Colonoscopy Preparation Using Generic for Colyte (GaviLyte - C) It is very important that you read these instructions well in advance and follow them completely to ensure a successful exam. It is critical for you to thoroughly clean out your colon, which for most patients is harder than the test itself. Stool remaining in the colon can hide polyps or other abnormalities, and it may cause you to reschedule the procedure and repeat your copay if your colon is not well prepared. Pick up your prescribed GaviLyte-C (generic for Colyte) powder kit from the pharmacy. Due to regulatory requirements and your safety, you must arrange for someone to drive you home after the procedure. Be sure to have a driver who is prepared to remain at the facility during, which will take between 2 to 3 hours. If you do not have a driver, your appointment will be rescheduled. Diet Instructions ONE DAY BEFORE NO SOLID FOODS Drink clear liquids ALL DAY Water (plain or flavored), light/clear tea, broth, Ensure Clear, Gatorade, apple or white grape juice, Sprite, 7-Up, Ginger-Ale, Jello (yellow or green only), popsicles (non-pulp). No red, purple, or orange. NO ALCOHOL AVOID: Milk, shakes, smoothies, juices that are red or purple, orange juice. No red colored fluids (these may mimic blood). See Additional Local Instructions below for any additional dietary instructions or restrictions DAY OF DO NOT drink or eat anything after finishing the remainder of your GaviLyte-C solution at least 3 hours before your appointment. You can drink clear liquids up to 3 hours before your appointment. No gum, candy, or breath mints. Continues next page
Bowel Preparation Important Instructions ONE DAY BEFORE 1. Add water to the fill line on your GaviLyte-C container. Do not mix more than 48 hours before your appointment. 2. Replace cap tightly and SHAKE well until all powder is dissolved. You may drink it at room temperature or keep it cold in the refrigerator before drinking. It may help to drink it through a straw. You may add the flavor packet that comes with your container or add 1 to 2 packets (2 quart) of Crystal Light yellow lemonade only. 3. Between 4 to 6 p.m., drink ½ the bottle (approximately 2 liters). Drink 8 ounces (or a large glass) every 15 to 20 minutes (over a 2 to 3 hour period) until half of the bottle is gone. You will drink the remaining half on the day of your procedure. 4. Continue to drink clear liquids after finishing your evening prep until you go to bed. Due to the large amount of fluid in your stomach, you may feel bloated or nauseated. Confirm that you have a driver who will bring you to your appointment and stay in the facility during. Take your regular medications the day before your Procedure unless otherwise directed by your doctor. If you have diabetes, see the back for additional instructions. DAY OF 1. You may take your medications with sips of water. (Take them 1 hour before drinking your GaviLyte-C solution so that the medicines have time to absorb.) 2. 4 to 5 hours before your appointment, start drinking the remainder of your GaviLyte-C solution. You should finish drinking the solution at least 3 hours before your scheduled arrival time. DO NOT wear contact lens. DO NOT wear any jewelry or bring valuables. DO NOT apply lotion to skin Wear comfortable, loose fitting clothes. Wear flat shoes or sneakers.
MEDICATION INSTRUCTIONS These medications may be continued as usual: Acetaminophen (Tylenol): It is okay to continue taking acetaminophen (also known as Tylenol). Aspirin: It is okay to continue taking your daily low dose (81mg) aspirin treatment. Blood pressure medications such as atenolol, metoprolol, carvedilol, or lisinopril may be continued, including the day before and the day of. Please contact your physician as directed to see if it is safe to stop the following medications: Dabigatran (Pradaxa): Contact your cardiologist or primary care physician to make sure it is safe to stop taking this medication 2 days before the procedure, as well as the day of (3 days total). Diuretics (Water Pills): DO NOT take your diuretic the day before. You can resume taking your diuretic after, that same day. Diuretics include furosemide (generic for Lasix), hydrochlorothiazide, and triamterence/hydrochlorothiazide (generic for Maxzide). Clopidogrel (generic for Plavix), aspirin/dipyridamole (Aggrenox), or other blood thinners: Contact your cardiologist or primary care physician to make sure it is safe to stop taking these medications 7 days before the procedure. Iron supplements: STOP taking your iron supplements 7 days before. Nonsteroidal Anti-inflammatories (NSAIDs): STOP taking your nonsteroidal anti-inflammatory medications, such as ibuprofen (also known as Advil or Motrin), or naprosyn (also known as Aleve) 7 days before the procedure. Check with your primary care doctor before, if you have any questions. Warfarin (generic for Coumadin): Contact your primary care doctor or the Anticoagulation Clinic to make sure it is safe to stoptaking Warfarin 5 days before the procedure.
