BowelPrepGuide https://bowelprepguide.com Your guide to excellent bowel prep Thu, 18 Oct 2018 05:25:11 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.8 92279279 Heart failure colonoscopy prep https://bowelprepguide.com/heart-failure-colonoscopy-prep/ https://bowelprepguide.com/heart-failure-colonoscopy-prep/#respond Thu, 18 Oct 2018 03:31:46 +0000 https://bowelprepguide.com/?p=8005   Heart failure colonoscopy prep is the bowel prep for a patient with heart failure. People with heart failure are often on many medications like water pills and blood thinners.  These medications can affect bowel prep for colonoscopy. Patients with heart failure can safely have colonoscopy. What is heart failure? Health failure is a medical […]

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heart failure colonoscopy prep

 

Heart failure colonoscopy prep is the bowel prep for a patient with heart failure. People with heart failure are often on many medications like water pills and blood thinners.  These medications can affect bowel prep for colonoscopy. Patients with heart failure can safely have colonoscopy.

What is heart failure?

Health failure is a medical condition in which the heart cannot pump enough blood to meet the needs of the body. It can affect both sides or just one side of the heart. Heart failure does not mean the heart has stopped working. Patients with heart failure have a variety of symptoms. These include swollen legs, difficulty breathing, cough, fatigue, dizziness and irregular heart beats.

What are the stages of heart failure

There are different stages of heart failure. For more information on the stages of heart failure, click HERE.

Who should not be prepped for colonoscopy

  • Patients with hypersensitivity to any of the ingredients of the the bowel cleansing agent.
  • Those with a gastrointestinal obstruction that will prevent passage of liquid into the intestine.
  • Patients with an ileus.
  • Unconscious patients. In some instances, bowel cleansing agent can be given through a nasogastric tube.
  • Inability to swallow. In certain cases, bowel cleansing agent can be given through a nasogastric tube.
  • Patients with toxic colitis or toxic megacolon.

Common side effects of bowel prep

  • Nausea.
  • Abdominal distention.
  • Dehydration.
  • Abdominal cramps.
  • Low blood volume.
  • Lightheadedness.
  • Dizziness.
  • Abnormal electrolytes like low potassium, low sodium, low magnesium and low chloride.

 

Which bowel cleansing agents should be avoided by people with heart failure?

Oral sodium phosphate should be avoided in patients with heart failure. Examples of oral sodium phosphate drugs are VisicolOsmoprep, and Fleet Phospho Soda. Some patients with heart failure also have kidney failure. Also, these medications should be avoided in patients with kidney failure. Read kidney failure colonoscopy prep.

In 2006, the US Food and Drug Administration (FDA) issued a warning regarding oral sodium phosphate use in high risk patients. These patients include those with kidney disease, liver disease, heart failure, high blood calcium, and elderly patients over the age of 55. Also included are patients taking certain medications like NSAIDS, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and diuretics.

Polyethylene glycol (PEG) based bowel cleansing agents such as Golytely, Nulytely, Trilyte, and Colyte are preferred in patients with heart failure. Suprep, Clenpiq and Prepopik can also be used.

All bowel cleansing agents have the potential to cause arrhythmia because of changes in electrolytes . Having heart failure does not mean you should not stay hydrated during the bowel prep process.

How to do heart failure colonoscopy prep

Suggested Reading

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Kidney failure colonoscopy prep https://bowelprepguide.com/kidney-failure-colonoscopy-prep/ https://bowelprepguide.com/kidney-failure-colonoscopy-prep/#respond Tue, 09 Oct 2018 14:00:54 +0000 https://bowelprepguide.com/?p=8003   Kidney failure colonoscopy prep is the bowel prep for a patient with kidney failure. There are different stages of chronic kidney disease. The most advanced stage is stage 5 in which the patient rely on dialysis to live. Patients with kidney failure can have colonoscopy. What is kidney failure? Kidney failure is the most […]

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kidney failure colonoscopy prep

Kidney failure colonoscopy prep is the bowel prep for a patient with kidney failure. There are different stages of chronic kidney disease. The most advanced stage is stage 5 in which the patient rely on dialysis to live. Patients with kidney failure can have colonoscopy.

What is kidney failure?

Kidney failure is the most serious form of kidney disease in which a person cannot live without dialysis or kidney transplant. There are 2 types of dialysis-hemodialysis and peritoneal dialysis.

What are the stages of kidney failure

The stages are based on estimated glomerular filtration rate or eGFR.

  • 1 with normal or high eGFR (eGFR > 90 mL/min)
  •  2 Mild kidney disease (eGFR = 60-89 mL/min)
  • 3A Moderate kidney disease (eGFR = 45-59 mL/min)
  •  3B Moderate kidney disease (eGFR = 30-44 mL/min)
  • 4 Severe kidney disease (eGFR = 15-29 mL/min)
  •  5 End Stage kidney disease (eGFR <15 mL/min). People with stage 5 kidney failure need dialysis to live.

