Colonoscopy


 

COLONOSCOPY PREP INSTRUCTIONS:

Our goal is to help you clean your gastrointestinal tract with the help of liquids and laxatives. 

Our success will require you to follow these instructions to move your bowels multiple times before your colonoscopy. An unprepped colon leads to missed colon abnormalities and you may be asked to return sooner than expected to repeat the procedure, if your colon is poorly prepped. 

Everyone's colon is different-- & you may require more liquids & prep solution than most people. It is often not possible to predict this, but you will know if the prep solution is not working, if you have not had loose stools/diarrhea on the day before the procedure. 

 

5 Days before the Procedure:

Please let your primary care provider know you are planning to stop any medications.

Do NOT stop any of your home medications, including blood pressure medication or aspirin.

Do NOT take Vitamin E; iron supplements; Gingko; St. John's-Wort or fish oil.

Do NOT eat popcorn, quinoa, seeds or nuts.

Do NOT take anti-inflammatory/pain medications like Advil, Aleve, Motrin, Ibuprofen, Diclofenac

 

2 Days before the Procedure:

Take 2000 mg of magnesium citrate with 8 oz of water (or 2 tablespoons of Milk of Magnesia)

before bedtime.

 

A loose watery bowel movement (stool) should result in approximately 1 hour. 

 

 

The Day before the Procedure: Start Your Bowel Cleansing Marathon:

 
If your stool looks like this, keep drinking liquids!


 Image Source: https://www.sciencedirect.com/science/article/pii/S2351979716000062#fig1

 


Before 10 AM, light breakfast with eggs, plain yogurt with honey or no fruit Kefir. 

No grains, fruit/vegetables/fiber. Drink coffee, tea, fresh juice without pulp, broth.

No solid food after 10 AM. 

 

Drink clear liquids only-- at least one, 8-oz glass every hour for 12hrs.

You may take Gas X liquid or tablets for bloating. 

 

At 2PM: 

  • Begin drinking the bowel prep solution you & your doctor agreed to be the most appropriate.
  • Take 1200 mg of magnesium citrate with 8 oz of water.
  • Please drink ALL of the prep solution & clear liquid diet described in detail below.
  • Drink large amounts of liquids to prevent dehydration throughout the day.
  • Do not drink red, orange or blue colored liquids.
  • Do not eat any solid, soft, or pureed food with pulp.

 

 
If your stool looks like this, keep going!

 Image Source: https://www.sciencedirect.com/science/article/pii/S2351979716000062#fig1

“Clear liquids” examples:

  • Clear broth (without noodles or solids): garlic, vegetable, chicken, turkey broth.
  • Clear drinks preferred: Pedialyte or iced tea, Sprite, Squirt, 7-up, Gatorade, Lemonade.
  • Popsicles: no ice cream or yogurt bars.
  • Tea: Green tea, White tea or Chamomile (No milk or cream)
  • Jell-O without fruit or solids (no red or orange Jell-O).
  • Any juices without pulp (such as apple, white grape, white cranberry and pear)

 

 
This is what your stool should look like

 Image Source: https://www.sciencedirect.com/science/article/pii/S2351979716000062#fig1

 

Patients on ASA/Anti-coagulants:

  • Discontinue the following medications or other non-steroidal, anti-inflammatory medications for 7 days prior to the procedure: Ecotrin, Aspirin, Baby Aspirin, Excedrin, Anacin, Aggrenox, Xerelto, Alka-Seltzer, Motrin, Advil, Ibuprofen, Toradol, Aleve, Naproxen, Diclofenac, Meloxicam, Fish Oil, Indocin, Feldene, Coumadin (Warfarin), and Plavix (Clopidogrel). 
  • PLEASE TAKE YOUR BLOOD PRESSURE MEDICATION WITH ONLY WATER NO LATER THAN 4 HOURS PRIOR YOUR PROCEDURE. 
  • If you prefer, you may drink BLACK coffee or tea-- but with NO dairy/milk. If you eat food or drink any dairy/milk on the day of your procedure, it will be postponed or cancelled.
     

