COLONOSCOPY
NuLytely  Prep

What is a Colonoscopy?  Colonoscopy is a state of the art procedure that uses a colonoscope to examine and visualize the entire large intestine or colon.  The colonoscope is a long, flexible fiber-optic tube about the thickness of a finger that has a minute television camera in its tip.  The doctor uses the colonoscope to examine the entire lower gastrointestinal tract for any abnormalities appearing on x-rays and to remove polyps.  During the procedure, the colonoscope is gently inserted into t he rectum and along the colon.  Air is introduced to inflate the colon, allowing the physician to carefully examine the lining.  If suspicious or abnormal areas appear, they are photographed or tissue samples are taken for further study and examination.  The procedure usually takes less than 30 min, but if polyps must be removed, it can last up to an hour. 

Why a Colonoscopy? Colonoscopy is an important procedure used in the detection of colon cancer.  Almost all colon cancers start as polyps (benign growths of colon) that later become cancerous.  A colonoscopy can find what is causing symptoms such as rectal bleeding or changes in bowel habits that x-ray tests cannot.  Barium enema shows just shadows and can miss cancers and small lesions.  Before the colonoscope, major abdominal surgery was the only way to explore the colon and remove polyps.  Thanks to the colonoscope, most polyps and tumors can be removed early, safely and without surgery. 

Preparation Instructions: To ensure an effective and accurate procedure, the colon must be completely empty of waste material.  Solid or opaque matter retained in the colon prolongs the colonoscopy and can reduce its effectiveness, making a repeat examination necessary.  Follow the colonoscopy preparation instructions carefully.  Diet is a very important part of the cleansing process. 

During the Colonoscopy: To make you relaxed and sleepy, you will be given medication through a vein.  While you are lying in a comfortable position, the colonoscope is inserted into the rectum and gently advanced through the colon while the lining is examined thoroughly.  During the insertion and observation, you may be asked to change positions to assist the doctor in maneuvering the colonoscope for optimal visualization.  The colonoscope is then slowly withdrawn while the colon is again carefully examined.  The procedure is well tolerated and rarely causes pain.  If there is discomfort, it is very mild.  Many patients fall asleep during the examination and may not, because of medications, even remember having the test done. 

NOTE:  DUE TO THE MEDICATION, YOU WILL NOT BE ABLE TO DRIVE YOURSELF HOME.  AN ADULT MUST ACCOMPANY YOU AND REMAIN UNTIL PATIENT DISCHARGE 

You will be kept in the recovery room until most of the effects of the medication have worn off.

You may not remember all the details explained to you during or after the procedure.  The doctor will speak to the person accompanying you regarding the findings of the colonoscopy.  If you do not approve of this, please notify us.  The Surgery Center will also try to call you after the examination to find out how you are doing at home.  Do not return to work for the rest of the day.  Rest for at least two hours when you get home, as you may feel drowsy from the medication all day.  Resume your previous medication dosage and time schedule unless otherwise instructed.  You will be able to resume your regular diet and activities after the colonoscopy, unless otherwise instructed.  If you had a polyp removed, you may be on a liquid diet for 12 hours and restricted from any heavy lifting for 24 hours.  If a biopsy was taken we will contact you in one week with the results.  If we do not, please call us. 

Possible complications: Colonoscopies are safe and very low in risk.  Most are free from complications and the benefits of the procedure greatly outweigh the risk.  However, like any other effective diagnostic or therapeutic procedure, complications can occur.   Possible complications are perforation of the colon and heavy bleeding.  A perforation of the colon involves injury to the bowel wall, but is quite rare.  The doctor has performed more than 10,000 colonoscopies and has never had a patient develop this complication.  Persistent bleeding may require hospitalization.  If you develop abdominal pain that is not gas related or any rectal bleeding, please contact the doctor immediately.

COLONOSCOPY PREP

Day before the procedure: __________________________________________
BREAKFAST: You may have a normal breakfast if it is consumed by 8:00 am.
8:00AM: Begin a full liquid diet, which includes the following:

Carbonated drinks
Fruit drinks
Skim Milk
Sustacal, Ensure, Boost, Slim Fast (canned)
Custard/Pudding
Broth
Protein shakes		 Coffee/Tea
Milkshakes and ice cream.
Sherbet
Water
Jell-O
Gatorade

 

4:30PM

Take 4 Dulcolax tablets with an 8oz glass of water.  If you have chronic diarrhea, ulcerative colitis, or have had difficulty with Dulcolax in the past, you may omit this step. 

5:00PM

 Mix the contents of the Nulytely (or GoLytely, CoLyte) powder with ½ gallon of tap water and shake vigorously. *Note: You will be given a gallon container, but only fill it ½ full of water* When the powder has completely dissolved, if not already flavored you may flavor the solution with 1-2 tbsp. of pre-sweetened powdered drink mix (e.g. Kool-Aid). The solution should not be refrigerated longer than 30 minutes before drinking.
5:30PM

Begin drinking the solution.  Drink it as quickly as possible, consuming at least one quart an hour.  Half of the mixture must be consumed by 7:30PM. If you feel full, rest for a few minutes before continuing to drink.  If you develop nausea or vomiting and cannot finish drinking the solution, see additional instructions.  Apply Xylocaine ointment around the anal region to reduce irritation from loose stools.
NOTE: Remain at home after taking the laxatives. Apply Xylocaine jelly around the rectal opening before diarrhea begins.
Day of procedure: You may have clear liquids up to four (4) hours before your procedure. Give yourself a regular fleet enema one-hour before leaving home. You will not be able to drive yourself home.  An adult to drive you home must accompany you.  The driver must stay in the facility until patient discharge.

Your colonoscopy has been scheduled for:   Date:__________ Time:__________

(  ) Surgery Center Plus Inc.
7430 N. Shadeland Ave
Suite 100  (on the first floor) 		 (  ) Community Hospital North
7150 Clearvista Dr.
Outpatient Registration

Additional Instructions

If you develop nausea or vomiting while drinking the solution:

  1. Stop drinking the solution

  2. Purchase an enema bag from any drugstore.  At least 4 hours before your colonoscopy, give yourself warm tap water enemas (2 pints at one time).  Continue this every hour until the colon is clear of stool.  If you need more than four enemas, notify the doctor.  Give yourself a Dulcolax suppository one hour before leaving home.

Medications and other conditions relating to the procedure

  1. Stop taking aspirin, anti-arthritis, Ibuprofen or blood thinning drugs at least 5 days before the day of your colonoscopy.  Ask the doctor who prescribed those medications for you before stopping.  You may take Tylenol or if you currently are taking Vioxx or Celebrex, you may continue taking those.

  2. Do not take iron or multi-vitamins containing iron for 2 days prior to your colonoscopy.

  3. If you take more than 500mg of vitamin C per day, you must continue to the vitamin C every day, including the day of your colonoscopy. (with small sip of water)

  4. Do not take any insulin or anti-diabetic medication on the morning of your colonoscopy.  Notify the doctor that you have not taken any anti-diabetic drugs.

  5. Notify the doctor if you take any blood-thinners such as Coumadin.

  6. Take only heart, seizure or steroidal medications as usual. Hold all other medications (day of procedure)

  7. If you have any heart valve problems, arterial grafts, pacemaker, hip prosthesis, etc, please notify the doctor before your colonoscopy.  You may need to be given antibiotics before your procedure.

  8. Women of childbearing age: Colonoscopy should not be done if you are pregnant.  If you suspect that you are, notify the doctor to cancel the colonoscopy.

  9. Ileostomy/colostomy patients must bring a new pouch with them to the Surgery Center/hospital.

Revised 11/01