How to Take Bowel Preparation Medicine

How to Take Bowel Preparation Medicine
Information for Patients having a Colonoscopy
This leaflet gives instructions for how and when to take bowel preparation medicine.
Bowel preparation medicine, which is a laxative, needs to be taken before
procedures such as colonoscopy, flexible sigmoidoscopy or CT colonography to
cleanse and empty the bowel. You should also have a separate leaflet which
describes the procedure itself.
To get a clear view of the lining of your bowel, it must be as empty and clean as
possible.
You will need to follow a low fibre diet for 2 days beforehand.
You will need to take the laxatives included in your pack with this leaflet.
The laxative will give you watery diarrhoea so you must drink adequate fluids and
obviously stay close to a toilet.
Special Precautions for Bowel Preparation
If you are taking any regular medication for stomach, bowel, heart, lung, kidney or
other medical conditions, please continue these as normal, you may take your
medications with a glass of water on the day of your examination.
For patients on warfarin, stop taking this
taking warfarin for a metallic heart valve
clot) or pulmonary embolism, please do
need to make alternative plans to thin your
drug 5 days before. However, if you are
or previous venous thrombosis (blood
not stop it, and do let us know as we will
blood around the time of your procedure
For patients on Pradaxa (dabigatran), stop taking this drug 3 days before. However,
if you are taking this for a metallic heart valve or previous venous thrombosis
(blood clot) or pulmonary embolism, please do not stop it, and do let us know as
we will need to make alternative plans to thin your blood around the time of your
procedure
For patients on clopidogrel, do not take it for 7 days prior to your procedure, you
may restart it after your procedure. However if you have had a coronary stent
inserted less than 12 months ago please do not stop the clopidogrel, and let us
know
Aspirin 75mg daily is ok to continue.
If you have had a heart attack or acute heart failure or a coronary stent inserted
recently, it is advisable to wait until your condition has stabilised before having your
colonoscopy, usually 3 months. Check with us and your cardiologist.
If you are asthmatic, please bring your inhalers with you.
If you are taking any regular medication for diabetes, check with the nursing staff for
specific instructions. We will send you a special leaflet that explains how to control
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your blood sugar around the time of your procedure. Please bring your diabetic
pills or insulin with you [it is important to maintain a blood sugar above 5 leading
up to your procedure, check your glucose level and if necessary suck some glucose
tablets ahead of your procedure to achieve this].
If you have a colostomy (external stool bag on a stoma from previous bowel
surgery), the bowel preparation medicine will work in the same way. You are
advised to put on a drainable appliance before taking the medicine until after the
examination. If you do not have any drainable appliances (pouches), please contact
your stoma care nurse at Wexham Park Hospital on 01753 633734 or bleep via the
hospital switchboard on 01753 633000.
Please let us know if you are pregnant or trying to conceive.
Note: Patients taking the oral contraceptive pill should take alternative precautions
during the week following taking bowel prep as rapid bowel transit may make the pill
ineffective.
If you are in poor health or very frail, this procedure may not be for you. Come
to see us first in the outpatient clinic to decide if this indeed the best way to check
your bowel. It may be better to check you using the alternative techniques discussed
above.
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BOWEL PREPARATION
Seven days before your examination
If you normally take any iron tablets, stop taking them now.
Four days before your examination
Stop taking any constipating agents, e.g., Lomotil, codeine phosphate etc, but
continue with other medication and any laxatives.
Avoid fibre supplements such as Fybogel.
Two days before your examination
EAT ONLY foods from the following list.
Permitted foods:
Chicken
Cheese
Eggs
White bread
Honey (but not jam or marmalade)
Rich tea biscuits
Plain yoghurt
White fish
Potatoes (without the skin)
Chapattis
Butter or margarine
Yellow jelly (but not red)
Ice cream
Foods NOT permitted:
High fibre foods
Fruit
Mushrooms
Wholemeal bread
Sweet corn
Red meat
Vegetables
Salads
Nuts
Cereals or pulses in any form
The day before your examination
Have a good breakfast, and a light lunch, of foods taken from yesterday's permitted list.
After this do not eat any solid food until after your examination but drink plenty of clear
fluids (tea, coffee, squash, non-alcoholic drinks, carbonated drinks, water, clear soups,
Bovril, Oxo, etc.). You may have small amounts of milk in tea and coffee. Clear jelly
and ice cream are permitted.
**If your admission time is at or after 3.00pm tomorrow, you may have a light evening
meal today, from the list of permitted foods.
Taking the laxative
Follow the instructions here, not the manufacturer’s instructions. 10 senna tablets and
two sachets of Citramag are enclosed. Please follow the instructions for taking
this medication which begin overleaf. Please note that the time at which you
must take the bowel prep varies depending on the time of your appointment.
Please follow the instructions on the correct sheet. For comfort during the bowel
preparation, you may wish to put some ointment on your bottom. Zinc and castor oil,
Sudocrem and Vaseline are all suitable.
