Colonoscopy Instructions GoLYTELY

Transcription

1 Sophie M. Balzora, MD 355 West 52 nd Street, 6 th FL New York, NY Colonoscopy Instructions GoLYTELY Your procedure is scheduled for: / / at AM Please arrive at: AM Diet: You must maintain a clear liquid diet throughout the entire day prior to the procedure (see below). Please do not eat or drink anything at least 6 hours prior to your procedure Medications: If you are taking any antiplatelet/nonsteroidal medications (i.e. aspirin, ibuprofen, Advil, Motrin, Aleve, naproxen, Plavix, clopidogrel, etc) o STOP 7 days prior o CONTINUE If you are taking any blood thinners/anticoagulants (i.e. Coumadin, warfarin, Lovenox) o STOP 5 days prior o STOP 3 days prior o STOP 1 day prior o CONTINUE If you are taking turmeric, fish oil, or vitamin E, please STOP the supplement 7 days prior to the procedure. If you are on any diabetes medications (insulin, oral medications), please STOP the medication the evening prior to your procedure. If you are taking iron supplementations, please STOP the medication 7 days prior to the procedure. Please take all other medications as previously prescribed. For your safety, you must arrange for an escort to be available to pick you up after the procedure as you will have received sedative medications. The procedure will be cancelled if an escort is not available. This is for your safety. ***Please contact Dr. Balzora s office with any questions regarding the procedure*** Page 1

2 GoLYTELY Instructions (Split dose) The GoLYTELY kit contains a disposable, 4L jug, a powder packet, and a pineapple flavor packet for optional use. You will have to purchase four 5mg bisacodyl (Dulcolax ) tablets over the counter from the pharmacy. You should complete the entire prep to ensure the most effective cleansing. *Important Do not follow the instructions on the GoLYTELY box. Instead, please follow the instructions detailed to you below. Remember: The key to a good prep is to drink plenty of clear liquids throughout the day, not only to clean out your colon, but also to stay well-hydrated! You must maintain a clear liquid diet for the entire day prior to the procedure. No exceptions! This will help you to achieve an adequate prep for the colonoscopy, which is important to helping to make the exam safe for you. What constitutes a clear liquid? Here are some examples: Water Clear soup or broth Gatorade Fruit juices without pulp Soft drinks Tea and/or coffee without milk (sugar is OK) Jello or any gelatin desserts with nothing added Hard candies Important note: Avoid any red or purple liquid, such as cranberry juice or grape juice, as the coloring can interfere with the results of your exam. Also avoid milk, dairy products, and nondairy coffee creamer. Do not eat or drink anything at least 6 hours prior to your exam (this includes gum and candy). Continue to take your prescribed medications with a small sip of water the morning of your exam unless instructed otherwise. Page 2

3 STEP 1: MIX THE GoLYTELY SOLUTION STEP 2: TAKE THE BISACODYL TABLETS The day before your procedure: Add the flavor packet to the powder contained in the GoLYTELY kit if you wish, or drink as is. Add lukewarm drinking water to the top of the line of the bottle. o Close the bottle with its cap and shake vigorously to dissolve the powder. o The mixed solution should be clear and colorless even with the addition of the flavor packet. Put the solution in the refrigerator. The solution should be consumed within 24h. Around 6PM the day before your procedure: Take all of the bisacodyl (Dulcolax ) tablets with a sip of water. o Do not chew or crush the tablet. o Do not take the tablet within an hour of taking any antacids. Around 7PM the day before your procedure (Step 3): STEPS 3 & 4: DRINK THE SOLUTION Drink one 8-oz. glass of GoLYTELY every 15 minutes until half of the bottle is finished (~8 glasses). Put the remaining half of the GoLYTELY in the refrigerator to drink the next morning. Continue to drink clear liquids throughout the evening. Bowel movements should begin about 1 hour after consumption. o Helpful hint! Put some Vaseline ointment around the anal area to prevent irritation. Baby wipes help too. 6 hours prior to your procedure (Step 4): Photos courtesy of HalfLytely online patient instructions Drink the remainder of the solution as instructed above. Do not eat or drink anything after consuming the remainder of the prep. Page 3

