Suite 1, 96 Farrington Road, Leeming WA 6149

Ph 9312 1888

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  • BOWEL PREP INSTRUCTIONS

DR DEREK CHEN

DR DEREK CHENDR DEREK CHENDR DEREK CHEN

TIPS FOR A SAFE & SUCCESSFUL COLONOSCOPY

For a successful colonoscopy, your colon must be clear of any stool. This allows your doctor to see your entire colon.  It is extremely important to follow these preparation instructions to clear your colon of any stool, otherwise the procedure may need to be repeated.

If you are unsure of any aspects of the preparation or you are having an adverse reaction ring 9312 1888 (Monday to Thursday 9:00-16:30) or the Hospital that you will be having your procedure at (after hours).



One Week Before Your Colonoscopy 

  • Arrange for a driver for your procedure.
  • Purchase GLYCOPREP-O kit plus an additional sachet of GLYCOPREP ORANGE 70g from pharmacy. 
  • GLYCOPREP-O kit itself contains 1 blister pack containing 3 Bisacodyl 5mg tablets, 1 sachet of Magnesium Citrate 21.5g, and 3 sachets of GLYCOPREP ORANGE 70g
  • Yes, this means that you end up with a total of 4  sachets of GLYCOPREP ORANGE 70g 
  • Purchase any clear fluids and low residue foods you might want leading up to the procedure (see list below). Also consider purchasing baby wipes and hard candies.
  • Stop taking iron supplements
  • Avoid foods with seeds. 
  • Make sure you know what to do with your blood thinning and diabetes medications (refer to below).


What if I have a tendency towards constipation? 

  • Avoid high residue foods for 1 week prior to procedure. 
  • Start a clear fluids diet for 2 days prior to procedure.
  • If your constipation is significant, have 2 sachets of Movicol daily starting 2 days prior to procedure (no prescription needed). 


TWO Days Before Your Colonoscopy 

Avoid high residue foods, generally any foods that ‘crunches’ in your mouth.  

AVOID High Residue Foods

  • Nuts
  • Popcorn
  • Seeds: chia, fennel, flax, poppy
  • Whole grains or high fibre grains: brown or wild rice; whole grain bread, rolls, pasta or crackers; whole grain or high fibre cereal (granola, raisin bran, oatmeal); bread or cereal with nuts or seeds 
  • Legumes: beans; lentils; dried beans, peas or lentils
  • Fruits: raw fruit with seeds or skins; cooked or canned fruit with seeds or skin; raisins or other dried fruits 
  • Vegetables: brussel sprouts; cabbage; corn; cucumbers; green peas; onions; potatoes with skin; tomatoes
  • Other: coconut; fibre supplements; olives; pickles; salad dressing with seeds or nuts; soups with vegetables or legumes 


ALLOWED Low Residue Foods 

  • Dairy: cheese; milk; yoghurt 
  • Protein: chicken; eggs; fish; pork; shrimp; tofu; turkey
  • Bread & grains: white bread or bagels (NO whole grain or any seeds); White rice (NO brown or wild rice); white pasta (NO whole grain)
  • Condiments: peanut or almond butter (NO crunch); butter or margarine; vegetable oil; mayonnaise or sour cream
  • Dessert: ice-cream; pudding; sorbet (NO pieces of fruit or seeds); cookies or cake made with white flour & NO seeds, fruit or nuts 


Drink as much clear fluids as you can before, during and after having the preparation solution to prevent dehydration. 


ALLOWED Clear Fluids 

Clear fluids is any fluid you can see through. Avoid red or purple liquids as the remaining liquid in your colon can be tinted red or purple and be confused for bleeding. 

  • Water, including coconut water 
  • Black tea or coffee (NO milk or cream)
  • Carbonated beverages (soda or sparkling water)
  • Clear soup
  • Cordial
  • Fruit juice without pulp (apple, lemonade, orange)
  • Jelly
  • Sports drinks (Gatorade, Powerade)
  • Popsicles

Medications and your procedure

Instructions for Blood Thinning Medications 

  • If you have a history of a stroke, heart attack, blood clots or cardiac stent in the last 12 months, please contact Dr Chen for specific instructions. 
  • If you do not have a history of the above events, please follow this: 
    • Aspirin (CARTIA, ASTRIX, SOLPRIN) - continue.
    • Clopidogrel (PLAVIX, ISCOVER) - continue.
    • XARELTO, PRADAXA, ELIQUIS - stop 3 days prior. 
    • Warfarin - stop 5 days prior.


Instructions for Diabetes Medications

  • Schedule your procedure for the morning if possible.
  • If you take any of the listed medications below, stop them 3 days prior to your procedure: FORXIGA (dapaglifloxin), GLYXAMBI (linagliptin, empagliflozin), JARDIAMET (metformin, empagliflozin), JARDIANCE (empagliflozin), QTERN (saxagliptin, dapagliflozin), SEGLUROMET (metformin, ertugluflozin), STEGLATRO (ertugluflozin),  STEGLUJAN (sitagliptin, ertugliflozin) and XIGDUO (metformin & dapagliflozin). 
  • If you control your diabetes with ORAL medications alone: take your normal medication dose on the morning on the day prior to procedure, then do not take any more diabetes medications until after the procedure is complete and you have eaten. 
  • If you control your diabetes with INSULIN alone: take ½ of your normal insulin dose the day prior to procedure, then do not take any more diabetes medications until after the procedure is complete and you have eaten
  • If you control your diabetes with BOTH INSULIN & ORAL medications: follow both set of instructions as above. 
  • If you use an INSULIN PUMP: please contact your Endocrinologist for specific instructions. 

