Bowel Preparation Guide https://bowelprepguide.com Your guide to excellent bowel prep Sun, 10 Sep 2017 00:31:43 +0000 en-US hourly 1 https://wordpress.org/?v=4.8.2 92279279 10 Fun Facts about Colonoscopy https://bowelprepguide.com/10-fun-facts-colonoscopy/ https://bowelprepguide.com/10-fun-facts-colonoscopy/#respond Tue, 22 Aug 2017 01:10:41 +0000 https://bowelprepguide.com/?p=6881 10 Fun Facts about Colonoscopy Nothing is funny about colonoscopy or colon cancer. These 10 fun facts about colonoscopy provide interesting numbers to keep in mind when you or your loved ones get a colonoscopy. 1.  2nd. Each time you think about the inconvenience of colonoscopy, remember that colorectal cancer is the 2nd leading cause of […]

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10 fun facts about colonoscopy

10 Fun Facts about Colonoscopy

Nothing is funny about colonoscopy or colon cancer. These 10 fun facts about colonoscopy provide interesting numbers to keep in mind when you or your loved ones get a colonoscopy.

1.  2nd.

Each time you think about the inconvenience of colonoscopy, remember that colorectal cancer is the 2nd leading cause of cancer death in the U.S.

2.  3rd

Colon cancer is the 3rd most common cancer in men and women. Read key statistics for colorectal cancer.

3. 50 years old.

Average risk individuals should begin screening for colorectal cancer at age 50.

4. 40 years

Individuals with family history of colorectal cancer or precancerous polyps (adenoma) in a first degree relative before age 60 years or 2 or more first degree relatives at any age should begin screening for colorectal cancer using colonoscopy at age 40 or 10 years before the youngest case in the immediate family. Screening with colonoscopy is recommended every 5 years in this population.

5. 10 years.

An average risk person without colon polyps on screening colonoscopy should have repeat screening colonoscopy 10 years after.

6. 6 minutes.

An effective physician should spend a minimum of 6 minutes withdrawing the scope from the cecum (start of the colon) to the anus in order to allow for adequate inspection. Physicians that spend less than 6 minutes are more likely to miss colon polyps.

7. 5 hours.

The split-dose regimen has been shown in multiple studies to be superior to non-split-dose regimen for bowel preparation. The superiority of the split-dose regimen is lost if the second dose is consumed more than 5 hours before the scheduled colonoscopy. The bowel cleansing agent should therefore be finished within 3 to 4 hours of scheduled colonoscopy. Read the 5hr rule study.

8. 25 percent.

An effective physician should detect precancerous polyps in at least 25% of average risk persons presenting for screening colonoscopy. This figure (25%) is for men and women.  For men, it should be 30% and for women, it should be 20%. According to a study published in the New England Journal of Medicine in 2014, each 1% increase in the adenoma detection rate was associated with a 3% decrease in colorectal cancer.

9. 95 percent.

An effective physician should be able to complete the colonoscopy (reach the cecum or the terminal ileum) in at least 95% of all screening colonoscopies.

10. < 1:1000.

An effective physician should have less than one in a thousand patients with a complication of perforation during screening colonoscopies.

To get the most out of colonoscopy, read the 3 P’s of colonoscopy: factors that determine the outcome of colonoscopy.

 

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Sneezing, runny nose and tearing after colonoscopy https://bowelprepguide.com/sneezing-running-nose/ https://bowelprepguide.com/sneezing-running-nose/#respond Mon, 14 Aug 2017 02:06:13 +0000 https://bowelprepguide.com/?p=6570   Sneezing, running nose and tearing after colonoscopy A study published in the Canadian Journal of Gastroenterology in 2011 confirmed that patients getting supplemental oxygen via nasal cannula during colonoscopy can develop symptoms of rhinitis. Symptoms of rhinitis include sneezing, rhinorrhea (runny nose), itchy nose, tearing. These symptoms only occur in about 3% of patients. […]

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sneezing and running nose after colonoscopy

 

Sneezing, running nose and tearing after colonoscopy

A study published in the Canadian Journal of Gastroenterology in 2011 confirmed that patients getting supplemental oxygen via nasal cannula during colonoscopy can develop symptoms of rhinitis. Symptoms of rhinitis include sneezing, rhinorrhea (runny nose), itchy nose, tearing.