4 Colonoscopy FAQs The Basics What is a colonoscopy? A colonoscopy is a procedure used to visually examine the colon. The procedure uses a long, flexible tube, or colonoscope, with a camera at its tip, in order to both diagnose and sometimes even treat, conditions affecting the colon. Colonoscopies are traditionally performed in an outpatient setting, but under special circumstances, can also be done in the hospital. Courtesy of hcplive.com When is a colonoscopy performed and what can it detect? A colonoscopy is performed for many reasons. One of the most common reasons is for colon cancer screening. The goal of colon cancer screening is to find abnormal growths, or polyps, that can potentially lead to cancer in the future. Preventing cancer is the goal of screening! Other reasons to have a colonoscopy include abdominal pain, unintentional weight loss, bleeding, or anemia, just to name a few. The procedure is able to detect many abnormalities and conditions, including but not limited to polyps, cancers, ulcers, inflammation and many other abnormalities. If a polyp is found, the goal is to remove it, as certain polyps can grow into a colon cancer in the future. If any other abnormalities are seen, a sample of tissue, or biopsy, is taken, and sent to the laboratory for further analysis. Biopsy results traditionally take about seven days. What are the risks of a colonoscopy? The procedure is overall quite safe. But with any medical procedure, there are risks involved. The physicians performing the procedure and administrating sedative medications will discuss the risks of the procedure with you in more detail when consent for the procedure is obtained. Page 4

5 Will it hurt? The exam overall is very well-tolerated. Sedative medications are also given to help calm you during the procedure. Common symptoms may include cramping, muscle spasm, or discomfort of the lower abdomen during the procedure, or an urge to move your bowels. These symptoms are often attributable to the accumulation of gas inside the large intestine that the physician inserts through the colonoscope in order to perform the procedure. These symptoms oftentimes reside with the passage of gas from below. Do not hesitate to tell your physician if you are experiencing pain during the procedure. What should I expect? Preparing for the Procedure Seven to ten days prior to the procedure If you are taking any anti-platelet agents, please let us know. Medications such as nonsteroidal anti-inflammatory drugs, or NSAIDs [i.e. aspirin, naproxen (Aleve, Midol), ibuprofen (Motrin, Advil)], clopidogrel (Plavix), Aggrenox, ticlopidine (Ticlid), may need to be held days prior to the procedure, as they can increase the risk of bleeding. You may continue to take Tylenol if you already do so, as it is not an NSAID. Please do not stop these medications on your own. It is imperative to consult with your cardiologist or prescribing physician prior to altering the dose of or stopping the medication, so it can be done appropriately and safely. If you are taking any blood thinners, please let us know. Medications such as warfarin (Coumadin) or enoxaparin (Lovenox) are blood thinners, or anticoagulants, which are necessary for many different conditions. These medications may need to be held or their dosages altered days prior to the procedure, as they can increase the risk of bleeding. Please do not stop these medications on your own. It is imperative to consult with your cardiologist or prescribing physician prior to altering the dose of or stopping the medication, so it can be done appropriately and safely. The day prior to the procedure You must maintain a clear liquid diet as instructed. Follow the directions for the colon preparation as instructed. Please do not eat or drink anything at least 6h prior to your procedure (except for essential medications with a small sip of water), otherwise it may be cancelled. If you suffer from diabetes, the dosages of your diabetes medications will need to be altered the day before and/or the day of the procedure. Please consult the prescribing physician prior to the procedure so that this can be done safely. Page 5

6 The day of the procedure Important: You are required to have an escort accompany you to the endoscopy suite to take you home after the procedure. This strict rule is for your safety, as you will have received sedatives during the procedure (see below). The procedure cannot begin until an escort is present, and if one is not available to you, the procedure will have to be rescheduled. Please take medications such as heart and blood pressure pills as usually prescribed the morning of the procedure with a small sip of water. Expect to devote approximately 1.5 hours of your time to the procedure from checking in, getting changed, undergoing the procedure, and the recovery period. The physician performing the procedure, or an anesthesiologist, will administer a short-acting sedative immediately prior to starting the procedure through an intravenous (IV) line to make you more relaxed for the procedure. Though moderate or deep sedation is certainly not required for the procedure, it is overwhelmingly preferred amongst patients. During the procedure, you will lie on your left side on an examination table. The colonoscope is inserted into the anus and passed through the colon as described above. The procedure itself lasts approximately thirty minutes on average. After the Procedure Following the colonoscopy, patients are moved to the recovery room to allow the sedatives to wear off while they are under the observation of a nurse. During this time, patients may experience some bloating or gas, and sometimes some mild cramping, a side effect of the medication or the procedure, which subsides during recovery with the passage of gas from below. Unless instructed otherwise, you may immediately resume a normal diet and medications. You are not permitted to drive a car or operate heavy machinery. ***Please contact Dr. Balzora s office with any questions regarding the procedure*** Page 6