MALCOLM GROW MEDICAL CLINICS AND SURGERY CENTER 240-612-1560 Split-Dose Colyte Optical Colonoscopy Preparation Instructions Procedure Date/ Arrival Time Please report to the front desk of Same Day Surgery in building 1060 on the 2nd floor PURPOSE OF COLONOSCOPY: (A) A diagnostic exam that allows the physician to carefully examine the lining of the large intestine or colon with a flexible tube equipped with a light and a camera. (B) Abnormalities can be visualized and further information an be obtained by taking a biopsy. (C) An interventional exam, where if a polyp is found, it will be removed. MEDICATIONS REQUIRED FOR PROCEDURE - 1 Plastic jug with a powder called PEG- CoLyte (1 gallon) - 2 Bisacodyl (Dulcolax) laxative tablets - 8 Simethicone (Gas-x) tablets It is advised to pick up your medications at least 5 days prior to your procedure GENERAL INSTRUCTIONS You will receive sedation for your procedure and will not be able to drive yourself home after the procedure. You must have a responsible adult (18 years or older) accompany you home. Please have your responsible adult available to discuss your discharge instructions prior to your discharge. You will not be permitted to use any form of military or public transportation after your procedure if you are unaccompanied by an adult. Bus, taxi or shuttle drivers do not fulfill the requirement of a responsible adult. - It's required that females of childbearing age have a urine pregnancy test done within 72 hours prior to the procedure. Menopause is defined as cessation of a menstrual period for more than 12 months (without the use of hormone birth control); if your last period was more recent, please submit a pregnancy test. It can be done at any MTF within 72 hours of your procedure. - Wear easily washable/comfortable clothing. Remove acrylic and colored nail polish from finger nails. Two- piece outfits/sports (no underwire) bra for women are preferable. Jewelry should be left at home and personal items (cell phones, tablets, wallet, purse, etc.) will be left with you escort. - DO NOT DRINK ANY ALCOHOL once you begin the prep. - You will NOT be able to drink alcohol or drive 24 hours following your procedure. SPECIAL MEDICATION INSTRUCTIONS - You may take Tylenol (acetaminophen) if you need a pain reliever. Avoid medications such as: Nuprin/Advil/ Motrin/ibuprofen, Aleve/naproxen, Mobic/meloxicam, Clinoril/sulindac, Relafen, Indocin/indomethacin, Daypro, Feldene, Voltaren/diclofenac for 7 days prior to your procedure. - Oral iron or fiber supplements (such as Metamucil, Citrucel, Fibercon), Vitamin E, fish oil, or Pepto-Bismol should be discontinued 7 days prior to the procedure. Please check with your physician for any substitutes. - Heart and blood pressure medications should be continued and taken normally. Please bring your blood pressure medication with you, if you do not take it in the morning. - If you are diabetic: check with your physician/ PCM regarding your medications, especially insulin, (see next page for more information).
- If you take oral diabetes medications (pills): Do not take the medication the night before or the morning of your procedure. If you take insulin (1 or 2 injections per day): Take one-half (1/2) of your usual morning dose of NPH, Lente or Novolin 70/30 or Lantus insulin and do not take Regular, Novolog, or Humalog insulin the morning of your procedure. If you take evening insulin, follow these same instructions for your dose the evening before your procedure. If you are on three or more injections per day, please contact the health care provider who manages your diabetes for further instructions. Check your blood sugar the day before and the morning of your procedure. Please bring your diabetes medication to your appointment. - If you are taking any blood thinning medication such as: Xarelto (Rivaroxaban), Apixaban (Eliquis), Prasugrel (Effient), Ticagrelor (Brillianta), Coumadin (Warfarin), Pradaxa, Ticlid (Ticlopidine), Plavix (Clopidogrel), Persantime, Aggrenox or Lovenox (Enoxaparin) please contact your doctor for specific instructions at least 1 week prior to your procedure for at 240-612-1560. If you are taking Aspirin, take it as normal unless otherwise instructed by your provider. LENGTH OF TIME Preparation Time: ½-1 hour; Procedure: ½-1 hours; Recovery: ½-2 hours= 1½ -4 hours There will be a waiting period prior to the procedure. Our staff strives to give every patient individualized, quality care. We apologize for any inconvenience that waiting may cause you. PROCEDURE 1) An intravenous line (IV) will be placed in order to provide medication for sedation, pain, and comfort. You will be receiving conscious/moderate sedation - you may be semi-awake or asleep for the procedure depending on how the medications affect you, but the goal is comfort. 2) Oxygen will be administered and your heart rate/ blood pressure and breathing will be continuously monitored throughout the procedure. 3) While lying comfortably on your left side, the physician will insert the flexible, lubricated scope into the rectum and carefully advance it through the colon. Some air and water will be placed in the colon to assist in the exam, which may be expelled afterwards. After the exam, you will rest in the recovery room until you are able to tolerate liquids and walk unassisted. PREPARING FOR YOUR PROCEDURE Preparation is of the utmost importance in providing quality exam. The instructions below should be followed to optimize the outcome of your exam. 7 DAYS BEFORE YOUR PROCEDURE Avoid seeds, nuts, oatmeal or other whole grains, beans, peas, corn, and the peels of fruits and vegetables as these may remain in the colon after completion of the prep. This is a low residue diet. 2-3 DAYS BEFORE YOUR PROCEDURE Follow a low fat and low fiber diet (see last page) Drink plenty of fluids throughout the period 2-3 days before your procedure to avoid dehydration.