These symptoms only occur in about 3% of patients.

The symptoms do not appear to be the related to seasonal allergies.

Symptoms can last a few days at times.

Treatment of these symptoms depends on the severity. For many, the symptoms will go away on their own. For some, treatment is necessary. Try humidifiers or saline nasal sprays first. Decongestants may help. Decongestants may be in tablet form like Sudafed or nasal spray like Afrin. Some people may benefit from an antihistamine nasal spray like Astelin or a steroid nasal spray like Flonase.

Over the counter antihistamines like Benadryl and Zyrtec do not seem to work well for this condition.

Rhinitis after colonoscopy is not life threatening and will eventually go away.

 

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Poop: Everything you wanted to know but too shy to ask https://bowelprepguide.com/everything-you-want-to-know-about-poop/ https://bowelprepguide.com/everything-you-want-to-know-about-poop/#respond Mon, 03 Jul 2017 05:33:21 +0000 https://bowelprepguide.com/?p=3131   Poop: Everything you wanted to know but too shy to ask Poop. We all do it. Poop is the end product of the digestive process. It is removed from the body through a bowel movement (defecation). It is mostly water, about 75%. The solid component, about 25% is composed of dead bacteria (30%), indigestible […]

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bowelprepguide.com answers your poop questions

 

Poop: Everything you wanted to know but too shy to ask

Poop. We all do it. Poop is the end product of the digestive process. It is removed from the body through a bowel movement (defecation). It is mostly water, about 75%. The solid component, about 25% is composed of dead bacteria (30%), indigestible fiber (30%), fat (20%), inorganic substances such as calcium phosphate and iron phosphate (10-20%), and protein (2-3%). Well formed poop is usually solid in consistency. It takes the shape of the colon and is often S-shaped. A well formed stool is denser than water and usually sinks to the bottom of the toilet. Loose stools tend to float more. Poop may float as a result of change in diet (e.g. high fat diet) that produces more gas, infection, or diseases can cause fat malabsorption like celiac disease or chronic pancreatitis. Some mucus in the poop is normal. It is abnormal if the amount is large, if it is persistent or if it is associated with other changes like blood in stool, diarrhea, fever, bloating or belly aches.

Poop never smells good. The bad smell comes from bacteria and gas associated with the breakdown of food.  Certain foods and medications can change the smell of poop. Persistently foul smelling poop can be due to serious conditions like infection, inflammatory bowel disease like ulcerative colitis or Crohn’s disease or malabsorption.

The brown color of poop comes from the action of bacteria on bilirubin. Diseases, food, and medications can change the color of poop. Black stool may be the result of bleeding from the stomach or intestine. Stomach acid turns red blood dark. This kind of poop is usually black and tarry.  Black poop can also be the due to use of iron tablets or bismuth containing substances such as PeptoBismuth®. Certain foods like licorice, grape juice and Oreo cookies can also turn poop black. Red poop can come from food and food colorings like beets, medications like Omnicef or a serious condition like bleeding from the gastrointestinal tract. Bleeding from the small intestine or proximal colon can lead to maroon-colored poop. Food, medications and rapid movement of food materials through the intestine that does not allow time for the action of bacteria on bilirubin can cause poop to be green. Food like milk only diet, medications like aluminum hydroxide and barium or diseases in which the bile flow is blocked can cause poop to be light gray or white.

No two individuals are the same when it comes to the frequency of poop. Frequency ranges from once in 3 days to 3 times a day. Most people poop once a day. Constipation has different meanings for different people but usually involves 2 or more of the following: straining when you poop, lumpy or hard stools, sensation of incomplete evacuation, sensation of blockage in the anus, manual maneuvers to aid pooping like digital evacuation, or fewer than 3 poops per week. Constipation can be idiopathic (unknown cause) or caused by medications, diseases like diabetes mellitus, multiple sclerosis, Parkinson disease, hypothyroidism, injuries like spinal cord injury, diseases that affect the gut, and cancer.

