COLONOSCOPY PREPARATION-CONSTIPATION/DIABETIC

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1 Cancellation Policy: We must receive your cancellation request within 72 hours of your procedure date. Cancellation notices that are received less than 72 hours prior to procedure will result in a $ cancellation fee. The following instructions are your Doctor s specific directions. Please follow the directions carefully. 3 DAYS BEFORE THE PROCEDURE If you are taking Coumadin, Plavix or Lovenox for either a history of prior stroke, or for coronary stents, or for atrial fibrillation or artificial heart valves please contact the scheduling Department at TWO DAYS BEFORE THE PROCEDURE NO SOLID FOODS. TWO DAYS BEFORE YOUR EXAM YOU MUST BE ON A CLEAR LIQUID DIET BOTH DAYS. NO SOLID FOODS OR DAIRY PRODUCTS ALLOWED. A clear liquid diet is necessary for a colonoscopy. A complete cleansing of the entire bowel is essential for effective results, so that there will be no need for retesting. Your Clear Liquid diet options: Tea and Coffee Clear Juices Powdered Lemonade Water/ Vitamin Water Such as apple or white grape juice Carbonated Beverages NO DAIRY NO PULP NO PULP Sports Drinks Popsicles Jell-O Broths/ Coconut Water Honey/Sugar

2 WITHOUT MILK OR ADDED FRUIT It is very important to keep hydrated. Drink plenty of clear liquids while doing the prep (at least 8 ounces every hour) 1 6:00 PM Two days before your procedure Drink the entire bottle of Magnesium Citrate. You may mix it with Sprite, 7-Up or Gingerale. If you have Congestive Heart Failure or have Kidney- Renal Failure DO NOT drink THE DAY BEFORE THE PROCEDURE 2 2:00 PM the day before your procedure Pour the 64 oz. of Propel into a pitcher and chill in the refrigerator. 3 4:00 PM the day before your procedure Drink the entire bottle of Magnesium Citrate. You may mix it with Sprite, 7-Up or Gingerale. If you have Congestive Heart Failure or have Kidney-Renal Failure DO NOT drink

3 4 4:30 PM the day before your procedure Take two Dulcolax tablets with at least 8 oz. of water. 5 5:30 PM the night before your procedure Mix the ENTIRE bottle of Miralax (238g) with the 64 oz. of the chilled Propel. 6 5:30 PM the night before your procedure Begin drinking HALF OF THE MIXTURE (32 oz.) Drink an 8 oz. glass of the solution every 15 minutes until gone. Complete by 7:30pm If you become nauseated or begin vomiting while drinking the solution, slow down and when the nausea subsides begin drinking the solution again. Lying on your right side can help empty the stomach. 7 7:30 PM the night before your procedure Take two Dulcolax tablets with at least 8 oz. of water. * Total tablets consumed is four. Dispose of the remainder.

4 8 10:15 PM the night before the procedure, drink the OTHER HALF OF THE MIXTURE (32 oz.). Drink an 8 oz. glass of the solution every 15 minutes until gone. Nothing to eat or drink after midnight. THE DAY OF THE PROCEDURE - NOTHING TO EAT OR DRINK after midnight. - If you take blood pressure medication you may do so the day of the procedure with just a sip of water. - If you have questions regarding medications, please call your doctor at (816) PLEASE DO NOT APPLY ANY LOTION, VASELINE, BABY OIL, OR BODY SPRAY. - Come to your procedure with NO MASCARA. YOU WILL BE MEDICATED FOR THIS PROCEDURE. IT IS NECESSARY TO HAVE SOMEONE WITH YOU TO DRIVE YOU HOME. YOUR DOCTOR WILL SPEAK WITH YOU AFTER THE PROCEDURE; YOU MAY WANT TO HAVE YOUR DRIVER WITH YOU AT THAT, AS YOU MAY NOT RECALL THE DISCUSSION DUE TO SEDATION. If you have any questions or concerns about the preparation please contact the Colon Prep Center by calling or by ing customerservicegroup@accuhealthpartners.com.

5 Colonoscopies and Diabetic Patients For patients with diabetes a colonoscopy can be challenging especially if you are taking medications to regulate your blood sugar. Below are some tips to help you have a safe preparation and a successful colonoscopy. Before you start a liquid diet you should contact your health care provider that manages your diabetes. If you take oral medications or insulin make sure to ask them the dosages and when you should take these medications. Schedule your colonoscopy for the first procedure of the morning. This will shorten the amount of time that you have to fast. Verify that the doctor s office knows that you are diabetic and that you need be the first or second patient the doctor sees that morning. Check your blood sugar levels frequently. Check your blood sugar levels before each meal and before bedtime (at least every 4-6hrs). Bring your meter and test strips with you to your procedure. The American Diabetes Association states that a sugar-free liquid diet is not recommended for patients with diabetes. Diabetics need sugar and the carbohydrates they contain in order to manage their blood glucose levels when they are taking diabetes medications. It is recommended that diabetics should consume about 200 g of carbohydrates the day of their clear liquid diet spread out over the day. Even though you are consuming sugar-these liquid carbohydrates are replacing what you would normally eat and should not cause your blood sugar to rise too high. Be sure to drink plenty of liquids to avoid becoming dehydrated while you re using the laxative. If your blood sugar falls too low you can treat it with clear juice, non-diet soda, or glucose gel. Clear liquid food choices for the day before your colonoscopy: Food Items Grams of Carbohydrate Apple juice (4 ounces) 15 White grape juice (4 ounces) 20 Sports drink such as Gatorade (8 ounces) 14 Gelatin (Jello), regular sweetened (1/2 cup) 15 Popsicles or ice pops (read the label) 15 Italian ice--not sherbet (read the label) 30 Sugar (for coffee or tea) (1 teaspoon or packet) 4 Fat-free broth, bouillon, or consommé 0 Diet clear soda 0 Coffee 0 Tea, unsweetened or diet 0 Flavored water 0 Sample Menu Breakfast Lunch Dinner Apple or white grape juice (1 cup) Broth (3/4 cup) Broth (3/4 cup) Sweetened gelatin (1 cup) Italian ice (1/2 cup) Apple or white grape juice (1 cup) Tea with lemon Sweetened gelatin (1/2 cup) Sweetened gelatin (1/2 cup) Tea with lemon Tea with lemon Clear liquid food chart and sample menu (slightly modified): Diabetes Medication Instructions for Colonoscopy Preparation and Procedure. CONCORD: Concord Hospital, Web. < Contributing author: Catherine Parkhurst, RN,MSN,CDE, Diabetes Education St. Joseph Medical Center