ADDITIONAL INSTRUCTIONS FOR DIABETICS (Unless otherwise instructed by your primary care doctor or Endocrinologist) ONE DAY BEFORE DAY OF Type 2 Diabetes Take ½ of the usual dose of your DO NOT take any oral diabetes diabetes medications, including both medications, such as glipizide insulin and oral medications, in the (generic for Glucotrol) or morning before your clear liquids. pioglitazone (generic for Actos). Check your blood sugars at least You may continue metformin twice (in the morning before beginning (generic for Glucophage). your clear liquids and at bedtime). Check your blood sugar in the morning before your arrival time. Type 1 Diabetes Contact your Endocrinologist or Diabetic Care Provider. If you take any long-acting insulin, take half the dose. DO NOT take any short-acting insulin (Insulin Regular, Aspart, Lispro) unless you are using a sliding scale. Check your blood sugar in the morning before your arrival time. ADDITIONAL LOCAL INSTRUCTIONS Appointment Day and Time Location of your GI Department Additional Dietary Instructions This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only. 2013, The Permanente Medical Group, Inc. All rights reserved.
Colonoscopy with Possible Biopsy / Polypectomy Information Sheet Colonoscopy In a colonoscopy we insert a long, flexible tube into your rectum and move it through the length of your colon (large intestine). A video camera at the tip of the tube lets us search for polyps or other problems in the colon wall. If we see a polyp or something unusual, we may take a small biopsy (sample for testing) or remove the abnormal tissue. Benefits of Colonoscopy Let s your doctor examine the lining of the colon, remove polyps and get tissue samples. Screens for colorectal cancer and may treat or prevent colorectal cancer. Can identify the cause of unexplained symptoms like blood in the stool, diarrhea, and anemia. Risks of Colonoscopy (include the following but are not limited to) Perforation: There is a very small risk that the procedure can tear or puncture the colon wall. This is rare, but if it happens, you may need an operation to repair the tear. Bleeding: If we remove or treat abnormal tissue during your colonoscopy you might have some bleeding during or after the procedure. Occasionally, the bleeding does not stop or becomes worse. You may need to have an operation, another colonoscopy, or a blood transfusion. Missed pathology: There is always a small chance that a polyp, cancer, or other lesion will be missed during the procedure. Sometimes the procedure will be repeated if the bowel is not cleared of stool or the colon cannot be completely examined. Allergic reactions to anesthesia and medications can rarely cause heart or breathing complications. In very rare cases, you can die from a serious reaction. Heart attack or stroke: A patient may suffer a heart attack or stroke due to the procedure and/or medication. This is rare. Alternatives to Colonoscopy For cancer screening alternatives include stool sample testing for hidden blood. For unexplained symptoms you may choose to wait or try medical therapy with close follow-up. Where can you learn more? If you have any questions about the risks of this procedure, please discuss them with your doctor. Look at EMMI, our new online instructional video. This can be accessed through the Gastroenterology physician homepage at kp.org/mydoctor. Go online to kp.org and enter the code Z368 or colonoscopy in the search box. 2012, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Dept of Gastroenterology. (Revised 07-12) RL 9.0
Upper Driver Endoscopy Agreement /& Colonoscopy Medication Log Information Please bring Sheet this page with you to your appointment Driver Certification I,, am scheduled to have a sedated procedure in the Gastroenterology/Outpatient Procedure Center on understand that I will not be able to drive home due to the medications. I have arranged for. I to be my adult designated driver (18 years or older). I understand that my procedure will not be performed until the Gastroenterology/OPPC staff confirms that my driver is available. Driver s Name: Home: ( ) Cell: ( ) Patient Signature: Date: Staff: Medication List Please list current medications and when the last dose was taken. You should include over-thecounter medications and supplements. Please bring this to your appointment. Medication Dosage Date Time 2012, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Dept of Gastroenterology. (Revised 07-12)