Diarrhea also has different meaning for different people but can be characterized by an increase in the volume or frequency of stool or a decrease in the consistency of stool (loose or watery). It can be acute (≤ 14 days in duration) or chronic (>30 days). It can be functional or secondary to other causes like infection, medications, inflammation. It can be bloody or non-bloody. Eating a wrong meal, eating too much or eating an exotic or unusual meal can give us acute diarrhea. This does not usually last long. Diarrhea can be caused by food poisoning, infections, inflammations, medications, toxins, cancer.

The Bristol stool chart is a useful tool to monitor your stool and detect changes in bowel habits (constipation or diarrhea).

Oily poop can be greasy or fatty. You may see oil droplets or skid mark in the toilet after flushing. The stool is also often foul smelling, pale, and bulky. The medical term for oily poop is steatorrhea. This can happen due to abnormal digestion (break down) and absorption of fat. Common causes of oily poop are chronic pancreatitis,  bile salt (detergent that helps remove fat) deficiency –cirrhosis, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), Crohn’s disease of the terminal ileum, terminal ileum resection, bacterial overgrowth; diseases of the small intestine like celiac disease, giardia infection, lymphoma.

The involuntary loss of stool is called fecal incontinence. It can be caused by aging, obesity, anal fistula, anal injuries, childbirth injuries, post-cholecystectomy syndrome, diabetes, stroke, and medications. Having diarrhea makes you prone to having fecal incontinence.

Pain with defecation or dyschezia can be due to a variety of conditions including anal fissure, hemorrhoids, proctalgia fugax, chronic proctalgia, proctitis, solitary rectal ulcer, anal cancer.

Poop is no longer a waste material. Poop is life.

The population of bacteria in our poop is a reflection of the population of microorganism in our gut. This population is called microbiota. Abnormal modification of this population is called Dysbiosis. Dysbiosis has been linked to several disease conditions like Clostridium difficile infection (C.diff), inflammatory bowel disease (ulcerative colitis or Crohn’s disease), irritable bowel disease, metabolic syndrome, obesity, behavioral disorders, to mention a few.

If bad poop cause diseases; can good poop heal diseases?

Stool transplant or Fecal microbiota transplantation (FMT) is a procedure in which stool or fecal material is collected from a healthy donor, processed, and then transplanted to a recipient.  Stool transplant is the most effective therapy for severe or recurrent Clostridium difficile colitis (C.diff).

Some studies have also shown FMT to induce remission in active ulcerative colitis. Multiple studies are ongoing.

Poop now exist in capsule form and may be available as a prescription soon.

So have you pooped today?  What was the consistency? The color? The shape? The effort to get it out? How did you feel afterwards?

For answers to all up your poop questions; click HERE

 

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How to spot a complication after colonoscopy https://bowelprepguide.com/spot-a-complication-after-colonoscopy/ https://bowelprepguide.com/spot-a-complication-after-colonoscopy/#respond Thu, 08 Jun 2017 01:43:33 +0000 https://bowelprepguide.com/?p=2325 How to spot a complication after colonoscopy Colonoscopy is a life saving procedure. Like most procedures, it comes with risks. These risks include bleeding, infection, and tear in the colon (perforation). These complications occur in less than one percent of patients.  Complications that occur during colonoscopy are usually addressed by your doctor. How can you spot a complication […]

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how to spot a complication after colonoscopy

How to spot a complication after colonoscopy

Colonoscopy is a life saving procedure. Like most procedures, it comes with risks. These risks include bleeding, infection, and tear in the colon (perforation). These complications occur in less than one percent of patients.  Complications that occur during colonoscopy are usually addressed by your doctor. How can you spot a complication after you have been discharged home from your colonoscopy?

  • Abdominal pain: You may have some abdominal cramps following a colonoscopy. This is often due to the air used to inflate the colon during the procedure. You should not hold unto any gas or flatus. You should pass gas as much as possible. If you have persistent abdominal pain or cramps or if your pain is getting worse, you should contact your doctor immediately. This may be a sign of perforation.

 

  • Fever: If you develop fever (temperature above 100.4 F) or chills after your colonoscopy, call your doctor. This may be a sign of infection.

 

  • Bleeding: A small amount of rectal bleeding may be seen after colonoscopy especially after a biopsy or removal of polyp. If rectal bleeding is severe (large amount) or persistent, you should contact your doctor immediately. This may be a sign of serious bleeding.

