COLONOSCOPY BOWEL PREPARATION with PICOPREP – (Morning procedure)
· Please follow instructions carefully. The success of your examination depends on the bowel being as clear as possible, otherwise the examination may need to be postponed and the preparation repeated.
· Bowel movements start within 2-3 hours after taking the first PicoPrep dose and may continue intermittently for up to three hours after the last dose.
· PicoPrep produces watery stools which will become clear with no solid matter.
· It is advisable to remain near a toilet and apply Vaseline to the anus after each loose stool.
TWO days before the procedure:
Follow a soft, Fibre-free diet on this day e.g. Pasta, pumpkin, steamed fish or chicken, clear soup, clear jelly. Avoid fibrous vegetables and fruit with seeds or pips.
ONE day before the procedure:
Breakfast at 08:00: Black tea / coffee, (soft) boiled / poached egg and white or brown bread or toast (not whole wheat) Thereafter drink only approved clear liquids.
Lunch and Dinner: Drink only approved clear liquids and jelly.
Approved clear fluids: Water, black tea/coffee, clear fruit juices eg apple, litchi, grape juice, Bovril drinks, clear chicken broth, Energy drinks (Energade, Game), jelly (only green and yellow).
No solid foods, milk or dairy products (yogurt, custard, ice cream) allowed. No Oros, red or purple drinks or red wine allowed.
PREPARATION – 4 SACHETS PICOPREP
Dissolve each sachet Picoprep in 250ml hot water to form a clear solution. Chill with ice cubes and drink followed by a glass of water.
11:00 Drink a glass of water or clear fluids.
12:00 Drink a glass of water or clear fluids.
13:00 Take the 1st sachet Picoprep followed by a glass of water.
14:00 Drink a glass of water or clear fluids.
15:00 Drink a glass of water or clear fluids.
16:00 Take the 2nd sachet Picoprep followed by a glass of water.
17:00 Drink a glass of water or clear fluids.
18:00 Drink a glass of water or clear fluids.
19:00 Take the 3rd sachet Picoprep followed by a glass of water.
20:00 Drink a glass of water or clear fluids.
04:00 on day of procedure Take the 4th sachet Picoprep followed by a glass of water.
Morning of procedure: Small sips of water may be taken until 4 hours before the procedure.
SEDATION IS GIVEN SO SOMEBODY MUST DRIVE YOU HOME.
COLONOSCOPY BOWEL PREPARATION with PICOPREP – (Afternoon procedure)
· Please follow instructions carefully. The success of your examination depends on the bowel being as clear as possible, otherwise the examination may need to be postponed and the preparation repeated.
· Bowel movements start within 2-3 hours after taking the first PicoPrep dose, and may continue intermittently for up to three hours after the last dose.
· PicoPrep produces watery stools which will become clear with no solid matter.
· It is advisable to remain near a toilet and apply Vaseline to the anus after each loose stool.
TWO days before the procedure:
Follow a soft, Fibre-free diet on this day e.g. Pasta, pumpkin, steamed fish or chicken, clear soup, clear jelly. Avoid fibrous vegetables and fruit with seeds or pips.
ONE day before the procedure:
STEP 1
Have a light lunch at 12:00 ie. Black tea / coffee with or without sugar, boiled / poached egg, white or brown bread or toast (not wholewheat). Thereafter drink only approved clear liquids.
Drink only approved clear liquids and jelly for supper.
Approved clear fluids: Water, black tea/coffee, clear fruit juice eg. Apple- Litchie- grape juice, Bovril drinks, clear chicken broth, Energy drinks (Energade, Game), jelly (only green and yellow).
No solid foods, milk or dairy products (yogurt, custard, ice cream) allowed.
No gas cool drinks, red and purple drinks or red wine allowed.
STEP 2
PREPARATION – 4 SACHETS PICOPREP
Dissolve each sachet Picoprep in 250ml hot water to form a clear solution. Chill with ice cubes and drink followed by a glass of water.