Carer

It is important to arrange to have a 'carer' to care for you when you leave the hospital. Every patient who has a procedure performed under sedation and is leaving hospital within the same day as their procedure needs to be handed over to a carer (over 18 years of age). This person will be responsible for your wellbeing and recovery for up to 24hrs. 

Work arrangements

It is important that you re-arrange your normal activities and take time off for :

  • the day of the procedure
  • The day after your procedure (if instructed)


A medical certificate will be provided by Dr Chen on the day of the procedure if required (including the person responsible for picking you up from hospital & caring for you at home).

Being prepared

You will need to start the low residue diet 2 days prior to your colonoscopy.


This reduces the fibre in your bowel, which makes it easier when you start the bowel cleansing regime.


Refer to the diet plan for items you can and cannot eat, as well as the sample menu :

During your diet & bowel preparation regime

It is important to follow the diet & bowel preparation instructions that have been provided to you. For a successful colonoscopy, it is very important that the bowel is cleaned well. This will enable Dr Chen to clearly see the lining of the bowel.


Poor preparation may mean that the procedure will be stopped and that you will have to repeat the preparations and procedure on another day.


Failure to have a bowel motion


People vary in the time it takes to have a bowel motion after commencing bowel preparation. To help relieve any concerns about your progress, the following information may help guide you.


Helpful hints and tips


  • If you become ill or have severe pain, seek medical advice from your GP or nearest Emergency Department.
  • Hydration is essential for effective bowel prep
  • Straws: Use a straw to drink the prep as far back on the tongue as possible to reduce the amount of prep solution your taste buds are getting. Sipping is better than gulping.
  • Hard candies: Suck on a candy (e.g. menthol candy) after drinking the prep. Or gargle mouthwash to “clear out” the bad taste
  • Keep warm
  • Some people find that drinking the solution very quickly and then using a "chaser" such as apple juice helps the prep go down easier
  • If you feel nauseated while taking the preparation, stop for half an hour. Have a hot drink and walk around. Resume drinking the solution more slowly
  • Baby wipes: Use flushable baby wipes or extra soft toilet paper to reduce anal irritation.
  • If you have haemorrhoids, use your haemorrhoid ointment to help reduce discomfort
  • Stay near a bathroom
  • If you feel bloated, try walking around. Suck some peppermints or drink peppermint tea

* Your Bowel Preparation *

1 Day prior to procedure :

A) GLYCOPREP ORANGE 70g preparation instructions

Dissolve each of the 4 sachets of GLYCOPREP ORANGE into 1L of water using a suitable container (total of 4 containers) in the morning.

Chill in a refrigerator prior to drinking

B) Magnesium citrate preparation instructions

Dissolve the entire sachet of Magnesium citrate into 1 mug of hot water (~250ml). Mix and then allow to cool / chill in refrigerator

C) For breakfast, have a light breakfast (low residue)

D) After breakfast, do NOT eat any more solid food after that. Start drinking clear fluids only, aiming for at least 200ml per hour

E) At 2pm, take the 3 x Bisacodyl tablets with a full glass of water

F) At 4pm, drink the Magnesium Citrate solution and continue to sip clear fluids.

G) At 6pm, 7.30pm, 9pm - drink each litre of GLYCOPREP ORANGE over 1 hour. Continue sipping on clear fluids until bed time.

On day of procedure :

H) 5 hours before your admission time - Drink the last litre of GLYCOPREP ORANGE

eg. 8am admission time = drink at 3am, 2pm admission time = drink at 9am. Continue drinking clear fluids until 2 hours before admission to stay hydrated.

If you've had a sleeve gastrectomy ....

And you don't think you can tolerate drinking 4L of bowel prep, then try Picoprep instead

Picoprep for AM colonoscopy (pdf)Download
Picoprep for PM colonoscopy (pdf)Download

On the day of your Colonoscopy

If despite following all instructions and your bowel motions are not clear, go to the hospital as planned, and at the admissions desk, ask to speak to a nurse as soon as possible regarding concerns about your bowel preparation

For your safety and comfort

  • Wear loose comfortable clothing
  • Do not drive yourself home
  • Bring your Medicare and Private health insurance details along
  • Must have an escort home by a friend or relative
  • Must have someone with you for the remainder of the day as well as overnight

Important

  • Stop smoking at least 24 hours before your procedure
  • Do not drink any alcohol (including beer) for 24hrs prior to your procedure
  • Follow any relevant medication plan as instructed
  • Do not wear makeup, nail polish, jewellery or perfumes
  • Do not bring valuables or large sums of money with you. The hospital cannot accept responsibility for these items

Post procedure

Planning for going home after the procedure

Before your go home, Dr Chen will discuss with you the findings of the procedure and relevant findings. You will be given a copy of your procedure report and discharge instructions. A copy of this report will also be sent to your GP. Your procedure and results are to be discussed at a follow-up appointment with your GP (allow 2-3 business days generally for the results to become available). Dr Chen will also email you a copy of your results.


A nurse will also speak with you and your carer about what to expect when you leave.

Important information for after your procedure

After you leave the hospital, if you have any non-urgent concerns, please speak with your GP or contact Dr Chen (via office phone or email) or the procedure department directly.


If you or your carer notice any of the following, please present to your nearest Emergency Department or phone an ambulance on 000.


  • persistent heavy bleeding from bowels or black tarry bowel motions
  • shortness of breath or difficulty breathing
  • Rapid heart beat, dizziness
  • Increasing drowsiness, including difficulty rousing from sleep
  • Increasing persistent pain unrelieved by medication
  • Inability to keep fluids down
  • High fever
  • Have any other concerns where you feel you need medical assistance

Contact Us

Please send through a message if you have questions about your bowel preparation that isn't covered above

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Dr Derek Chen - Perth Specialist Surgeon

Suite 1, 96 Farrington Road, Leeming WA 6149

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09:00 am – 04:30 am


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