Dr. Hugh Kendall, MD, CM, FRCSC (Gen. Surgery)

Preparation Instructions for Colonoscopy

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Above all else, preparation is the key to success
Alexander Graham Bell

General Information about preparing for colonoscopy

A day or two before your preparation day, buy a box of PICO - SALAX (2 packets). It is available at any pharmacy, without a prescription. (Durham Endosurgery Center will give you a prescription to remit to your drug plan, if desired.) You should also buy two tablets of Dulcolax (also non-prescription). PICO-SALAX has a generic competitor that you may be offered, called PURGODAN. There is a small price difference. PICO-SALAX is more expensive, but offers a Cranberry flavouring addition to orange. Both are taken similarly, and both are effective.

If, for any reason, you have been given a different preparation ( such as MOVI-PREP, Bi-PREP, Colyte, Golytely) by the doctor in Durham Endosurgery, please follow the specific instructions on those packages.

Most people should be able to work the day before the procedure. The only difference between your preparation day (i.e. the day before the colonoscopy) is that all of your energy, sugar, salt, and calories will be in the form of CLEAR FLUIDS . No solid food all day (or indeed, until after your procedure is done). Clear Fluids are things you can see through. Apple juice is OK; orange juice is not. Tea or coffee is OK; tea or coffee with milk or cream is not. Common clear fluids that will get you through the day feeling fine include juice, soda, Gatorade, popsicles, jello, clear soups and teas - in unlimited quantities. You need not feel hungry or thirsty on your preparation day.

The liquid that washes out your bowels in the evening is almost all from the liquid you drink throughout the day; not the liquid in the PICO-SALAX. Therefore, the more you drink during the day, the easier, faster, and better the prep will work.

In addition to drinking lots all day before your procedure, it can be helpful to mix up the 2 glasses in the morning, and place them in the refrigerator; some people find the prep is easier to drink if chilled.

Once your prep has 'worked', you can continue to drink clear fluids in unlimited quantities, until 6 hours before your procedure. (i.e. if your prep is done by midnight, and your procedure is at 11:00AM, you may continue to drink clear fluids until 5:00 AM)

NO CANNABIS PRODUCTS TODAY OR ON THE MORNING OF YOUR PROCEDURE (it affects sedation)
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PIERCINGS:
All lip, tongue and nose piercings should be removed before undergoing any procedure where you are sedated. There is a small risk of the piercing coming dislodged or undone, and going in to your lungs.
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CANNABIS PRODUCTS:
Use of cannabis products will significantly increase your resistance to sedation (some studies quote by 200% or more). Please refrain from any cannabis products (CBD oils, edibles, vaporized, smoked) for 72 hours before your procedure.
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YOU WILL REQUIRE SOMEONE TO DRIVE YOU HOME. You must be accompanied from the premises by another adult. You may either be driven, or take a taxi with this other adult. If you do not have another adult to accompany you from the facility, your procedure may be cancelled.

My quoted arrival time is at or before noon

My quoted arrival time is AFTER 12 NOON

 

If your arrival time is quoted AT or BEFORE NOON, then follow these instructions below :

BREAKFAST
Light, fluids only. After that, only clear liquids throughout the day. Drink lots of fluids during the day.

You might mix up your bowel prep and put it in the fridge for later.
THROUGHOUT THE DAY
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~ 4:00 PM
take the DULCOLAX tablets. They will increase the contractions of the intestine, and help the prep to go through faster.
~ 6:00 PM (or immediately on returning from work)
take the first packet of PICO-SALAX. Mix the bag in cold water and stir for 2-3 minutes. The mixture may overheat, then let cool before drinking. Drink at least three big (8 ounce) glasses of clear fluids following the PICO-SALAX, over the next hour. Continue with clear liquids ONLY from this point.
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~ 9:00 PM
Mix the second packet of PICO-SALAX in cold water and stir for 2-3 minutes. The mixture may overheat, then let cool before drinking. Drink at least three big (8 ounce) glasses of clear fluids following the PICO-SALAX, over the next hour. Continue with clear liquids ONLY from this point, but stop all liquids 6 hours before your procedure (Tiny sips with medication in the morning are OK)
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MORNING OF YOUR PROCEDURE
NOTHING TO EAT OR DRINK.