13:00 Drink a glass of water or clear fluids.
14:00 Drink a glass of water or clear fluids.
15:00 Drink a glass of water or clear fluids.
16:00 Drink a glass of water or clear fluids.
17:00 Dissolve the 1st sachet Picoprep in 250ml hot water. Chill with ice cubes and drink followed by a glass of water.
18:00 Drink a glass of water or clear fluids.
19:00 Drink a glass of water or clear fluids.
20:00 Mix the 2nd sachet Picoprep as before and drink followed by a glass of water.
Keep drinking approved clear fluids until bedtime.
Morning of procedure:
06:00:Take the 3rd sachet Picoprep followed by a glass of water.
07:00 Drink a glass of water or clear fluids.
08h00 Take the 4th sachet Picoprep followed by a glass of water.
Small sips of water may be taken until 4 hours before the procedure.
SEDATION IS GIVEN SO SOMEBODY MUST DRIVE YOU HOME.
Please read prior to the procedure
What is a Colonoscopy?
A colonoscopy is a day-case procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, or changes in bowel habit. Colonoscopy is also advised in individuals without symptoms to check for colorectal polyps or cancer. A screening colonoscopy is recommended for anyone aged 50 years or older, and persons with a family history of colon polyps or cancer should be screened at an age 10 years younger than it was diagnosed in the family member.
What Happens Before a Colonoscopy?
To complete a successful colonoscopy, the bowel must be clean so that the physician can clearly view the inside of the colon. It is very important that you read and follow all the instructions for your bowel preparation well before the procedure. Without proper preparation, the colonoscopy will not be successful and may have to be repeated. You may experience some irritation of the skin around the anus due to passage of liquid stools.
This can be eased by:
· Applying a thin layer of Vaseline around the anus before drinking the PicoPrep, and after each bowel movement
· Wiping with cotton wool soaked in warm water, rather than using toilet paper.
· Non-scented disposable wet wipes can also be used. Dry by dabbing with a soft towel or cloth.
· Sit in a bath filled with warm water, dab dry with a towel and apply Vaseline.
What Happens During a Colonoscopy?
The doctor will insert a long flexible instrument into the rectum and will advance to the caecum (beginning of the colon). If necessary, pieces of tissue (biopsy) can be removed for testing, and polyps can be identified and removed. The colonoscopy may allow accurate diagnosis and treatment of colorectal problems, without the need for a major operation. The colonoscope is disinfected between procedures.
You will have an intravenous line inserted (a “drip”) and will be lying on your left side. A sedative and a pain-relieving drug will be administered to make you more relaxed during the procedure. Your vital signs are monitored, and you will be breathing oxygen to maintain a normal blood oxygen concentration.
The procedure lasts between 20 and 40 minutes on average, and you will be allowed to rest until fully awake.
You may feel slightly bloated and uncomfortable after the procedure, due to air inserted into your colon to improve visualization.
What Happens After a Colonoscopy?
You will remain in a recovery room for observation until you are ready for discharge. You may feel some cramping or a sensation of having gas, but this soon passes. A responsible adult must drive you home. Avoid driving and operating machinery for 24 hours. Avoid alcohol and take a course of Probiflora/ other probiotic capsules to restore intestinal flora.
Unless otherwise directed you may resume your normal diet after the colonoscopy. Wait until the day after the procedure before resuming normal activities e.g. exercise. If polyps were removed or biopsies taken, avoid using aspirin and anti-inflammatory drugs for 2 weeks. Paracetamol e.g. Panado, Tylenol etc may be used.
If you are on anti-coagulants e.g. Warfarin or Plavix, your physician will advise when it is safe for you to restart the medication.
If a biopsy was taken or a polyp removed, mild rectal bleeding may be noted for 1-2 days after the procedure. If heavier bleeding is encountered e.g. clots of blood, or if you have severe abdominal pain, this must be reported immediately. If you are unable to contact the physician, report to the emergency department of the clinic or hospital where the procedure was performed.