 

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Colonoscopy Prep Shopping List https://bowelprepguide.com/colonoscopy-prep-shopping-list/ https://bowelprepguide.com/colonoscopy-prep-shopping-list/#comments Tue, 30 May 2017 04:14:52 +0000 https://bowelprepguide.com/?p=2091 This colonoscopy prep shopping list provides a list of essential items for a successful colonoscopy.

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You’ve been scheduled for colonoscopy. It’s time to go shopping!

Like every great shopper, you need a list. Here is a list of items to shop for:

  1. Bowel cleansing agent. This is usually a prescription medication (Golytely, Suprep, Moviprep, Prepopik) or over the counter medication (Miralax plus Gatorade).  Often, your doctor also want you to use bisacodyl (Dulcolax). Dulcolax is available over the counter.
  2. Clear liquid diet. Most patients are told to be on a clear liquid diet a day before colonoscopy. Acceptable items that qualify as liquid diet include water, coffee without milk, tea without milk, lemonade from powdered mix, carbonated beverages and soda, clear juices such as apple and white grape, plain or flavored gelatin, sports drinks such as Gatorade® , All-Sports®, Powerade®; sorbet, popsicles, honey, sugar, hard candy, fat-free broth, bouillon or consommé.
  3. Flavors. You can add lemon juice, lemon slices or sugar free flavor enhancers like Crystal Light® to your bowel cleansing agents to improve the taste.
  4. Straws. Sipping is better than gulping; so get some straws.
  5. Sugar free menthol-candy. Suck on menthol candy (e.g. Halls menthol candy) during ingestion of the bowel prep solution. This has been shown in research to improve taste allowing patients to complete their bowel preparation.
  6. Wipes. Because you will be pooping quite a bit, use the softest toilet paper possible or adult wet wipes with aloe and vitamin E. You can also get medicated wipes like Tucks.
  7. Lube. To prevent or treat anal irritation and soreness as a result of diarrhea from the bowel cleansing agent, use Vaseline or Desitin. You can also use any cream or ointment for hemorrhoids.
  8. Ice. The bowel cleansing agent is better consumed cold. Chill the bowel cleansing liquid by putting it in a fridge or ice bucket. Do not put ice in the bowel cleansing agent itself.
  9. Alarm clock. Your doctor wants you to take your bowel cleansing agent at specific times. If you’re given the split dose regimen, you must take half of the bowel cleansing agent the evening before your colonoscopy (usually around 5:00-6:00PM) and the second half 4-5 hours before your scheduled colonoscopy. You should also arrive at the surgery center at a specific time and on time. An alarm clock will help you stay on track.  An alarm clock is often on your phone or wrist watch so you may not need to buy another one.
  10. Book, Magazine, Newspaper or DVD. To pass time during bowel preparation, get something to read or watch. Nowadays, our phone or ipad has everything we need to pass time.

Don’t be a poor prep. Good luck!

 

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Bowel Cleansing Regimen for Patients With Previous Inadequate Bowel Prep https://bowelprepguide.com/bowel-cleansing-regimen-for-patients-with-previous-inadequate-bowel-prep/ https://bowelprepguide.com/bowel-cleansing-regimen-for-patients-with-previous-inadequate-bowel-prep/#respond Mon, 29 May 2017 04:20:31 +0000 https://bowelprepguide.com/?p=1023 Up to 25% of all bowel preparations for colonoscopy are considered inadequate. What bowel cleansing regimen should be used for these patients with previous inadequate bowel preparation? In a study by Gimeno-Garcia et al published by the American Journal of Gastroenterology, patients with inadequate cleansing at index colonoscopy were randomized to 4-L split-dose polyethylene-glycol (PEG) […]

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Up to 25% of all bowel preparations for colonoscopy are considered inadequate. What bowel cleansing regimen should be used for these patients with previous inadequate bowel preparation? In a study by Gimeno-Garcia et al published by the American Journal of Gastroenterology, patients with inadequate cleansing at index colonoscopy were randomized to 4-L split-dose polyethylene-glycol (PEG) regimen vs. 2-L split-dose PEG plus ascorbic acid (PEG+Asc) regimen. All individuals underwent a 3-day low-residue diet and received 10 mg of bisacodyl, the day before colonoscopy. Cleansing was considered to be adequate if the Boston Bowel Preparation Scale scored≥2 at each colonic segment.