Tiny sips of water with your medications is OK.

NO CANNABIS PRODUCTS (it affects sedation)
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Individual responses to laxatives vary; for most people the bowel movements start around the time of taking the second sachet. You will have several movements that become progressively more liquid, eventually clear liquid. Most people have between 6 and 8 bowel movements in total. Some patients find movements begin within 30 minutes of the first packet. Please stay within easy access to the bathroom. (Ignore that one on your own risk!) Do not be alarmed if the movements are not perfectly clear; as long as they are the greenish water, the preparation will probably be fine.


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PIERCINGS:
All lip, tongue and nose piercings should be removed before undergoing any procedure where you are sedated. There is a small risk of the piercing coming dislodged or undone, and going in to your lungs.
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CANNABIS PRODUCTS:
Use of cannabis products will significantly increase your resistance to sedation (some studies quote by 200% or more). Please refrain from any cannabis products (CBD oils, edibles, vaporized, smoked) for 72 hours before your procedure.
 

If your arrival time is quoted AFTER NOON, then follow these instructions below:

BREAKFAST
Light, fluids only. After that, only clear liquids throughout the day. Drink lots of fluids during the day.

You might mix up your bowel prep and put it in the fridge for later.
THROUGHOUT THE DAY
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~ 6:00 PM
Take the DULCOLAX tablets. They will increase the contractions of the intestine, and help the prep to go through faster.
~ 8:00 PM
Soon after the Dulcolax, take the first packet of PICO-SALAX. Mix the bag in cold water and stir for 2-3 minutes. The mixture may overheat, then let cool before drinking. Drink at least three big (8 ounce) glasses of clear fluids following the PICO-SALAX, over the next hour. Continue with clear liquids ONLY from this point.
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GO TO BED
Within a few hours after the sachet, you may or may not have 1 or 2 bowel movements prior to midnight.
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MORNING OF YOUR PROCEDURE
~ 6:00 - 6:30 AM
Take the second packet of PICO-SALAX. Mix the bag in cold water and stir for 2-3 minutes. The mixture may overheat, then let cool before drinking. Drink at least three big (8 ounce) glasses of clear fluids following the PICO-SALAX, over the next hour. Continue with clear liquids ONLY from this point.
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WITHIN 6 HOURS OF YOUR PROCEDURE
NOTHING TO EAT OR DRINK.

Tiny sips of water with your medications is OK.

NO CANNABIS PRODUCTS (it affects sedation)
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Individual responses to laxatives vary; most people will have several movements that become progressively more liquid, eventually clear liquid. Most people have between 6 and 8 bowel movements in total. Some patients find movements begin within 30 minutes of the each packet. Please stay within easy access to the bathroom. (Ignore that one on your own risk!) Do not be alarmed if the movements are not perfectly clear; as long as they are the greenish water, the preparation will probably be fine.
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PIERCINGS:
All lip, tongue and nose piercings should be removed before undergoing any procedure where you are sedated. There is a small risk of the piercing coming dislodged or undone, and going in to your lungs.
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CANNABIS PRODUCTS:
Use of cannabis products will significantly increase your resistance to sedation (some studies quote by 200% or more). Please refrain from any cannabis products (CBD oils, edibles, vaporized, smoked) for 72 hours before your procedure.

If you are confused about conflicting instructions between our office and the package insert :

  • For PICO-SALAX and PURGODAN, please prefer the instructions given to you at Durham Endosurgery Centre, over the instructions on the package
  • For all other preparations (Go-lytely, Co-lyte, MOVI-Prep, BI-Prep, etc.) please prefer the instructions on the package.