Advanced Gastroenterology, PLLC

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1 You should arrive for your procedure(s) at: Day: Date: Time: Your Procedure has been scheduled with: Advanced Gastroenterology, PLLC 2415 NE 134 th St., Suite 205 Vancouver, WA Ph: (360) Fax: (360) Extended Colyte/TriLyte/GoLytely/NuLytely COLONOSCOPY PREPARATION INSTRUCTIONS APPOINTMENT DATE: Dr. Son Do Dr. Samuel Sim Your Procedure has been scheduled at: Legacy Salmon Creek Hospital Special Procedures/Surgery-2 nd Floor 2211 NE 139 th Street Vancouver, WA Southwest Washington Medical Center Same Day Surgery Endoscopy 400 NE Mother Joseph Place Vancouver, WA 98664

2 Medication Instructions for GI Procedures Special Instructions for Coumadin/Diabetic Medications: Coumadin/Plavix: Your last dose should be taken on. At the time of your procedure, your doctor will tell you when to restart the Coumadin/Plavix. Diabetic Pills: Do not take your diabetes pills the day of your procedure. You can take ½ the dose of your diabetes pills the day before the procedure. Insulin: On the day before your test: Take your regular dose in the morning. That night, take ½ your regular dose. On the day of your test: Do not take any insulin. Make sure to take your blood sugar that morning and report it to the nursing staff as they prepare you for your procedure Allowed Medications: Medications you take for the following conditions should be continued as usual on the day of the procedure. These should be taken with a small amount of water, 4 hours before your arrival time. Heart Problems High blood pressure Fluid retention Female hormones Thyroid disorder Depression or anxiety Asthma/emphysema Stomach ulcer or excess acid Seizure disorder NOT Allowed Medications: Ibuprofen/Motrin Advil/Aleve Ticlid Plavix Celebrex Aspirin

3 Preparation Instructions for Colonoscopy with Extended Colyte/TriLyte/GoLytely/NuLytely (Extended Prep) Appt. Date / / Check-in Time: : AM/PM Mon Tues Wed Thur Fri Sat Sun Mon Tues Wed Thur Fri Sat Sun Mon Tues Wed Thur Fri Sat Sun *Stop all aspirin & anti-inflammatory products. *A.M.: Start your low fiber diet. Page 4 section A is a list of the foods you can eat. *Purchase: 1 gallon of Colyte /TriLyte/GoLytely/NuLytely 1-10oz bottle of Magnesium Citrate The pharmacy will require a prescription to purchase the preparation. Mon Tues Wed Thur Fri Sat Sun Mon Tues Wed Thur Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Continue your low fiber diet After your evening meal and prior to going to bed, drink the 10oz bottle of Magnesium Citrate. *A.M.: Start your clear liquid diet. Page 4 section B is a list of clear liquids you may have. *3:00 P.M.: Begin drinking the Colyte /TriLyte/GoLytely/NuLytely. *Continue drinking the other half of the solution. : Continue drinking the other half of the solution. : You CANNOT have anything else to eat or drink until your procedure is completed. *DO NOT ADD SUGAR OR OTHER : Check-in time SWEETNER. The first few glasses may make you feel full or bloated. Sip slowly. It is important you drink ALL of the preparation. You will begin to pass watery stool within a few hours. Important: Concern for your safety makes us insist you have someone to drive you home. If you have not arranged for a driver, the procedure will be postponed. You will be ready to go home about 3 hours after your arrival. Your driver will need to come into the Endoscopy Center to pick you up. Taxi or C-Van is not allowed unless you are escorted by a friend or family member. You will not be allowed to drive for 24 hours.

4 Section A: Permitted Low Fiber Diet Suggestions: Meats-Poultry, Beef, Fish, Pork Dairy-NO CHEESE-including cottage cheese and cream cheese Pasta-NO RED SAUCE Rice-White Only Eggs Banana-NO other fruits allowed White Bread Condiments/Spices and beverages ~Any other LOW FIBER foods are permitted~ Do not have any of the following foods during this period: Popcorn, seeds, nuts, multi-grain bread, salad, cheese, fruits, vegetables or high-fiber foods Section B: Clear Liquid Diet Please select clear liquids from the following list, omitting any RED or PURPLE items: Water Soft drinks (orange, ginger ale, cola, Sprite, 7-Up, etc.) Sports drinks/gatorade/powerade Kool-Aid Strained fruit juices without pulp (apple, white grape, white cranberry, orange, lemonade, etc.) Tea or coffee (no milk or nondairy creamer) Low-salt chicken or beef bouillon/broth Hard candies Jell-O (lemon, lime or orange; no fruit or toppings) Popsicles, Italian ice ( no ice cream, sherbets, or fruit bars) *DO NOT DRINK ANYTHING RED OR PURPLE IN COLOR *DO NOT DRINK ANY ALCOHOLIC BEVERAGES

5 Colonoscopy Preparation Frequently Asked Questions Is there any way I can make this taste any better? You can try sucking on hard candy. You can rinse your mouth with water or a mouthwash. Do not eat or drink anything while you are drinking the solution. Try drinking the solution with a straw. Why avoid red & purple liquids? The red & purple color can persist in the colon & potentially look like blood. However, cranberry juice is permitted since it is a natural red color. I feel like vomiting & don t think I can drink anymore. What can I do? It is important that you continue to drink the solution if at all possible. Without a clean bowel, the doctor will not be able to see the inside of your colon to complete the examination. If you experience nausea, wait 15 minutes & resume drinking slowly. If you do vomit, wait 45 minutes & begin drinking the solution again. Try sipping the solution with a straw. I drank a lot of the solution & I have not gone to the bathroom yet. What should I do? Keep drinking. Most people have a bowel movement after an hour. Some patients may take 2 hours or longer. I am taking the prep & now have loose, watery stool. Do I still need the rest of the prep? Yes, you may have solid stool higher in the colon that needs to be eliminated. I already have diarrhea prior to taking the prep. Do I still have to take the prep? Yes, you must take the prep as directed. Your colon is approximately 6 feet long. The entire colon must be emptied for Dr.Do to see the colon clearly. I see yellow color in the toilet bowl & a few flecks. What do I do? If you have finished the entire solution or if your last bowel movements were clear enough that you were able to see the bottom of the toilet, you should be fine. My bottom is sore. What can I do? When cleaning the area, avoid rubbing, gently pat with a wet washcloth or moist baby wipes. You may also apply Vaseline. Can I drink alcoholic beverages? Do not drink any alcoholic beverages prior to your procedure since they can cause dehydration. Can I chew gum or suck on candy? Yes, but nothing with soft centers or red color. Can I brush my teeth? Please do. Can I wear my dentures? Yes, you may wear your dentures to the Endoscopy Suite. However, you may be asked to remove them depending on the procedure you are having. I have been instructed not to take aspirin products, anti-inflammatory medications or blood thinners for several days prior to the procedure. What can I take for headaches & pain relief? You may take Tylenol. Can I have the colonoscopy done if I have my menstrual period? Yes, the procedure can still be performed. We ask that you use a tampon if possible (not absolutely necessary). Why do I have to stop taking aspirin, anti-inflammatory medications & blood thinners? Some medications (prescription & over-the-counter) can reduce the body s ability to form blood clots & taking these before a colonoscopy procedure may increase your risk of bleeding if a polyp needs to be removed.

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