Colonoscopy prep

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I was wanting to know what prep people use for colonoscopy. We use picoprep 2 pkts one at 8am and one at 7pm. we still tend to get a lot of liquid faeces especially on the afternoon cases. I also think its cruel to give some one bowel prep at such a late time so they are up half the night going to the toilet.

I also read a piece of research in a pubmed abstract about low residue diet, they stated they and done a trial on 150 patients half being on low residue and half not and their was no diference in the outcome when they had a barium enema. Any body have any thought on this.

Specializes in ER/PDN.
I was wanting to know what prep people use for colonoscopy. We use picoprep 2 pkts one at 8am and one at 7pm. we still tend to get a lot of liquid faeces especially on the afternoon cases. I also think its cruel to give some one bowel prep at such a late time so they are up half the night going to the toilet.

I also read a piece of research in a pubmed abstract about low residue diet, they stated they and done a trial on 150 patients half being on low residue and half not and their was no diference in the outcome when they had a barium enema. Any body have any thought on this.

OUr hospital uses GoLytely. It usually does the trick

Here is the prep that I had to follow for a colonoscopy.

Starting at midnight the day before:

clear liquids only all day

At 5:00PM, drink one 1.5 ounce (43 ml) bottle of Fleets Phospha Soda with 5-8 8 ounce (230ml) glasses of water

At 6:30PM, if the diarrhea is still brown or there is solid stool, repeat with another 1.5 ounce bottle and 5-8 8 ounce glasses of water (I had to do this)

At 8:00PM, one Fleet's Phospha Soda enema, held at least 5 minutes

Nothing by mouth after midnight

The colonoscopy started at 7:30AM

As preps go, this would seem to be about as tolerable as they get, especially since some doctors use a two-day prep. I was awake by choice up to the junction of the transverse and ascending colon. Bowel movements that morning were light brown, and during the colonoscopy, my colon was liquid-filled, with the occasional fecal particle.

My doctor seemed uncomfortable when I asked him if the brown particle was fecal matter. I guess he was not used to having patients asking those kind of questions (colonoscopy without sedation is rare, unfortunately, in America).

Michael E. Shultz

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"Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read."

Groucho Marx

Specializes in Geriatrics, Med-Surg.

I had my third colonoscopy last Fall. The first two used the (IMO) horrific, most foul-tasting and explosive diarrhea causing Fleets Phospho-Soda. The first time, the doctor told me to only use water to mix with. After the initial PM dose, I honestly didn't know how I'd be able to get up at 4am and down the other half without barfing it back up. ICK! Somehow I did it. Second time, they at least let me mix lemonade with it...much better, but still gross. Last Fall though, was by far the least unpleasant and painful. I did a PM and AM mix of Miralax and Gatorade. The doc also prescribed Magnesium Citrate (just in case), but it was not necessary.

I didn't keep my instructions, but I found this form on the net that seems to have similar instructions.

Miralax bowel prep:

http://www.austingastro.com/forms/ central/MiralaxGatoradeIce_c.pdf

I can't wait for the "camera technology" to become more readily used...where you swallow a tiny camera instead of the fun, turn on your side and let me stick this tubing up your back door routine.

camera info:

http://www.umich.edu/~urecord/0304/Aug16_04/23.shtml

Specializes in NICU.

Both hospitals I've worked at use GoLytely, I think a half gallon if I remember correctly from my CNA days. I haven't given it myself at my current hospital(I'm in the NICU) but I do know it is the standard bowel prep here.

ETA: When I was a CNA, it was on PMs, so that's when the patients had to drink their GoLytely, then NPO after midnight and scopes were done in the morning. I rememeber many an evening serving GoLytely to patients on the toilet.

Specializes in Oncology/Haemetology/HIV.
(colonoscopy without sedation is rare, unfortunately, in America).

As someone that went through several colonoscopies without any pain med or sedation whatsoever for any portion of the procedure, I am more than happy that sedation is used now and feel quite "fortunate" in that. I still am usually awake enough to watch the camera shots.

I used to be prepped with :

- low residue diet for three days prior.

- no aspirin for 7 days prior.

- after light dinner, at 1600 on day prior, 4 liters golytely.

Now I do 24 hours prior of clear liquids

- Mag Citrate at 1200 with 3 tabs ducolax.

- Mag Citrate at 1600 with 3 tabs duculax.

( I no longer tolerate golytely and have to be tested every one to two years)

Caroladybelle,

How well does your new prep seem to work? I have Crohn's and will need to have a scope soon(been 3 years,oops). The fleets soda prep makes me so ill and nauseous. I wonder how the Mag Citrate and dulcolax would work for a colonoscopy.Thanks.

Specializes in Nurse Scientist-Research.

When I worked with adults they always gave the Golytely/Nulytely prep and often the patients didn't need a modified diet and most didn't need to finish because their stools would run clear before that. These would be inpatients in a hospital.

I've had two preps and had the joy of taking the fleet's phospha-soda one bottle at night then another at 4am. It caused me SEVERE cramps, like catch my breath, break out in a sweat and just hope it would pass.

Best idea for handling the prep though I saw from a very nice lady that had been through it before and she wasn't shy. She sat on a bedside potty facing the TV with a overbed table across her lap set up with her Golytely and several cups. She sat there, drank her prep, watched TV and called us every couple of hours to empty the potty. I was so happy to have a continent bowel prep patient that I almost enjoyed emptying it. Also loved her attitude.

We have good success with golytely, 1/2 lytely(which is biscodyl tablets early in the day and 2 liters of golyte in the evening) or visicol tablets. All preps require clear liquids the day before. The more liquids the better the prep. The key success to the prep is drinking alot of liquids with the prep substance to flush out the colon.

Specializes in Oncology/Haemetology/HIV.
Caroladybelle,

How well does your new prep seem to work? I have Crohn's and will need to have a scope soon(been 3 years,oops). The fleets soda prep makes me so ill and nauseous. I wonder how the Mag Citrate and dulcolax would work for a colonoscopy.Thanks.

I have Ulcerative Colitis, and the prep works fine.

I did get propofol with last scope and was not awake during it. No nasty drug hangover either.

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