Who should not be prepped for colonoscopy

  • Patients with hypersensitivity to any of the ingredients of the the bowel cleansing agent.
  • Those with a gastrointestinal obstruction that will prevent passage of liquid into the intestine.
  • Patients with an ileus.
  • Unconscious patients. In some instances, bowel cleansing agent can be given through a nasogastric tube.
  • Inability to swallow. In certain cases, bowel cleansing agent can be given through a nasogastric tube.
  • Patients with toxic colitis or toxic megacolon.

Common side effects of bowel prep

  • Nausea.
  • Abdominal distention.
  • Dehydration.
  • Abdominal cramps.
  • Low blood volume.
  • Lightheadedness.
  • Dizziness.
  • Abnormal electrolytes like low potassium, low sodium, low magnesium and low chloride.

 

Which bowel cleansing agents should be avoided by people with kidney disease?

Oral sodium phosphate should be avoided in patients with chronic kidney disease. Patients with chronic kidney disease are more likely to develop acute phosphate nephropathy after using oral sodium phosphate.

In 2006, the US Food and Drug Administration (FDA) issued a warning regarding oral sodium phosphate use in high risk patients. These patients include those with kidney disease, liver disease, heart failure, high blood calcium, and elderly patients over the age of 55. It also include patients taking certain medications like NSAIDS, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and diuretics.

In 2008, another warning was issued by the FDA. It required a black box warning for oral sodium phosphate drugs like Visicol and Osmoprep. Osmoprep appears to be better tolerated than Visicol. Also, the FDA warned against the use of Fleet Phospho Soda for bowel cleansing prior to colonoscopy.

Polyethylene glycol (PEG) based bowel cleansing agents such as Golytely, Nulytely, Trilyte, and Colyte are preferred in patients with chronic kidney disease. Manufacturers advised caution with use of Suprep, Clenpiq and Prepopik in patients with kidney disease.

All bowel cleansing agents have the potential to cause kidney failure because of diarrhea and changes in electrolytes. Having kidney disease does not mean you should not stay hydrated.

How to do kidney failure colonoscopy prep

Suggested Reading

 

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Consent for colonoscopy. The informed patient. https://bowelprepguide.com/consent-for-colonoscopy/ https://bowelprepguide.com/consent-for-colonoscopy/#respond Sun, 30 Sep 2018 02:34:54 +0000 https://bowelprepguide.com/?p=7900   Consent for colonoscopy is a precondition for colonoscopy. Several issues surround the idea of consent for colonoscopy. It is a legal requirement based on the principles of autonomy and self determination. Every person has the right to determine if they want a procedure such as colonoscopy or not. What is informed consent?  This is […]

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consent for colonoscopy

 

Consent for colonoscopy is a precondition for colonoscopy. Several issues surround the idea of consent for colonoscopy. It is a legal requirement based on the principles of autonomy and self determination. Every person has the right to determine if they want a procedure such as colonoscopy or not.

What is informed consent? 

This is a legal requirement for a physician to disclose relevant information to a patient in a way and manner that allows the patient to understand, evaluate, and authorize a specific surgical or medical intervention.

What should be disclosed during informed consent? 

  • The patient’s medical problems, diagnosis, and test results.
  • Nature of colonoscopy.
  • The reason for the colonoscopy.
  • Benefits of colonoscopy.
  • The risks of colonoscopy.
  • Alternatives to colonoscopy
  • The patient’s prognosis if colonoscopy is declined.

Risks and complications of colonoscopy

Common risks and complications

  • Adverse effects of medications given for sedation. 
  • Redness, pain or bruising at the injection site.
  • Mild abdominal pains and discomfort.
  • Nausea and vomiting.
  • Lightheadedness and dizziness.
  • Headaches.
  • Muscle aches and pains.

Uncommon risks and complications

  • Fewer than 1 in every 1,000 person accidentally get a hole in the colon. This is called perforation. If detected at the time of colonoscopy, it can be repaired without the need for surgery. Surgery may be needed to repair the perforation. A colostomy may be needed.
  • Less than 1 in every 1000 person experience a significant bleeding. This is usually from a site where a polyp is removed. Bleeding can occur up to 2 weeks after the colonoscopy. The bleeding may stop on its own, require blood transfusion or another colonoscopy to stop the bleeding.
  • Inability to see the entire colon. This may be due to inadequate bowel prep, a tortuous colon, a redundant colon or a blockage.
  • Difficulty breathing.
  • Pneumonia from aspiration.
  • Low blood pressure requiring intervention.
  • Abnormal heart rhythm.
  • Heart attack.
  • A polyp or lesion may be missed. Small polyps may be missed 5-10 percent of the time.
  • Sneezing and runny nose. 

