Patients with severe constipation may require regular laxatives, an increased fluid intake and
enemas for several days prior to commencement of bowel prep.
Patients with established or impending bowel obstruction should not receive stimulant
laxatives. If bowel prep is necessary this should be performed very carefully after consultation
with gastroenterology or surgical colleagues.
Patients who have had colonic surgery: You need to know details of the operation.
Any patient with a colostomy receiving oral bowel prep will need a special drainage colostomy bag
contact stoma nurses.
PATIENTS REQUIRING ADMISSION
Frail, disabled or elderly patients who may have difficulty getting to and from the toilet or who
are at risk of falls due to dehydration
Some brittle or unsupported diabetics on insulin. (Most can manage at home see protocol)
Patients who require supervised bowel prep (eg where previous prep at home has failed)
Patients who require colonic wash-out per stoma (see above)
IN-PATIENT BOWEL PREP
If you have any reason to suspect that bowel prep has been inadequate, PLEASE let the Endoscopy
Unit know in advance.
Morning appointment
If you are taking iron tablets (anything with Ferrous in the name) or
constipating medications such as loperamide (Imodium) or codeine
phosphate, these should be stopped at least 5 days before the test.
If you are taking Warfarin tablets and have been given no specific advice about
whether to continue with them, please contact the Endoscopy Unit for guidance.
TWO DAYS BEFORE THE TEST (i.e. Wednesday if your test if on a Friday)
From two days before the test you may eat only low residue foods.
Foods from the following list are acceptable: boiled or steamed white fish, boiled
chicken, potato (no skin), egg, cheese, white bread, butter (or margarine),
seedless jam, Marmite, honey, rich tea biscuits, chocolate, yoghurt, jelly (any
colour except red) and ice-cream.
Do not eat red meat, fruit, vegetables, nuts, pulses or cereals in any form.
You are now ready to begin taking the bowel clearing medicine (please turn the
page for detailed instructions).
After breakfast you must eat no solid food but drink as much clear fluid as
possible.
Clear fluids include fruit juices (without pulp), fizzy drinks or tea and coffee
(without milk). Bovril or clear soup (watery without bits in it) can be taken to
keep your strength up and sugary drinks such as Lucozade provide energy.
The more you drink, the better your bowel preparation will be.
Afternoon appointment
Morning appointment
If you are taking iron tablets (anything with Ferrous in the name) or
constipating medications such as loperamide (Imodium) or codeine
phosphate, these should be stopped at least 5 days before the test.
If you are taking Warfarin tablets and have been given no specific advice about
whether to continue with them, please contact the Endoscopy Unit for guidance.
TWO DAYS BEFORE THE TEST (i.e. Wednesday if your test if on a Friday)
From two days before the test you may eat only low residue foods.
Foods from the following list are acceptable: boiled or steamed white fish, boiled
chicken, potato (no skin), egg, cheese, white bread, butter (or margarine),
seedless jam, Marmite, honey, rich tea biscuits, chocolate, yoghurt, jelly (any
colour except red) and ice-cream.
Do not eat red meat, fruit, vegetables, nuts, pulses or cereals in any form.
You are now ready to begin taking the bowel clearing medicine (please turn the
page for detailed instructions).
After lunch you must eat no solid food but drink as much clear fluid as
possible.
Clear fluids include fruit juices (without pulp), fizzy drinks or tea and coffee
(without milk). Bovril or clear soup (watery without bits in it) can be taken to
keep your strength up and sugary drinks such as Lucozade provide energy.
The more you drink, the better your bowel preparation will be.
Afternoon appointment
Morning appointment
The medication will clear out the bowel resulting in diarrhoea within
three hours of the first dose, so stay near a toilet!
Applying a barrier cream (such as zinc & castor oil or Sudocrem) to the skin
around your bottom will prevent soreness.
******
Take your regular medication with a small amount of water (except diabetes
tablets see above)
You should continue to drink clear fluid (preferably water) until two hours before
the appointment time for your colonoscopy.
You must not eat or drink for 2 hours before the test.
You will usually be allowed to eat and drink again one hour after the test.
******
If you vomit the Picolax or have any other concerns please contact the Endoscopy
Unit on 0151 706 *******: A member of the nursing staff will be happy to assist you.
Afternoon appointment
PICOLAX
AFTERNOON APPOINTMENT
You will have been given three sachets of Picolax. You must start taking these on
the day before the test according to the following instructions.
ON THE DAY BEFORE THE TEST
At 2 oclock in the afternoon empty one sachet of Picolax into a glass and mix with
4 dessert spoonfuls of water. Warning: the solution will become hot. Wait 5
minutes until the reaction is complete and then fill the glass with cold water, making
it up to about 150ml (1/4 pint) of liquid. Drink the solution.
NB
The medication will clear out the bowel resulting in diarrhoea within
three hours of the first dose, so stay near a toilet!
Applying a barrier cream (such as zinc & castor oil or Sudocrem) to the skin
around your bottom will prevent soreness.
******
******
You should continue to drink clear fluid (preferably water) until two hours before
the appointment time for your colonoscopy.
You must not eat or drink for 2 hours before the test.
You will usually be allowed to eat and drink again one hour after the test.
******
If you vomit the Picolax or have any other concerns please contact the Endoscopy
Unit on 0151 706 *******: A member of the nursing staff will be happy to assist you.
Morning appointment
Some people find Klean Prep easier to drink if they add a flavour such as lime
cordial.
At 4 oclock in the afternoon, make up the next sachet as above and drink it over
about an hour.
NB: The medicine will clear out the bowel resulting in diarrhoea within
three hours of the first dose, so stay near a toilet!
If you have not had a bowel movement by 6 pm, do not take any more KleanPrep but wait until you have a bowel movement and then start taking KleanPrep again.
At 6 oclock in the evening make up the next sachet and drink the liquid as before.
At 8 oclock in the evening make up the last sachet and drink it.
Throughout the day, you can continue to drink as much additional clear fluid as
you like.
******
Take your regular medication with a small amount of water (except diabetes
tablets see above)
You should continue to drink clear fluid (preferably water) until two hours before
the appointment time for your colonoscopy.
You must not eat or drink for 2 hours before the test.
You will usually be allowed to eat and drink again one hour after the test.
******
If you vomit the Klean-prep or have any other concerns please contact the
Endoscopy Unit on 0151 706 *******: A member of the nursing staff will be happy to
assist you.
Afternoon appointment
Some people find Klean Prep easier to drink if they add a flavour such as lime
cordial.
At 6 oclock in the evening, make up the next sachet as above and drink it over
about an hour.
NB: The medicine will clear out the bowel resulting in diarrhoea within
three hours of the first dose, so stay near a toilet!
Throughout the day, you can continue to drink as much additional clear fluid as
you like.
If you have not had a bowel movement by the next morning, do not take any
more Klean-Prep but contact the Endoscopy Unit for further advice.
******
******
You should continue to drink clear fluid (preferably water) until two hours before
the appointment time for your colonoscopy.
You must not eat or drink for 2 hours before the test.
You will usually be allowed to eat and drink again one hour after the test.
******
If you vomit the Klean-prep or have any other concerns please contact the
Endoscopy Unit on 0151 706******: A member of the nursing staff will be happy to
assist you.