Adequate bowel cleansing was significantly higher in patients randomized to 4L PEG regimen vs. those randomized to 2L PEG+Asc regimen (81.1% vs. 67.4%).  There was no difference between the 2 groups on withdrawal time, polyp detection rate or adenoma detection rate.

This study is the first randomized study to examine bowel cleansing regimen in patients with previous inadequate bowel preparation.

How to use the regimen:

3 days before colonoscopy: Low residue (low fiber) diet

2 days before colonoscopy: Low residue (low fiber) diet

1 day before colonoscopy: Low residue (low fiber) diet

2 tablets of Bisacodyl (10mg)  at 19:00 hours

2 Liters of PEG-based agent (Colyte, Golytely, NuLYTELY, or TriLyte) at 20:00 hours

Day of colonoscopy: 2 Liters of PEG-based agent (Colyte, Golytely, NuLYTELY, or TriLyte)  4 hours before scheduled colonoscopy.

 

Reference: Gimeno-Garcia et al. Comparison of Two Intensive Bowel Cleansing Regimens in Patients With Previous Poor Bowel Preparation: A Randomized Controlled Study. Am J Gastroenterol advance online publication, 14 March 2017; doi: 10.1038/ajg.2017.53   .

 

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24 Ways to Prepare the Bowel for Colonoscopy https://bowelprepguide.com/24-ways-to-prepare-the-bowel-for-colonoscopy/ https://bowelprepguide.com/24-ways-to-prepare-the-bowel-for-colonoscopy/#respond Mon, 22 May 2017 02:15:42 +0000 https://bowelprepguide.com/?p=1263 There are 24 options for bowel preparation prior to colonoscopy. These options are based on available bowel cleansing agents on the market. The agents include Golytely, Nulytely, Trilyte, Colyte, Prepopik, Suprep, MoviPrep, Miralax, HalfLytely and OsmoPrep. They are all in liquid form except Osmoprep. Bisacodyl or Magnesium Citrate can be used in conjunction with some […]

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There are 24 options for bowel preparation prior to colonoscopy. These options are based on available bowel cleansing agents on the market. The agents include Golytely, Nulytely, Trilyte, Colyte, Prepopik, Suprep, MoviPrep, Miralax, HalfLytely and OsmoPrep. They are all in liquid form except Osmoprep. Bisacodyl or Magnesium Citrate can be used in conjunction with some of the bowel cleansing agents for enhanced purgative effect. Bisacodyl is often used because it comes in tablet form distinguishing it from the liquid form of the bowel cleansing agent.

Bowel Cleansing Agents Day-Before Regimen Split-Dose Regimen
Golytely/Nulytely/Trilyte/Colyte Yes Yes
Golytely/Nulytely/Trilyte/Colyte plus Bisacodyl Yes Yes
Prepopik Yes Yes
Prepopik plus Bisacodyl Yes Yes
Suprep Yes Yes
Suprep plus Bisacodyl Yes Yes
Moviprep Yes Yes
Moviprep plus Bisacodyl Yes Yes
Miralax and Gatorade Yes Yes
Miralax and Gatorade plus Bisacodyl Yes Yes
Halflytely Yes No
Osmoprep Yes Yes
2 day bowel prep regimen No Yes

 

Bowel cleansing agents can be consumed in 2 ways; as day-before or as split-dose.  In the day-before regimen, the bowel cleansing agent is completely consumed the day before colonoscopy. In the split-dose regimen, half of the bowel cleansing agent is consumed the day before colonoscopy and the remaining half is consumed on the day of colonoscopy, about 4-5 hours before the scheduled colonoscopy. The split-dose regimen has been shown in multiple studies to be the most effective way to prepare the bowel for colonoscopy. If bisacodyl is used in conjunction with a bowel cleansing agent, it is used before the bowel cleansing agent; usually about one hour before. The 2 day bowel prep is often used for a patient with prior inadequate bowel preparation and involve the use of bisacodyl and a large volume polyethylene-glycol (PEG) based bowel cleansing agent such as Golytely, Trilyte, Nulytely or Colyte in a split-dose fashion.