Rare risks and complications

  • Anaphylaxis to medications used during the colonoscopy.
  • Infection such as bacteria in the blood stream. An antibiotic can be used to treat the infection.
  • Spleen rupture.
  • Stroke.
  • Death. This is very rare.

Who should obtain the informed consent?

  • The physician performing the colonoscopy.
  • Members of the health care team can help with the process.

Who should sign the consent form 

  • The patient, designated family member or the patient’s healthcare power of attorney.

Consent for colonoscopy in a emergency situation

  • In a life threatening situation, if there is not enough time to obtain consent from the patient or a family member, an informed consent can be forgone.
  • The emergency must be properly documented and other members of the healthcare team should agree with the decision.

Consent for colonoscopy in an incompetent person 

  • Consent can be obtained from a parent, adult child, legal guardian or surrogate.

 

Consent for colonoscopy is an integral aspect of colonoscopy. Colonoscopy saves lives. Know the risks and benefits. Read factors that determine the outcome of a colonoscopy. 

Suggested Reading

 

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How to do same day bowel prep for colonoscopy https://bowelprepguide.com/same-day-bowel-prep-for-colonoscopy/ https://bowelprepguide.com/same-day-bowel-prep-for-colonoscopy/#respond Thu, 20 Sep 2018 02:52:04 +0000 https://bowelprepguide.com/?p=7870 Same day bowel prep means using the entire bowel cleansing agent on the same day as your colonoscopy. There are 3 ways to take your bowel cleansing agent prior to colonoscopy: the day-before regimen, the split-dose regimen, and the same-day regimen. The same day bowel regimen is the same day bowel prep. The same day […]

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same day bowel prep for colonoscopy

Same day bowel prep means using the entire bowel cleansing agent on the same day as your colonoscopy. There are 3 ways to take your bowel cleansing agent prior to colonoscopy: the day-before regimen, the split-dose regimen, and the same-day regimen. The same day bowel regimen is the same day bowel prep.

The same day regimen is a relatively new method designed for afternoon colonoscopies. In the same-day regimen, the bowel cleansing agent is used in the morning of the colonoscopy. Same day prep has been found to be as effective as split-dose regimen for afternoon colonoscopies.

Video on how to use bowel cleansing agents 

 

How do I eat for the same day bowel prep

Most gastroenterologists recommend a low fiber diet 3 days before colonoscopy and a clear liquid diet a day before colonoscopy. So for same day bowel prep, you will need to be on clear liquid diet 24 hours before the colonoscopy. You may have a low fiber diet for breakfast the day before your colonoscopy. Thereafter, you will be on a clear liquid diet.

How to use your bowel cleansing agents for same day prep

  • Divide whatever agent you are given into two halves or portions.
  • If you are prescribed an over the counter laxative like magnesium citrate or dulcolax in addition to your bowel cleansing agent, use this 1 hour before your bowel cleansing agent.
  • Take the first half of your bowel cleansing agent 7 hours before your scheduled colonoscopy.
  • Take the 2nd half of your bowel cleansing agent 4 hours before your scheduled colonoscopy.
  • You can have clear liquids in between your bowel cleansing agent.
  • Do not drink anything 2 hours before your colonoscopy.

How to use Golytely, Trilyte, Colyte, Nulytely for same day bowel prep

  • Mix your bowel prep agent with water as instructed in the package label.
  • Refrigerate to chill.
  • Starting 7 hours before your colonoscopy, Drink the 1st half of the bowel prep agent at a rate of 8oz every 10-15 minutes until 2 Liters is completed.
  • Starting 4 hours before your colonoscopy, Drink the 2nd half of the bowel prep agent (2 Liters). Drink at a rate of 8oz every 10-15 minutes until finished. Be sure to finish 2 hrs before your scheduled colonoscopy.

How to use Osmoprep for same day bowel prep

  • Starting 7 hours before your colonoscopy, take 20 tablets of OsmoPrep with 40 oz of water.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • Starting 4 hours before your colonoscopy, take 12 tablets of OsmoPrep with 24 oz of water.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • Do not drink anything 2 hours before your colonoscopy.

How to use Suprep for same day bowel prep

  • Pour the contents of one bottle of SUPREP Bowel Prep Kit into the mixing container provided.
  • Fill the container with water to the 16 ounce fill line, and drink the entire amount 7 hours before your colonoscopy.
  • Drink two additional containers filled to the 16 ounce line with water over the next hour.
  • Pour the contents of the second bottle of SUPREP Bowel Prep Kit into the mixing container provided. Fill the container with water to the 16 ounce fill line, and drink the entire amount 4 hours before your colonoscopy.
  • Drink two additional containers filled to the 16 ounce line with water over the next hour.
  • Do not drink anything 2 hours before your colonoscopy.