You must have an empty stomach for 4 hours prior to the procedure to be safely sedated.

Help us prevent any risk of aspiration of liquid food into your lungs by following these specific recommendations. Your safety and excellent outcome is our priority. 

 

Patients with Diabetes:

  • Consult with your primary doctor on how to modify diabetic medication or insulin injection.
  • We suggest you not take your diabetes medications on the morning of your procedure, but you should take it as usual on the days prior, if sweetened drinks are consumed.  
  • Please check your blood sugar the day of your procedure.

 

On the Morning of Procedure Please Bring:

  • Your current ID and insurance Card.
  • A list your current medication with dosages (prescribed & over-the-counter), remedies, products and any known allergies to medications.
  • A licensed driver to transport you to your home after the procedure. Taxi’s not allowed.
  • Signed Consent or Clearance (if required) 
    (Please notify the staff immediately before procedure date)
  • Please notify staff if a wheelchair is needed for the patient, if unable to walk before procedure day.

 

What to Expect Day of Procedure 

⦁ Check in with the receptionist when you arrive to your appointment to complete necessary paperwork. You will be asked to sign a consent form to authorize the doctor to do your procedure as well sign a Notice of Privacy Practice. If you are a patient under 18 years of age, a parent or guardian must sign your paperwork. If you are an adult who is unable to sign the consent, you must have someone with you who is authorized to sign on your behalf. 

⦁ Plan to be at the center from 90 minutes to two hours. 

⦁ A nurse will record your vital signs (pulse, breathing, temperature) and ask you about allergies and other medical information. 

⦁ An I.V. will be inserted so you can receive IV fluids and medication.

⦁ If you are having an upper endoscopy, you will need to remove dentures, partial plates, and jewelry. 

 

After your Procedure:

⦁ Your actual procedure will last a very short time, typically an upper endoscopy/EGD takes ~15 minutes & a lower endoscopy/colonoscopy between 30 to 60 minutes. 

When the doctor is finished:

⦁ You will rest for a short time until the effects of the anesthesia medication wear off.

⦁ Dr. Bahamonde will then tell you &/or your designated healthcare proxy what she preliminarily found during the procedure, though the final diagnosis and treatment plan will be pending pathology results, usually 2 to 7 days later.

⦁ A nurse in the PACU (post-anesthesia care unit) will let you know when you can leave and will give you additional general instructions.

⦁ Take Gas X liquid or tablets if you experience residual bloating. It is expected for 1-2 days.  

⦁ Please call Dr. Bahamonde’s office or your primary care physician to schedule

your follow-up Telehealth visit for results and recommendations, usually in 2-4 weeks later.

 
______ MIRALAX 
  1. Mix 2 Liters of room temperature drinking water with the 238 grams of MiraLAX in a

    pitcher or jug. Mix/shake very well to make sure the ingredients are mixed well (dissolved). 

 

  1. Chill the container of liquid prep & follow Split dose (2 day regimen; preferred method):

 

at 2PM on the day before colonoscopy (6-10 hours before 2nd dose):

drink 1 Liter of the prep solution-- (8 oz) every 15 minutes until 1L is consumed  (half of the container contents). Then, drink an additional 16 oz of any clear liquid within 1-2 hours.

A loose watery bowel movement (stool) should result in approximately 1 hour. 

 

  1. Dose 2: at 8PM on the evening before the colonoscopy (6-10 hours after 1st dose,

no later than 4 hours prior to your colonoscopy): drink 1 Liter of prep solution; 8 oz (240 mL) every 15 minutes until the 1L is consumed (2L should be consumed, the entire container contents, within 1-2 hours).  Then, drink an additional 16 oz (480 mL) of any clear liquid (or broth).

 

On the morning of the procedure, you may drink clear liquids, black coffee or tea, No milk or dairy; no solid food. You must stop all drink/food 3-4 hours before the procedure.

 

SEE diagram below--

Please continue drinking clear liquids until stools are clear, as shown.  

Resources

OUR LOCATIONS

 

Pasadena Endoscopy Center

Arcadia Endoscopy Center