Gastrointestinal Associates LLP
Dr. Peter Cleavinger, Dr. Michele Diaz-Arias, Dr. Donald Gerhardt, Dr. Nicolas Llorens,
Dr. Matthew Struttmann, and Dr. Stephen Welsh
Your procedure is scheduled: [ ] Columbia Endoscopy Center (573)449-3500, 208 Portland St., Columbia, MO 65203 Date: __________________ Arrive at: _____________ Procedure Time: ____________ [ ] Boone Hospital (573)-815-6320, 1600 East Broadway, Columbia, MO 65201 Date: __________________ Arrive at: _____________ Procedure Time: ____________ SUPREP Bowel Prep
Modern colonoscopy is a diagnostic procedure to examine the colon or large intestine. Over the past 30 years, it has become a gold standard in screening for colon polyps and prevention of colorectal cancer. With modern methods of sedation and newer computerized flexible instruments, most exams are quick, painless, and very safe. The major obstacle is the day before. For an accurate and safe exam, it is very important that your colon be clean of all waste material by means of a restricted diet and laxative preparation or “prep”. Follow all instructions carefully so that the test will not need to be rescheduled. If you have any questions please call our office. To prepare for your colonoscopy you will need to purchase: [ ] One SUPREP Bowel Prep Kit (you will need a prescription) [ ] Two Dulcolax (Bisacodyl) tablets (these are over the counter) All bowel preps may cause some anal irritation. We also recommend: [ ] A soft brand of toilet tissue (such as Charmin Sensitive) [ ] A box of baby wipes or tucks pads (such as Huggies or Pampers Aloe wipes) [ ] A small tube of diaper rash or Zinc Oxide cream (such as A&D Zinc Oxide) When your appointment is scheduled: If you are on any blood thinning medications/anticoagulants (Coumadin, Jantoven, Warfarin, Plavix, Pradaxa, Effient, Xarelto, Brilinta, Aggrenox, Ticlid, Aggrastat, Avixtra, Iprivask, Lovenox, Dipyridamole), please contact our office at 573-777-8820. These medications often need to be stopped prior to the procedure.
Page 1 of 3 Three to Five days before the your colonoscopy:
1) Make arrangements for a responsible adult to accompany you to your appointment and
drive you home. If possible, this person should be someone we can share the results of the exam with.
2) Stop taking medications that contain iron. 3) Continue any other medications that you normally take. 4) For females, if you have started your menstrual period it is still okay to do the
colonoscopy. Female patients of appropriate age will be asked to provide a urine specimen for a pregnancy test the morning of your procedure at the facility.
5) It is helpful to eat lightly a few days before your exam. It makes the cleanout easier and
more effective. Try to avoid overeating to compensate for the upcoming fast. Please avoid Metamucil, raw vegetables, corn, and foods with skin or small seeds (like tomatoes, sesame seeds, kiwi, and cucumbers) for a few days before your exam.
The day before your colonoscopy:
1) Eat a clear liquid diet for breakfast, lunch, and dinner the day before the test. CLEAR LIQUIDS are anything you can see through. This includes clear water, fat free broths, bouillon, tea, coffee (without creamer), Kool-Aid, Crystal Light, carbonated beverages, sodas, fruit juices without pulp (apple, grape, cranberry), popsicles without pulp, Jell-O, hard candies, Italian ices, Gatorade. AVOID anything with red dye. NOT ALLOWED: Orange juice, fruit nectars, liquids you cannot see through, milk, cream. Please drink plenty of fluids during the day to prevent dehydration.
2) If you are a diabetic patient on insulin, please check with your primary physician
regarding necessary changes to your doses.
3) At approximately 8:00AM take the 2 Dulcolax (Bisacodyl) tablets with 8 ounces of water. 4) Between 12:00pm- 5:00PM, begin drinking the SUPREP. DO NOT DRINK SUPREP UNDILUTED. Pour one of the 6 ounce bottles of SUPREP into the mixing container and fill with cold water to the 16 ounce line and mix. Drink all of this over 15 minutes. For a safe prep and complete exam you MUST drink another 32 ounces of clear fluid over the next hour. Your stools should eventually be a clear yellow color and you should be able to see the bottom of the toilet through the fluid after prepping. 5) You may continue drinking clear liquids throughout the evening. The day of your colonoscopy:
1) No breakfast 2) At least 4 hours before your appointment, pour the second 6 ounce bottle of SUPREP
into the mixing container and fill with cold water to the 16 ounce line and mix. Drink all of this over 15 minutes. You MUST drink another 32 ounces of clear fluid over the next hour. You must finish drinking the final glass of water at least 3 hours before your check
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in time. You need to do the second dose the morning of your procedure even if your stools were clear the night before.
3) You cannot have any food, drink, candy, gum, chewing tobacco and should not smoke for
3 hours before your procedure. You should not have broth the morning of your procedure.
4) You may take blood pressure medications, seizure medications, prophylactic antibiotics,
and inhalers prior to your procedure with a sip of water. Take insulin as directed by your primary physician.
5) Dress comfortably. You may want to bring a change of clothes just in case you soil the
clothes you are wearing. You may want to consider wearing Depends if you have a long drive.
6) You will need to bring a driver, a list of your medications/vitamins (that includes the name, dose, frequency, and reason for taking the medication), driver’s license (or Identification), insurance card, and co-pay if your insurance requires one. Leave your jewelry and other valuables at home.
After arriving at the Endoscopy Center:
1) After arriving at the Center/Hospital, you are to check in. Sedatives/anesthesia will be
used for the procedure to help with any discomfort you may have, therefore an IV will be placed in your arm/hand.
2) You will need to sign a consent form authorizing the physician to perform the procedure.
The procedure takes 20-30 minutes, and recovery is about 30 minutes. Your total time at the Center/Hospital should be approximately 2-3 hours. Before you leave, you will receive information about the results of your colonoscopy, instructions regarding diet, IV, and follow up.
3) You will not be able to drive or return to work for the remainder of the day.
If you have any questions concerning the colonoscopy or prep, please do not hesitate to call our office at 573-777-8820.
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Short Research Papers on Knowledge, Innovation and Enterprise TARIQ SADAT, ROSLYN RUSSELL & MARK STEWART THE FORCES TRANSFORMING PHARMACEUTICAL INNOVATION MODELS Introduction The modern pharmaceutical industry has always been dominated by a few large pharmaceutical companies, or ‘big pharma’. Until recent times, the pharmaceutical industry has enjoyed success through big pharma
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