How to use Gatorade and Miralax for same day bowel prep

  • Mix 255 g of MiraLax with 64 oz of low-calorie Gatorade
  • Drink 32 oz of the solution at a rate of 8 oz every 10 min starting 7 hours before your colonoscopy.
  • Drink the remaining 32 oz of solution starting 4 hours before your colonoscopy procedure at a rate of 8 oz every 10 min.
  • Do not drink anything 2 hours before your colonoscopy.

How to use MoviPrep for same day bowel prep

  • Empty the contents of 1 pouch A and 1 pouch B into the container that comes with MoviPrep.
  • Add lukewarm water to the Fill line on the container.
  • Mix to completely dissolve the contents of pouch A and B into the lukewarm water.
  • Starting 7 hours before your colonoscopy, drink one 8 oz. (ounce) glass (240 mL) every 15 minutes. Be sure to drink all of the solution.
  • Repeat the mixing instructions.
  • Fill the container with 16 oz. (two 8 oz. glasses) of clear liquid and drink all of this liquid 4 hours before the scheduled colonoscopy.
  • Continue to drink clear liquids.
  • Do not drink anything 2 hours before your colonoscopy.

How to use Prepopik for same day bowel prep

  • Prepopik is supplied as two packets of powder.
  • The first packet is dissolved in 5 oz of cold water. Drink this 7 hours before your colonoscopy. Then, drink five 8oz cups of clear liquid.
  • Four hours before your colonoscopy, dissolve the second packet in 5 oz of cold water and drink. Then, drink at least three 8oz cups of clear liquid.
  • Do not drink anything 2 hours before your colonoscopy.

How to use Clenpiq for same day bowel prep

  • Take the first dose (1 bottle) of CLENPIQ 7 hours before your colonoscopy.
  • Follow CLENPIQ by drinking five 8-ounce cups (cup provided) of clear liquids (40 ounces total).
  • Take the second dose (the second bottle) of CLENPIQ 4 hours before your colonoscopy.
  • Following the CLENPIQ dose, drink at least three 8-ounce cups (cup provided) of clear liquids (24 ounces).
  • Do not drink anything 2 hours before your colonoscopy.

How to use Plenvu for same day bowel prep

  • Take the first dose of Plenvu 7 hours before your colonoscopy.
  • Open the carton and remove the dose 1 sachet.
  • Pour the contents of dose 1 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 1 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • Take the second dose of Plenvu 4 hours before your colonoscopy.
  • Pour the contents of dose 2 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 2 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • Avoid further fluid intake 2 hours before your colonoscopy.

 

Suggested Reading

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Do I go to sleep during colonoscopy? https://bowelprepguide.com/sleep-during-colonoscopy/ https://bowelprepguide.com/sleep-during-colonoscopy/#respond Sun, 16 Sep 2018 17:11:47 +0000 https://bowelprepguide.com/?p=7463 Colonoscopy is the most effective way to screen for colorectal cancer. It is also the best to way to diagnose diseases of the colon. After questions regarding bowel prep, people often have questions regarding sedation during colonoscopy.  Do I go to sleep during colonoscopy? Is colonoscopy painful? What medications are used for sedation during colonoscopy? […]

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sleep during colonoscopy

Colonoscopy is the most effective way to screen for colorectal cancer. It is also the best to way to diagnose diseases of the colon. After questions regarding bowel prep, people often have questions regarding sedation during colonoscopy.  Do I go to sleep during colonoscopy? Is colonoscopy painful? What medications are used for sedation during colonoscopy? What are the adverse events related to sedation in colonoscopy?

 

Types of sedation

  • Minimal sedation. This is a drug-induced state in which patients can still respond to verbal commands.
  • Moderate sedation. This is also known as conscious sedation or “Twilight sedation.” It is a drug-induced depression of consciousness in which patients can respond to tactile stimulation.
  • Deep sedation. This is a drug-induced depression of consciousness in which patients cannot be easily aroused though they may respond to painful stimuli.
  • General anesthesia. This is a drug-induced depression of consciousness in which the patient is not arousable even with painful stimuli. With general anesthesia, patients need assistance maintaining their airway. An anesthesiologist helps the patients breathe.

Sedation is a continuum. It is difficult to predict how patients will respond to sedatives. Patients may slip into any level of sedation at anytime. Some patients may sleep through a colonoscopy with medications used for minimal or moderate sedation.

 

What is MAC sedation or anesthesia? 