The 24 bowel preparation options are:

To see all the bowel preparation instructions, click here.

 

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Bowel Preparation Readiness Chart https://bowelprepguide.com/readiness-chart/ https://bowelprepguide.com/readiness-chart/#respond Tue, 16 May 2017 05:29:24 +0000 https://bowelprepguide.com/?p=1614  

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Low Fiber Diet for Colonoscopy https://bowelprepguide.com/low-fiber-diet-colonoscopy/ https://bowelprepguide.com/low-fiber-diet-colonoscopy/#respond Tue, 16 May 2017 02:23:40 +0000 https://bowelprepguide.com/?p=1601   Low fiber diet is low residue diet. Residue refers to undigested food or fibers that make up part of the stool. A low residue diet reduces the frequency and volume of stool while prolonging the time it takes food to travel the intestine. You should avoid the following food items: whole wheat breads, cereals, […]

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low fiber diet for colonoscopy

 

Low fiber diet is low residue diet.

Residue refers to undigested food or fibers that make up part of the stool. A low residue diet reduces the frequency and volume of stool while prolonging the time it takes food to travel the intestine.

You should avoid the following food items: whole wheat breads, cereals, crackers and rolls; whole wheat pasta, brown or wild rice; any item with nuts, seeds and fruits; buckwheat, granola, cornbread, pumpernickel bread; tough meat and meat items with skin; raw fruits, prunes and prune juice, berries, raisins and dried fruits; raw or partially cooked vegetables. You should also avoid milk and milk products.

If you are on a low residue diet, you may be allowed to have white bread, rolls and biscuits; white rice or noodles; plain crackers, potato rolls, skinless cooked potato; skinless chicken, skinless turkey, fish and other sea food; canned fruits without seeds or skin; eggs; vanilla wafers.

If you are on a low fiber diet, you can have a clear liquid diet.  Clear liquid diet excludes red and purple colored substances. Alcohol is also not allowed. Examples of clear liquid diet include water, tea, plain coffee, lemonade from powdered mix, carbonated beverages and soda, clear juices such as apple and white grape, plain or flavored gelatin, sports drinks such as Gatorade® , All-Sports®, Powerade®; sorbet, popsicles, honey, sugar, hard candy, fat-free broth, bouillon or consommé.

For a complete list of low fiber diet, read THIS.

 

 

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Clear Liquid Diet for Colonoscopy https://bowelprepguide.com/clear-liquid-diet-colonoscopy-2/ https://bowelprepguide.com/clear-liquid-diet-colonoscopy-2/#respond Tue, 16 May 2017 02:19:23 +0000 https://bowelprepguide.com/?p=1599   Clear liquid diet excludes red and purple colored substances. Alcohol is also not allowed. Examples of clear liquid diet include water, tea, plain coffee, lemonade from powdered mix, carbonated beverages and soda, clear juices such as apple and white grape, plain or flavored gelatin, sports drinks such as Gatorade® , All-Sports®, Powerade®; sorbet, popsicles, […]

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clear liquid diet for colonoscopy

 

Clear liquid diet excludes red and purple colored substances. Alcohol is also not allowed. Examples of clear liquid diet include water, tea, plain coffee, lemonade from powdered mix, carbonated beverages and soda, clear juices such as apple and white grape, plain or flavored gelatin, sports drinks such as Gatorade® , All-Sports®, Powerade®; sorbet, popsicles, honey, sugar, hard candy, fat-free broth, bouillon or consommé.

If you are on a clear liquid diet, you should also avoid low fiber diet. Therefore, you should avoid the following food items: whole wheat breads, cereals, crackers and rolls; whole wheat pasta, brown or wild rice; any item with nuts, seeds and fruits; buckwheat, granola, cornbread, pumpernickel bread; tough meat and meat items with skin; raw fruits, prunes and prune juice, berries, raisins and dried fruits; raw or partially cooked vegetables. You should also avoid milk and milk products.

For more information on clear liquid diet, read THIS.

 

 

 

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