Please bring a dressing gown, slippers and something to read. Do not bring valuable items
such as credit cards and jewellery.
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If your appointment is at 9.45 am or before
The day before your examination
Have a good breakfast and a light lunch at 12:00pm eating only foods from the
Permitted foods list on page 3.
After this, do not eat any solid food until after your examination but drink plenty of
clear fluids only such as tea, coffee, squash, carbonated drinks, water, clear soups,
Bovril and Oxo. You may have small amounts of milk in tea and coffee. Clear yellow
jelly and ice cream are also permitted. Drink at least 1½ litres of clear liquids during
the day.
At 4:00 pm in the comfort of your home, take all 10 Senna tablets with a glass of
water.
At 5.00 pm dissolve the contents of 1 sachet of Citramag in 200mls (8 fluid ounces)
of hot water in a measuring jug. Citramag fizzes and may spill if a large enough jug
is not used.
Allow the liquid to cool for at least half an hour before pouring it into a suitable glass
and drinking it.
At 7:00 pm, prepare and drink the second sachet of Citramag in the same way.
Stay close to an available toilet since you should expect frequent, watery bowel
movements, like diarrhoea, to start within 3 hours of taking Citramag. You may also
experience stomach cramps, but you must drink all the Citramag to ensure the
bowel is emptied completely.
Remember: You MUST drink plenty of clear fluids, throughout the day and evening,
to help avoid headaches and dehydration.
On the day of your examination
Take any prescribed tablets, other than those mentioned earlier, with a glass of
water.
You may have a light drink (water, squash, black tea) no later than 4 hours before
your appointment.
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If your appointment time is
between 10am and 3pm inclusive
The day before your examination
Have a good breakfast and a light lunch at 12:00pm eating only foods from the
Permitted foods list on page 3.
After this, do not eat any solid food until after your examination but drink plenty of
clear fluids only such as tea, coffee, squash, carbonated drinks, water, clear soups,
Bovril and Oxo. You may have small amounts of milk in tea and coffee. Clear yellow
jelly and ice cream are also permitted. Drink at least 1½ litres of clear liquids during
the day.
At 4:00 pm in the comfort of your home, take all 10 Senna tablets with a glass of
water.
At 5.00 pm dissolve the contents of one sachet of Citramag in 200mls (8 fluid
ounces) of hot water in a measuring jug. Citramag fizzes and may spill if a large
enough jug is not used.
Allow the liquid to cool for at least half an hour before pouring it into a suitable glass
and drinking it.
Stay close to an available toilet since you should expect watery bowel movements,
like diarrhoea, to start within 3 hours of taking Citramag. You may also experience
stomach cramps.
Remember: You MUST drink plenty of clear fluids throughout the day and evening to
help avoid headaches and dehydration.
On the day of your examination
At 6:00 am, prepare and drink the second sachet of Citramag.
Take any prescribed medications, other than those mentioned earlier, with a glass
of water.
You may have a light drink (water, squash, black tea) no later than 4 hours before
your appointment.
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If your appointment is after 3pm
On the day of your examination
Have a liquid breakfast before 8 am. This can include tea and coffee (without milk),
Bovril, fruit squashes, Coke or clear soup.
At 8:00 am, in the comfort of your home, take all 10 Senna tablets with a glass of
water.
Then, prepare and drink both sachets of Citramag. Dissolve the contents of one
sachet of Citramag in 200mls (8 fluid ounces) of hot water in a measuring jug.
Citramag fizzes and may spill if a large enough jug is not used.
Allow the liquid to cool for at least half an hour before pouring it into a suitable glass
and drinking it.
Take any prescribed medications other than those mentioned earlier.
You MUST drink plenty of clear fluids throughout the day to help avoid headaches
and dehydration. You may have a light drink (water, squash, black tea) no later than
4 hours before your appointment.
Stay close to an available toilet since you should expect watery bowel movements,
like diarrhoea, to start within 3 hours of taking Citramag. You may also experience
stomach cramps. By the time you have to leave for the hospital the bowel should be
empty.
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If you would like a copy of this leaflet on audiotape, in large print or translated, please
telephone 01753 634398
Title of leaflet: How to take Bowel Preparation Medicine: Information for Patients having a Colonoscopy
Reference No: H/030/1 Issue Date: September 2013
Review date: September 2015
Compiled by:
Dr Sass Levi, Lady Sobell GI Unit
Legal Notice
Please remember that this leaflet is intended as general information only. We aim to make the information as up to date
and accurate as possible, but please be warned that it is always subject to change. Please therefore always check
specific advice on any concerns you may have with your doctor.
Heatherwood Hospital
Wexham Park Hospital
London Road
Wexham Street
Ascot
Slough
Berkshire SL5 8AA
Berkshire SL2 4HL
Tel 01344 623333
Tel 01753 633000
Web: http://www.heatherwoodandwexham.nhs.uk/information-leaflets
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