  • MAC stands for monitored anesthesia care. It is a specific service in which an anesthesiologist has been requested to perform sedation for a patient undergoing a procedure like colonoscopy.
  • Having an anesthesiologist administer anesthesia instead of the gastroenterologist increase the overall cost of colonoscopy. An anesthesiologist is however necessary for certain colonoscopies.

 

Do I go to sleep during colonoscopy?

It depends. You can choose to be awake or asleep during colonoscopy. Because colonoscopy can be done without sedation, you can choose to watch your own colonoscopy. If you want to be asleep during colonoscopy, there are 2 main ways to achieve this.

You can choose moderate sedation or deep sedation.  With moderate sedation, patients are usually arousable at all times. This means they can be woken up if necessary. You may wake up during the procedure. This is not necessarily a bad thing because it alerts your physician to your discomfort so they can change their technique or give you more medications.

Moderate sedation is achieved with use of fentanyl and midazolam. Sometimes benadryl is also added. Deep sedation is achieved with use of propofol. In many places, an anesthesiologist or a nurse anesthetist administers the propofol.

Rarely is general anesthesia used for colonoscopy.

 

What medications are used for sedation during colonoscopy?

  • Several medications are available for sedation in the U.S. These include midazolam (versed), diazepam (valium), diphenhydramine (benadryl), promethazine (phenergan), meperidine (demerol), fentanyl, and propofol.
  • Midazolam and propofol are the most commonly used sedatives. Fentanyl is the most commonly used analgesic.
  • Propofol can be used alone whereas midazolam is often used in combination with fentanyl and benadryl.
  • Benadryl potentiates the effect of midazolam and fentanyl. It is particularly useful in patients that are difficult to sedate.

 

What are the adverse effects of sedatives during colonoscopy?

  • Some adverse effects are universal. These include drowsiness and impaired cognition for up to 24 hours after the procedure. This is the reason you need a an adult person to drive you home and why you should take the entire day off from work.
  • These medications can cause respiratory depression meaning your breathing may slow down. To prevent  this complication, you are given oxygen during the procedure. Also, you are monitored throughout the procedure. In addition, the medications are given a little at a time to gauge your response.
  • Midazolam can cause retrograde amnesia which is not bad for the procedure itself. It can also cause nasal itching and hiccups.
  • All drugs may cause adverse reactions. Life threatening reactions are rare.

 

How to make patients comfortable during colonoscopy without medication

  • Use water instead of air to inflate the colon. Room air causes abdominal cramps and bloating.
  • Inflate the colon with carbon dioxide (C02) instead of room air. Carbon-dioxide can be absorbed by the body and therefore less likely to cause abdominal distention, abdominal cramps and perforation.
  • Use a pediatric colonoscope instead of adult colonoscope for certain patients. Petite people as well as those with diverticulosis and known stricture may benefit from a smaller pediatric colonoscope.
  • Play a soft music. Music has been shown in some studies to reduce discomfort during colonoscopy.
  • Talk to patients. For patients that elect no sedation or minimal sedation, you can talk to them if they are awake. You can give a commentary of what you’re seeing on the screen.

 

Suggested Reading 

 

 

 

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The best way to prep for colonoscopy https://bowelprepguide.com/prep-for-colonoscopy/ https://bowelprepguide.com/prep-for-colonoscopy/#respond Mon, 03 Sep 2018 22:50:32 +0000 http://bowelprepguide.com/?p=709   Colonoscopy is a procedure that utilizes a flexible tube with light and camera at the end to look at the inner lining of a person’s large intestine (colon). It can be used to diagnose and treat diseases of the colon. It is the gold standard for screening for colorectal cancer because it is the […]

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prep for colonoscopy

 

Colonoscopy is a procedure that utilizes a flexible tube with light and camera at the end to look at the inner lining of a person’s large intestine (colon). It can be used to diagnose and treat diseases of the colon. It is the gold standard for screening for colorectal cancer because it is the only test that gives us the ability to remove precancerous polyps. Colon cancer usually grow from colon polyps. 

People hate colonoscopy for all kinds of reasons. Most people are not bothered by colonoscopy itself but the prep is unpleasant for many. You should do away with all the myths about bowel prep, colonoscopy and colon cancer.

What is the best way to prep for colonoscopy?

 

Discuss all your medications and health conditions with your provider

Know what medications to adjust or stop prior to your colonoscopy. Medications such as those for diabetes and high blood pressure may affect your stability for the procedure. Blood thinners may cause you to bleed during or after colonoscopy. Read medications and food to stop before colonoscopy. If your are diabetic and on insulin, special instructions are needed.

Schedule an appointment for your colonoscopy

Pick a date and time that is suitable for you. If you’re diabetic, pick an early appointment. Be sure to take the day off from work. Do not schedule another procedure or test after your colonoscopy.

