Plan to be with us for a total of two to three hours.  When you arrive, you will need to complete your paperwork and then change into a patient gown.  The nursing staff will perform a brief assessment, place an I.V., and take you into the procedure room where you will be sedated and undergo the colonoscopy.  The colonoscopy itself takes about 15-30 minutes. After the colonoscopy, you will rest in the recovery area while the sedative wears off.  Due to the sedation, you may not remember your conversation with the doctor after the colonoscopy.  Please have a family member or friend stay with you that can speak with the doctor and nurses after the procedure.  By law, you cannot drive the rest of the day of the colonoscopy.  We advise you to take the entire day off work.

A thorough cleansing of the colon is essential and the examination is most successful if you follow the directions for preparation completely, as outlined below.  If you have any questions about the test or preparation, please do not hesitate to call our office.

It is important for you to bring a list of all prescription medications and non-prescription products (over-the-counter, anti-inflammatory, herbal, vitamins, etc) you are taking and a list of any medications you are allergic to.

If you are taking a blood thinner Plavix or Coumadin please read the following: Coumadin (warfarin) needs to be stopped 3 days prior to procedure. You need to talk to prescribing physician and ask if you need to take Lovenox or Heparin as replacement for it.

If you are taking Plavix than you need to talk to the prescribing physician if you can stop it for one week prior to procedure as it may increase the risk of bleeding from the procedure and whether the benefits of being on plavix outweigh the risks of stopping it.

 Please note: NO CHEWING GUM ON THE DAY OF SURGERY

Purchase These Items Ahead of Time:

Purchase These Items Ahead of Time (does not need prescription):

1. 4 (four) Dulcolax tablets

2. One 238-gram bottle of Miralax or ½ of a 510 -gram bottle or similar strength.

3. 1 bottle of Magnesium Citrate 10 oz (CLEAR ONLY/not colored)

4. At least 1 (one) 64-ounce bottle of Gatorade (no red flavors) or 2 (two) 32 oz bottles. For diabetic patients, G2 is another alternative with half the sugar than regular Gatorade.

4. Tuck’s pads or Vaseline can be used to protect the anal area especially if you have hemorrhoids. (optional)  

Colonoscopy Preparation Timeline

5 or more days prior to colonoscopy:

• Arrange for a ride.  If you do not have a ride, we will have to cancel the procedure.  By law you will not be allowed to drive yourself home due to the anesthesia.

• Purchase the laxative medications listed above.

• Consider obtaining a protective ointment such as Preparation H, Desitin, or Vaseline to protect the anal area during the prep.  You can start to apply it after you take the first laxative.

• If you are taking a blood thinner Plavix or Coumadin please read the following: Coumadin (warfarin) needs to be stopped 3 days prior to procedure. You need to talk to prescribing physician and ask if you need to take Lovenox or Heparin as replacement for it.
  

If you are taking Plavix than you need to talk to the prescribing physician if you can stop it for one week prior to procedure as it may increase the risk of bleeding from the procedure and whether the benefits of being on plavix outweigh the risks of stopping it.

• If you have a history of heart valve problems or valve surgery or need antibiotics before surgery, please notify us.

• Check with your insurance carrier if you need pre-approval and that you understand your financial responsibility for the procedure. 

• Stop taking iron and vitamins with iron five days before the colonoscopy.

• Make any needed arrangements to be off work or school on the day of the colonoscopy.  Please remember, by law, you cannot drive the rest of the day of the colonoscopy.

• Read and familiarize yourself with the preparation instructions below.

• Please call us with any questions.
  

Three days prior to your colonoscopy:

• Review and plan dietary needs for the next two days.

• Confirm your ride.

• Last chance to cancel or you will be charged a NO SHOW fee

 Two days prior to your colonoscopy:

• Eat well-balanced meals but try to avoid nuts, popcorn, raw fruit, raw vegetables, and salads.

• List any allergies and all prescription medications and non-prescription products (over-the-counter, anti-inflammatory, herbal, vitamins, etc.) you are taking.  Bring these lists with you on the day of the colonoscopy.

One day prior to your colonoscopy:

Start on a Clear Liquid Diet when you get up and continue all day.    

Clear Liquid Diet (clear liquids: colors are OK as long as they’re not RED in color)

Soups:  Clear bouillon, chicken broth, vegetable broth, beef broth, or consommé 

Beverages:  Tea, coffee (without cream/milk), Kool-Aid, carbonated beverages, Gatorade

You may add sugar to coffee and tea but not milk or creamer (non-dairy creamers are okay).    

Juices:   White cranberry, apple, white grape, strained lemonade, limeade, and orange drink

Any juice that you can see through and has no pulp is acceptable.    

Dessert:  Italian ices, popsicles, Jell-O, and hard candy – no RED flavors! 

• Do not drink red colored beverages or eat red Jell-O.

• No solid food of any kind.   

• Throughout the day, make sure to drink at least eight glasses (two quarts) of fluids such as Gatorade or a similar product, preferably not only plain water. 

• Take your usual prescription medications (except iron).  If you are on coumadin or other blood thinners, please contact our office and your primary physician for specific instructions at least one week prior to the colonoscopy. 

•Diabetic Patients:  You may have your usual breakfast today and should take your diabetic medications.  Monitor your blood sugar at your usual times.  

1:00 p.m.  Take four Dulcolax tablets by mouth with any clear liquid of your choice. 

3:00 p.m.  Mix the 238-gram bottle of Miralax in 64 ounces of Gatorade.  Shake the solution until the Miralax is dissolved.  Drink eight-ounces every 10-15 minutes until the entire solution is gone.

8:00 p.m.         Drink the bottle of Magnesium Citrate with two 8 oz of clear liquid.

Remember to remain close to toilet facilities!

A thorough cleansing of the colon is essential and the examination is most successful if you follow the directions for preparation completely, as outlined below.  If you have any questions about the test or preparation, please do not hesitate to call our office. 

Please note: NPO after midnight of the day prior to procedure:

You may continue to have clear liquids until midnight. After midnight, do not eat or drink anything except you should take your medications with sips of water.

(If your procedure is later in day you may take clear liquids till 8 hrs prior to the procedure scheduled time) 

The day of your colonoscopy:

• Continue with all your usual prescription medications.  Please be sure to take any blood pressure or heart medications the morning of the test with a sip of water.  

• Diabetic Patients:  Do not take your diabetes pills today, but bring a dose with you to take after your colonoscopy.  If you are on Insulin, take ½ of usual NPH and no regular insulin.  Bring the remaining doses with you to take after your colonoscopy. 

• It is important for you to bring a list of all prescription medications and non-prescription products (over-the-counter, anti-inflammatory, herbal, vitamins, etc) you are taking and a list of any medications you are allergic to.  

•When you are ready to leave, your designated driver will take you home where you can eat and relax the rest of the day.  You will receive specific instructions about eating, activities, and medications before you leave.


PROCEDURE DAY:

6:00 AM – Take 2 tablets of Dulcolax with two 8 oz glasses of water.  This will ensure that your colon is completely clean for the procedure.

The day of your colonoscopy:

• Continue with all your usual prescription medications.  Please be sure to take any blood pressure or heart medications the morning of the test with a sip of water. 

• Diabetic Patients:  Do not take your diabetes pills today, but bring a dose with you to take after your colonoscopy.  If you are on Insulin, take ½ of usual NPH and no regular insulin.  Bring the remaining doses with you to take after your colonoscopy.

• When you are ready to leave, your designated driver will take you home where you can eat and relax the rest of the day.  You will receive specific instructions about eating, activities, and medications before you leave.

It is important to prep well otherwise small colon cancer and polyps can be missed