DAY OF YOUR PROCEDURE Time Instruction DO NOT FOLLOW ANY OTHER INSTRUCTIONS MORNING TIME In the morning, prepare the jug according to the instructions (fill to 4 liter mark) and refrigerate it for later use. Do not mix the solution with any other liquids except water. You may add Crystal Light powder to the jug to improve taste (avoid red or purple flavors, and use ONLY the ORIGINAL Crystal Light brand NOT the Pure, Energy, or other varieties) FOLLOW A RESTRICTED DIET OF CLEAR LIQUIDS NO SOLID FOODS ALL DAY-- CLEAR LIQUIDS ONLY **If you are diabetic, you will need to check your blood sugar 3-4 times per day while on the clear liquid diet. If your sugar is below 80 or above 180 call the advice line, your doctor, or the diabetic manager for further instructions** Coffee, Tea (no milk/espresso; sugar and sugar substitute are OK) Clear Juice without Pulp (Apple, White Grape, Lemonade) Broth, Bouillon Gatorade or Similar Sports Drinks Kool-Aid, Crystal Light Jell-o (no added fruit or toppings) Coconut water without pulp (1) Carbonated Soft Drinks (Coke, Pepsi, Sprite; Diet or Regular) AVOID RED OR PURPLE LIQUIDS; NO DAIRY OR PULP Drink plenty of fluid throughout the day to avoid dehydration, at least 8oz. of clear liquids every hour. The prep will work better, you will feel better and it will be easier to start your IV, if you avoid dehydration. 1500 (3:00 PM) Take BOTH (2) Bisacodyl (Dulcolax) tablets with plenty water. 1700 (5:00 PM) Start drinking the prepared jug of CoLyte Drink 1 cup (8oz) every 10-15 minutes until jug is HALF gone (approximately 64oz or 2 liter marking on the jug) Rapidly drinking a glassful is better than sipping an ounce or two at a time. A straw may be helpful to use when drinking to get the solution down easier. After finishing half the jug, chew and swallow 4 of the Simethicone (Gas-x) tablets with water THROUGHOUT THE EVENING Continue to drink water/clear liquids.
DAY OF THE PROCEDURE NO SOLID FOODS OR MILK PRODUCTS UNTIL AFTER COLONOSCOPY. Time (Follow table below) 5 HOURS PRIOR TO SHOW TIME Instruction Begin drinking the second half of the solution, drink 1 cup (8oz) of Colyte every 10-15 minutes until the rest of the jug is gone. 2 HOURS PRIOR TO SHOW TIME - You must finish the solution 2 hours prior to your show time. - After finishing the CoLyte solution, chew and swallow 4 of the Simethicone (Gas-x) tablets with wate WAIT 30 MINUTES AFTER FINISHING THE PREP TO TAKE ANY APPROVED MORNING MEDICATIONS WITH A SIP OF WATER - Stop drinking water. Do NOT eat or drink anything after this time. MORNING PREP SCHEUDLED ACCORDING TO SHOW TIME SHOW TIME START PREP FINISH PREP 06:30 AM 07:15 AM 08:30 AM 09:15 AM 10:00 AM 12:00 PM 12:30 PM 01:30 AM 02:15 AM 03:30 AM 04:15 AM 05:00 AM 07:00 AM 07:30 AM 04:30 AM 05:15 AM 06:30 AM 07:15 AM 08:00 AM 10:00 AM 10:30 AM If you have any questions, contact us at (240) 612-1560 on weekdays between the hours of 0700-1600. Please contact us if problems arise before you procedure or if you need to change or cancel. You must allow for at least 24 hours notice (72 hours is preferred) to cancel your procedure appointment. Disclaimer: If you have been scheduled for a colonoscopy via questionnaire or direct/open access services (i.e. colonoscopy scheduled without a preceding clinic appointment) there is a possibility you may have to be rescheduled. This will occur if you misrepresent or omit any medical history, medications, or information essential for the provider to make an informed decision about your eligibility to have your colonoscopy at MGMCSC. Upon signing the questionnaire you are asserting that you have answered all questions to the best of your ability and as accurately as possible. You may also be rescheduled based on any new findings on the day of procedure (i.e. information not readily apparent from the questionnaire or physical exam findings), as deemed by your provider. If you are rescheduled you will be given a new procedure date/time and your prep medications will be reordered for you to pick up ASAP.
Low Fiber Diet Foods Meats, fish, poultry and protein Lean tender cuts of meat Lean ground meat Tofu Fish and shellfish Eggs ALL beans, lentils ALL forms of nuts ALL legumes Processed meats (hotdogs, sausage and cold cuts), fatty meats, tough meats with gristle Bread, cereals and grains White breads/toast, waffles, French toast, plain rolls Pretzels Plain pasta or noodles White rice Crackers without added seeds, grains, or fiber Cereals without whole grain, added fibers, seeds, raisins, or other dried fruit Brown or wild rice Kasha (buckwheat) Other whole grains and cracked grain Corn bread or corn meal Graham crackers Wheat germs, bran, nuts, granola, coconut, dried fruit, and seeds Low fat milk and low fat milk drinks Yogurt without seeds or granola or fruit chunks Low fat cheese, cottage cheese Low Fat Ice cream or frozen desserts Milk and Cheese High in fat content dairy products Vegetables, fruits and desserts Tender, well-cooked fresh or canned vegetables without seeds, stems, or skins Sweet or white potatoes without skins Strained vegetable juices without pulp or spices Soft canned or cooked fruit without seeds or skins Well-ripened bananas (small amount) All raw or steamed vegetables ALL beans Peas, corn, and onions Cabbage, broccoli, cauliflower, Brussels sprouts and greens ALL raw or dried fruits Berries