Obtain a prescription for your bowel cleansing agent and go shopping

Several medications are available for bowel cleansing prior to colonoscopy. These include Golytely, Nulytely, Trilyte, Colyte, OsmoprepSuprep, Moviprep, Miralax-Gatorade, Prepopik, Clenpiq, Plenvu.   Pick up your bowel cleansing agent. Shop for bowel prep essentials like soft toilet tissue or baby wipes, artificial flavors, menthol candies, straws, and diaper rash cream. Read 10 tips for making colonoscopy preparation more tolerable.

Arrange for an adult to take you home from your colonoscopy

Make sure you have a responsible adult to take you home from your procedure. Most people require sedation for colonoscopy. Even though you’re recovered at the surgery center and you’re awake, driving is not recommended.

Follow the diet instructions given to you by your physician

Diet instructions differ based on your health conditions and risk for inadequate bowel preparation. In general, you should be on a low fiber diet 3 days before your colonoscopy. Most people are placed on a clear liquid diet a day before their colonoscopy.

Use the bowel cleansing agents as instructed

There are 3 ways to take your bowel cleansing agent: the day-before regimen, the split-dose regimen, and the same-day regimen.

In the day before regimen, the entire bowel cleansing agent is used the evening before the colonoscopy.

In the split-dose regimen, half the total dose of the bowel cleansing agent is used the evening before your colonoscopy and the 2nd half is used 4-5 hours before your colonoscopy. Split dosing leads to better colon cleansing and improved detection of polyps.

In the same-day regimen, the bowel cleansing agent is used in the morning of the colonoscopy. This can only be used for patients scheduled for afternoon colonoscopy.

Regardless of the regimen given to you by your physician, be sure to finish the entire bowel cleansing agent.

Drink plenty of fluids

Most people don’t do this enough. You need to drink plenty of fluids to stay hydrated. Fluids also help with your bowel cleansing by softening your stools and moving things along. Not drinking enough fluids may cause electrolyte imbalance and kidney failure.

Check your bowel readiness for colonoscopy

How can you tell if your colon is clean and ready for colonoscopy? Your last rectal effluent (stool after finishing your bowel prep agent) can act as a guide. Your stool should be clear, yellow, light and liquid. The presence of dark particles or thick brown or black stool means you are not ready for colonoscopy.

If your stool is not clear after taking your entire bowel prep agent, you may need additional prep agent. Therefore, contact your physician if your stool is still brown or has dark particles hours after finishing your bowel cleansing agent.

Wear comfortable clothes for your colonoscopy appointment

Your colonoscopy is not the time to dress formally or wear your Sunday best. Wear loose fitting and comfortable clothes. Avoid tight fitting garments, girdles, and pantyhose. You will change to a gown given by the hospital or surgery center. Leave your expensive jewelries at home. Do not bring any valuables to your colonoscopy.

Show up on time for your scheduled colonoscopy

Do not arrive late for your procedure. Arrive at the time you’re instructed to come. This may be 30 minutes to 1 hour before your actual procedure. Time is needed to get you ready for the procedure. You need to have an IV line inserted. There are forms to be signed and you need to change to a gown for the procedure.

Don’t be a poor prep and Good luck!

 

 

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Split Dosing for Bowel Preparation Agents https://bowelprepguide.com/split-dosing-dosages-for-bowel-preparation-agents/ Sat, 01 Sep 2018 21:00:06 +0000 http://bowelprepguide.com/?p=117 The split-dose regimen has been shown in multiple studies to be better than the day-before regimen for morning colonoscopies. Split dosing is associated with increased patient’s acceptance, tolerability and compliance. It leads to better bowel preparation. Almost all bowel preparation agent or purgative can be split-dosed. This table shows the different bowel prep agents, main […]

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split dosing of bowel prep agents for colonoscopy

The split-dose regimen has been shown in multiple studies to be better than the day-before regimen for morning colonoscopies. Split dosing is associated with increased patient’s acceptance, tolerability and compliance. It leads to better bowel preparation. Almost all bowel preparation agent or purgative can be split-dosed. This table shows the different bowel prep agents, main ingredients, the evening before the colonoscopy dose, the morning of the colonoscopy dose, and the total volume.

