall glasses (about 8-10 ounces each) of clear liquids throughout the day in addition to what you drink with your bowel prep solution/medication.

A clear liquid diet consists of drinking only “clear” liquids, such as:

Water
Mineral water
Clear fruit juices without pulp (apple, white grape, white cranberry, lemonade, etc)
Clear soft drinks
Clear sports drinks
Broth (chicken, beef, vegetable, or bone broth)
Popsicles or gelatin (such as Jell-O)
Coffee or tea (without milk)
Ensure clear or other clear meal-replacement drinks

Alcohol can make you dehydrated and you should not drink alcohol while preparing for your test.

Beginning 2 hours before your procedure, you should STOP drinking clear liquids. This means that you should not have anything to eat or drink beginning four hours before your procedure.

After your procedure, you will be able to resume a normal diet, unless otherwise instructed by your doctor.

Medications

You can take most prescription and non-prescription medications right up to the day of the colonoscopy.
Stop medications that are for diarrhea (Imodium, kaopectate) or contain iron 7 days prior to your procedure.
Blood thinners may need to be temporarily discontinued prior to procedure. The length of time you will need to stop your medication depends upon which drug you are taking. If you are on a blood thinner, you should consult with your prescribing doctor about whether you should continue or discontinue these medications. Do not stop these medications without first talking to your doctor. You will restart these medicines after the procedure, unless otherwise directed by your doctor.
Low-does aspirin can be continued and does not need to be stopped prior to your colonoscopy.
Insulin/diabetes medication doses may need to be adjusted. Consult your prescribing doctor.
Blood-pressure medicines should be continued while preparing for the test. On the day of your test, you should take your blood-pressure medicine with water at least two hours before your test.
Take your usual morning medicines, especially those for blood pressure, at least 4 hours prior to your procedure with a small amount of water.

Transportation

You must have someone accompany you home the day of your procedure, even if you take a cab. You will not be able to drive yourself home. You can also use public transportation (taxi or bus), but only if you have an adult who can escort you home. Medical transport may be arranged for safe transportation home. The medical procedure staff must be able to contact whoever will accompany you. If this person cannot be confirmed prior to the procedure, your procedure will be rescheduled for your safety. You should not drive a car, operate machinery, return to work, drink alcohol, or make any legal decisions the after your procedure until the following day.

Questions About Preparing for Your Procedure

My procedure is in several days and I have not yet picked up my prep solution and/or my pharmacy does not have it. What should I do?

Call our office during normal business hours, Monday-Friday 8-5 pm, and one of our staff members will be able to assist you and check on the prescription. Often, if your prescription is not picked up within 7 days of us sending it, your pharmacy will put the prep back on the shelf.
If your procedure is tomorrow and you do not have your prep and it is outside normal business hours, call our phone number to connect with one of our on-call providers.

The instructions state that I have to be on a clear liquid diet before my procedure. What can I have?

Hold a piece of newspaper or paper with print on it up to the liquid and try to read it, if you can read the words, the liquid is clear.
The following are recommendations for clear liquids: water, soda, ginger ale, clear sports drinks, apple juice, white cranberry juice, tea, black coffee (no cream or milk), chicken broth, Jell-O, and popsicles (as long as they are not red, orange, or purple).

I accidentally ate seeds during the week leading up to my procedure, do I need to reschedule?

It is important to follow all of the instructions provided by our office to ensure a successful exam, however, if you accidentally ate seeds or nuts you do not need to reschedule your procedure as long as you follow the clear liquid diet the day before your procedure and drink the prep solution as instructed.

I accidentally ate something the day before my procedure. Do I need to reschedule?

It is important to follow all of the instructions provided by our office to ensure a successful exam, however, if you accidentally ate something the day before your procedure before 12:00 PM, you do not need to reschedule as long as you begin the clear liquid diet and follow the rest of the instructions to prepare for your colonoscopy.
If you eat something after 12:00 PM, you will likely need to reschedule your procedure, please call our office.

What medications can I take the morning of my procedure?

You should continue to take your regular medications, unless otherwise instructed by our provider or nursing staff. Take them with a small amount of clear liquid at least 2 hours before your check-in time.
If you take any blood thinners or anti-platelet agents, i.e. Coumadin, Plavix, Pradaxa, etc., please follow the instructions provided by our office regarding these medications.
You may continue to take NSAIDs, Aspirin, and Tylenol, if needed.

What are some tips to make drinking the prep solution easier?

After mixing the prep, put it in the refrigerator; it may help to drink it cold (do not use ice).
Drinking the prep through a straw may help bypass some of the taste buds on your tongue.
You may suck on hard candy while drinking the solution. Remember, the candy should not be red, orange, or purple.
Nausea is common while drinking the prep. If this occurs, stop drinking for 30 minutes before restarting. Walking around may help relieve nausea.

While drinking the prep solution I felt nauseous and ended up vomiting. How should I proceed?

If you have retained enough of the prep that it has resulted in a bowel movement, you should proceed with the preparation and finish the prep solution. You should follow the tips in the answer above to help make drinking the prep solution easier.
If you have been unable to retain enough of the prep to result in a bowel movement, please call our office.

I have started my prep solution but have not experienced a bowel movement yet, is this normal?

Bowel movements usually occur within 3 hours of starting the prep but may take longer. If bowel movements have not started within 3 hours of starting prep, then an over-the-counter suppository (Dulcolax) is advised. Bowel movements should be watery. If they are not, drink a bottle of magnesium citrate. Proceed with the second dose of the prep solution at the appropriate time.

Can I drink all of the prep the night before instead of waking up in the morning to drink the second half of the prep solution?

Studies have shown that split-dose preps produce better cleansing. While this may mean that you need to wake up in the middle of the night or early morning to drink the second dose, the most important thing is that you get a good quality exam. A good quality exam will reduce the chance of having to repeat the prep/procedure. If there is stool residue stuck to the side of your colon, your doctor may not be able to find and remove all polyps.

How do I know when I have been fully prepped for my colonoscopy?

You will be fully prepped and ready for your procedure after drinking both doses of your prep and your bowel movements are a clear yellow fluid, like urine.

I have taken both doses of the prep solution but it is now the morning of my procedure and I am not having clear bowel movements. What should I do?

As long as you do not have a solid formed stool, you should come in for your procedure. If, after taking the second dose of prep solution, you still have solid formed stool – call our office the morning of your procedure.

I am having a menstrual period. Should I reschedule my colonoscopy appointment?