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Microsoft word - all prep instructions

Michael A. Berry M.D. Amy R. Woods M.D. T. Lanier Hagood M.D. Barbara L. O’Brien M.D. 1625 North Alston Street, Foley Alabama 36535 Phone: 251-970-1954 Fax: 251-970-1960 PREP INSTRUCTIONS FOR OUTPATIENT COLONOSCOPY

In order to ensure the best results from your test, it is important to follow these instructions
for your colonoscopy preparation.

The hospital will be in touch with you to pre-register you for your procedure. You may, however, call
them one day prior to the procedure if they have not contacted you.
7 days prior to your procedure you should discontinue the use of Aspirin, Vitamin E or any Non-
Steroidal, Anti-Inflammatory medications.
Please advise our office if you are taking Coumadin (Warfarin) or if you have an artificial heart valve.
Do not take oral diabetic medications or insulin the evening before or the morning of your procedure.
You may take blood pressure, heart or seizure medication the morning of the procedure with a sip of
water.
You MUST bring a driver (age 18 or older). He/she MUST remain with you during the procedure and
drive you home.
Please follow the instructions given in regard to CLEAR LIQUIDS.
When this is indicated you MAY NOT have any solid foods.
You may only have clear liquids such as:
 Chicken or beef broth, yellow or green Jell-O, clear grape juice, non-pulp apple juice, coffee or tea (no creamer), popsicles, clear soft drinks, hard candy, water, Gatorade. Avoid liquids that
contain red, orange, blue or purple colors. Again, NO milk products or creamers.

Remain close to bathroom facilities while drinking prep.
Report to the desk in the front lobby of the hospital 1 hour prior to your scheduled procedure time.
_______ GUT LAVAGE
THE DAY BEFORE YOUR PROCEDURE:
Clear liquids all day (refer to prior instructions)
 Mix your prep and refrigerate.  At 12:00-noon, take 4 Dulcolax tablets. This can be purchased over the counter.  At 4:00 p.m., begin drinking the colon prep at a rate of 10 oz. (large glass) every 10 minutes until completed.
THE DAY OF YOUR PROCEDURE:
 Do not eat or drink anything prior to your procedure.
_____ SUPREP
THE DAY BEFORE YOUR PROCEDURE:
Clear liquids all day (refer to prior instructions)
 4:00 p.m., pour the entire contents of one bottle of SUPREP bowel prep into the mixing container provided. Fill the container with water to the 16 oz. fill line as indicated on the mixing container. Drink the entire amount.  Over the next hour, drink 2 additional 16 oz. containers of plain water.
THE DAY OF YOUR PROCEDURE:
 Do not eat or drink anything other than what is required of your prep.  Beginning at __________a.m., (6 hours prior to your appointment), pour the entire contents of the other bottle of SUPREP Bowel prep into the mixing container provided. Fill the container with water to the 16 oz. fill line as indicated on the mixing container. Drink the entire amount.  Over the next hour drink 2 additional 16 oz. containers of plain water.  Continue CLEAR LIQUIDS (no milk products or creamer), until 4 hours prior to your procedure.

______ MIRALAX
THE DAY BEFORE YOUR PROCEDURE:
Clear liquids all day (refer to prior instructions)
 At 10:00 a.m., take 4 Dulcolax tablets. This can be purchased over the counter.  At 12:00 noon, mix 9 capfuls of Miralax in 20 oz. of water and drink over a 20 minute period.
THE DAY OF YOUR PROCEDURE:
Clear liquids, (refer to prior instructions), until 4 hours prior to your procedure time.

______ SPLIT DOSE
THE DAY BEFORE YOUR PROCEDURE
Clear liquids all day (refer to prior instructions)
 Mix your colonoscopy prep and refrigerate  At 12:00 noon, take 4 Dulcolax tablets. This can be purchased over the counter  AT 4:00 p.m., begin drinking mixture at a rate of 8 oz. glass every 10 minutes until you have completed ½ of the prep mixture. Note: you will only be drinking ½ of prepared prep mixture at this time so you will need to refrigerate the other ½ for the day of procedure.
THE DAY OF YOUR PROCEDURE:
 Drink the other ½ of prep mixture at _____________. (6 hours prior to scheduled procedure time), at a rate of 8 oz glass  You may continue drinking clear liquids (no milk products or creamers), until 4 hours prior to your scheduled

______ ADULT 2-DAY
2 DAYS BEFORE YOUR PROCEDURE:
Clear liquids all day (refer to prior instructions)
 At 1:00 p.m., drink 1 bottle (300cc) of cold Citrate of Magnesia  After drinking the Citrate of Magnesia, continue drinking clear liquids at least 8 ounces every ½ hour between 2-5 pm
THE DAY BEFORE YOUR PROCEDURE:
Clear liquids all day (refer to prior instructions)
 At 1:00 p.m., drink 1 bottle (300cc) of cold Citrate of Magnesia.
 After drinking the Citrate of Magnesia, continue drinking clear liquids at least 8 ounces every ½ hour between 2-5 pm
 At 6:00 p.m., take 4 Dulcolax tablets
You may have clear liquids (no milk products or creamers) until 4 hours prior to your procedure time.
THE DAY OF YOUR PROCEDURE: You may have clear liquids until 4 hours prior to your procedure time.

Source: http://gpccc.webstarts.com/uploads/a1.pdf

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