AgentIngredientsEvening VolumeMorning VolumeTotal Volume
Plenvu (Salix)PEG 3350 ES0.5L solution
16.9oz
0.5L solution
16.9oz
1L
33.8oz
Colyte (Alaven)PEG 3350 ES2L solution
67.6oz
2L solution
67.6oz
4L
135oz
GoLYTELY (Braintree) PEG 3350 ES2L solution
67.6oz
2L solution
67.6oz
4L
135oz
NuLYTELY (Braintree) PEG 3350 ES2L solution
67.6oz
2L solution
67.6oz
4L
135oz
TriLyte (Alaven) PEG 3350 ES2L solution
67.6oz
2L solution
67.6oz
4L
135oz
HalfLytely (Braintree) PEG 3350 ES,
Bisacodyl
One 5mg Bisacodyl with sip of water
2L solution
None67.6oz
MoviPrep (Salix)PEG, Na sulfate, NaCL, KCL, Na ascorbate, ascorbic acid33.8oz (MoviPrep powder + 1L water)
16oz water
49.8oz
33.8oz (MoviPrep powder + 1L water)
16oz water
49.8oz
99.6oz
SUPREP (Braintree)Na sulfate, K sulfate, Mg sulfate16oz (6oz Suprep powder + 10oz water)
32oz water
48oz
16oz (6oz Suprep powder + 10oz water)
32oz water
48oz
96oz
OsmoPrep (Salix) Na phosphate tablets20 tablets
40oz water
40oz water
12 tabs
24oz water
24oz water
64oz water
Visicol (Salix) Na phosphate tablets20 tablets
56 oz water
56 oz
20 tablets
56 oz water
56 oz
112oz water
Prepopik (Ferring)Na Picosulfate, Mg oxide, citric acid5oz Prepopik solution
40oz water
45oz
5oz Prepopik solution
24oz water
29 oz
74oz
CLENPIQ (Ferring)Na Picosulfate, Mg oxide, citric acid5.4oz CLENPIQ solution
5.4oz
5.4oz CLENPIQ solution
5.4 oz
10.8oz
Miralax (Bayer) with GatoradePEG119g PEG 3350 powder
32oz Gatorade
32oz
119g PEG 3350 powder
32oz Gatorade
32oz
64oz

How to do the split dosing

  • Do not consume the entire bowel cleansing agent at once or on the same day.
  • Take half the total dose of the bowel cleansing agent the evening before your colonoscopy. This is usually between 5:00-7:00 PM.
  • Continue to consume clear liquid diet after the first dose of the bowel cleansing agent.
  • Take the second half of your bowel cleansing agent on the day of your colonoscopy, about 4-5 hours before your scheduled colonoscopy.
  • Do not consume anything at least 2 hours before your colonoscopy.

 

Video on how to use bowel cleansing agents

 

 

Suggested Reading

How to use your bowel cleansing agents for colonoscopy. 

Medications and foods to stop before colonoscopy.

How to tell if your bowel is clean prior to colonoscopy. 

 

 

 

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BowelPrepGuide wins 1st SCOPY awards and more https://bowelprepguide.com/awards/ https://bowelprepguide.com/awards/#respond Sat, 01 Sep 2018 04:46:45 +0000 https://bowelprepguide.com/?p=7798 The American College of Gastroenterology initiated a new awards program in 2015 for the purpose of recognizing “the achievements of our members in their community engagement, education and awareness efforts for colorectal cancer.” The awards program is called SCOPY awards. SCOPY stands for Service Award for Colorectal Cancer Outreach, Prevention & Year-Round Excellence. BowelPrepGuide.com won the 2015 award […]

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BowelPrepGuide.com wins 1st SCOPY awardsThe American College of Gastroenterology initiated a new awards program in 2015 for the purpose of recognizing “the achievements of our members in their community engagement, education and awareness efforts for colorectal cancer.”

The awards program is called SCOPY awards. SCOPY stands for Service Award for Colorectal Cancer Outreach, Prevention & Year-Round Excellence.

BowelPrepGuide.com won the 2015 award for Best Patient Education Brochure, Flyer or Website. The website provides bowel preparation resources to patients and providers. It is the guide to excellent bowel prep.

2016

In 2016, Adewale Ajumobi, MD -the founder and editor of BowelPrepGuide won the SCOPY award for Best Infographic from a Private GI Practice.  This award was for Clear Liquid Diet for Colonoscopy Infographic via bowelprepguide.com.

clear liquid diet infographic

2017

In 2017, Adewale Ajumobi, MD -the founder and editor of BowelPrepGuide won the SCOPY award for Best Spanish Language Video. The award was for  Spanish language version of “Colonoscopy: What to Expect.”

 

 

 

 

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Distended. How to manage gas and bloating https://bowelprepguide.com/bloating/ https://bowelprepguide.com/bloating/#respond Tue, 21 Aug 2018 05:01:36 +0000 https://bowelprepguide.com/?p=7688 Bloating is a sensation of increased abdominal pressure with or without visible abdominal distention.  Feeling distended is common. It affects 16% to 19% of people. Only half the people that complain of bloating actually have abdominal distention when examined by a doctor. What causes bloating Aerophagia. This is excessive air swallowing. Aerophagia can be caused […]

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Distended. How to investigate and manage bloating

Bloating is a sensation of increased abdominal pressure with or without visible abdominal distention.  Feeling distended is common. It affects 16% to 19% of people. Only half the people that complain of bloating actually have abdominal distention when examined by a doctor.

What causes bloating

  • Aerophagia. This is excessive air swallowing. Aerophagia can be caused by fast eating, carbonated drinks, poorly fitting dentures, CPAP mask, and psychological disorders.
  • Gastroparesis. This is a stomach that is slow to empty.
  • Functional dyspepsia.
  • Gastrointestinal blockage.
  • Chronic constipation.
  • Irritable bowel syndrome.
  • Celiac disease.
  • Small intestinal bacterial overgrowth.
  • Inflammatory bowel disease (ulcerative colitis, crohn’s disease).
  • Certain foods.
  • Medications.
  • Pseudo-bloat or false bloat caused by ascites (fluid in the abdomen), abdominal fat, or pregnancy.

How to investigate bloating

  • Careful history and physical examination by your doctor.
  • Complete blood count.
  • Complete metabolic panel.
  • Blood sugar and hemoglobin A1C to test for diabetes mellitus.
  • Thyroid function tests.
  • Celiac serologies to test for celiac disease.
  • Helicobacter pylori testing.
  • Abdominal imaging studies like ultrasound and CT scan.
  • Upper endoscopy. Also known as esophagogastroduodenoscopy (EGD).
  • Gastric emptying study.
  • Smart pill motility study.
  • Hydrogen breath test.
  • Colonoscopy.
  • Enterography.
  • Anorectal manometry.
  • Tests are usually selected based on your history and examination. You do not necessarily need all of these tests.

 

How to treat bloating 

Since bloating is caused by several conditions, treatment is usually specific to the cause of the problem.

  • Avoid foods that are high in fermentable carbohydrates like wheat, beans, apples, pears, watermelon, onions, garlic, broccoli, artichokes, cauliflower, cabbage.
  • Stay away from high fiber diets.
  • Avoid carbonated drinks.
  • Stay away from chewing gums.
  • Eat slowly.
  • Properly fit your dentures and CPAP mask.
  • Try the Belly Bio App. 
  • See a gastroenterologist.

 

Suggested Reading

 

 

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Is coffee a clear liquid diet for colonoscopy https://bowelprepguide.com/is-coffee-a-clear-liquid/ https://bowelprepguide.com/is-coffee-a-clear-liquid/#respond Sun, 29 Jul 2018 03:05:03 +0000 https://bowelprepguide.com/?p=7704   Coffee is the most popular beverage in America. Worldwide, about 1 billion people drink this beverage every day. People love coffee for different reasons. For some, it is the boost in brain power and energy they get from the drink. For others, it is the social interactions often associated with the beverage. Whatever the […]

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is coffee a clear liquid diet

 

Coffee is the most popular beverage in America. Worldwide, about 1 billion people drink this beverage every day. People love coffee for different reasons. For some, it is the boost in brain power and energy they get from the drink. For others, it is the social interactions often associated with the beverage. Whatever the reason, people enjoy coffee. For a lot of people, a cup of joe in the morning is a necessity. Are you one of those people?

Food, Drinks and Colonoscopy 

Restrictions are often placed on what you can eat and drink prior to colonoscopy. Most physicians recommend a clear liquid diet the day before colonoscopy.  Read What food can I eat before colonoscopy. 

Is coffee a clear liquid diet? 

Yes. Coffee without milk or cream is considered clear liquid for colonoscopy.  This is despite the fact that clear liquid diet is often described as liquid you can read a newspaper through.  So go ahead, have your morning joe without milk. Adding milk or cream disqualify it as a clear liquid diet.

Tea without milk or cream is also a clear liquid diet for colonoscopy.

 

what to eat before colonoscopy

 

Coffee Facts 

  • The beans are the seeds of berries (cherries) from the Coffea plant.
  • There are 2 growing areas for the plant. Low altitude areas like Indonesia have more oxygen and more yield. And then high altitude areas like Ethiopia with low oxygen. The plants utilize anaerobic respiration. The beverage from this region is sweeter and creamier.
  • We have two ways of extracting beans from the berries. The wash method and the natural method. The wash method is a wet process while the natural method is a dry process.
  • Different roasts of coffee exist. They depend on how long the bean stays in the oven. There are light, medium, and dark roasts. Dark roasts retain more of the original flavor yet light roasts have more caffeine
  • There are different ways of brewing coffee. The two main ways are the total immersion (French press) method and the pour over (Chemex) method.
  • There are several ways of serving the beverage.

 

Coffee Benefits

 

Suggested Reading 

 

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