Gia colon prep
BRIAN D. CLARKE, M.D. SUSAN A. WOLFE, FNP, C
You are scheduled for a colonoscopy on ______________________, ____________________ 201_ . Report to outpatient registration at _________ a.m./p.m. at
Community Hospital North at 7150 Clearvista Pkwy, Phone (317) 621-5193
Carmel Endoscopy Center at 13421 Old Meridian St, Phone(317) 706-1600
You need to be accompanied by a driver for this exam.
(A taxi cab or bus is not
acceptable.) YOU WILL NEED TO PURCHASE:
SUPREP® Bowel Prep Kit
(Prescription required) Follow package instructions for mixing. Dulcolax (Bisacodyl) (2 tablets)
(No prescription required) – You may delete if you have intolerance or diarrhea
You may continue to take regular medications on day before procedure except medication that would prevent
your colon from being cleaned out. Example: Anti-diarrheal medications, fiber supplements. Heart
or blood pressure
medications: Take these on the morning of the colon exam. Diabetics
: Take half of your evening dose of insulin
on the day before the procedure but do not take oral
on the day of the colonoscopy until completed. (If any questions,
please contact the doctor that prescribes your insulin.) Iron supplements
(Ferrous sulfate): Stop 1 week before colonoscopy. Blood thinner:
Please discontinue Coumadin (warfarin), Lovenox (heparin), Aspirin (>81 mg)
3 days before
colonoscopy and Plavix (clopidogrel), Effient (prasugrel
), Pradaxa (dabigatran), Persantine
, Pletal (cilostazol)
, Ticlid (ticlopidine)
5 days before the colonoscopy. Discuss with your
prescribing physician for their approval before you stop any medicine that affects blood clotting. COLON PREP INSTRUCTIONS
The Day Before Your Colonoscopy:
1. Clear Liquid Diet
(see list below) beginning at breakfast. No solid food allowed.
2. 2:00 p.m. or immediately after work
Take 2 bisacodyl delayed release tablets with water (do NOT chew
or crush). First bowel movement should occur in about 1-4 hours after taking the laxative pills.
(Helpful hint: Topical A&D ointment or Vaseline can reduce anal irritation from the resulting diarrhea)
3. Wait for a bowel movement (or maximum of 4 hours
) then drink, 1 (6 oz) bottle of SUPREP®
kit cup and fill with cool drinking water to the 16 oz. line. Drink ALL of the solution.
4. Drink two more cups of 16 oz. of clear liquids of your choice over next hour to ensure adequate hydration
and an effective prep. You may experience some abdominal bloating and distention before the bowels move. The Morning of Your Colonoscopy:
At least 3 1/2 hours before leaving home for procedure (You may need to set an alarm!)
5. Early morning
Repeat step 3 and 4 by drinking 2nd bottle of SUPREP®
solution mixed in 10 oz of water
followed two more 16 ounce cups of clear liquids in an hour, DO NOT drink anything else after this.
6. If colonoscopy is in afternoon, clear liquids are encouraged up to 3 hours
before your arrival time.
CLEAR LIQUID DIET (No red or purple artificial colors)
Jell-O® or gelatin (plain without fruit), coffee or tea, low-salt bouillon/broth, juices without pulp, popsicles,
soda-pop, Crystal Light®, Kool-aid®, Gatorade® & hard candy. No milk products after lunch or fruit fiber. FINAL INSTRUCTIONS
Bring current medication list with dosages and a picture ID
**Please note: There is a $75.00 fee for procedures cancelled less than 48 hours (2 business days) before
Frequently Asked Questions about Colonoscopy
What is a colonoscopy?
Colonoscopy is a procedure that allows your physician to examine the lining of the rectum and colon for signs of
cancer, polyps, or other abnormalities. A flexible tube, about the thickness of an index finger is gently inserted
into the anus and advanced through the length of the entire colon. This instrument called a “colonoscope” is
equipped with a tiny video camera which sends pictures to a TV screen. What preparation is required?
The rectum and colon must be completely emptied of stool for the procedure to be effectively performed. When
scheduling for the procedure, our office will supply you with information regarding your prep and dietary
restrictions. You will also be sedated for the procedure, so you will need to arrange to have some one drive you
home afterwards. The sedation could impair your judgment and reflexes for the rest of the day, so you should not
drive or operate machinery until the next day. Why is colonoscopy performed?
Colonoscopy is usually done as either part of a routine screening for cancer, in patients with known polyps or
previous polyp removal, to evaluate a change in bowel habits or bleeding, or to evaluate inflammation in the
lining of the colon. Colon cancer has become the second leading cause of cancer deaths in the country, killing
nearly 60,000 people each year. The good news is that it is also one of the most preventable types of cancer.
This is because the majority of colon cancers begin as a small noncancerous growth called a polyp. Polyps grow
slowly and can eventually turn into cancer. This transformation can take as long as ten years, during which time
you feel perfectly fine, showing no symptoms. Who should be screened?
Colon cancer affects all races, men and women about equally. Current guidelines suggest screening for all
average risk adults over the age of 50. If the exam is normal and there are no other risk factors, repeat
examinations should be performed at ten year intervals.
High risk individuals are screened more often. These would include those with symptoms, prior colon cancer or
polyps, inflammatory bowel disease, and those with a family history of colon cancer or polyps. Will my insurance cover a screening colonoscopy?
Since screening colonoscopy is considered routine care, the answer will depend on the insurance plan. Medicare
recipients over the age of 50 are now covered for average risk screenings if they have not had a previous
colonoscopy within the past ten years. The Medicare Part B deductible is waived in these cases.
The State of Indiana passed a law in 2000 that requires most health insurance plans to cover colorectal cancer
screening exams and lab tests in accordance with the latest American Cancer Society guidelines. You will need
to contact your benefits representative for information specific to your plan. Will my benefits for routine procedures apply if a polyp is discovered during the course of a
Unfortunately, if a polyp or other abnormality is found during the course of a screening colonoscopy, most
insurance companies will not consider the procedure to be a routine screening, but instead cover the service as a
CliniCal Practice DeveloPment Louisa Stone People with advanced disease approaching the end of life require sensitive consideration with regard to infection control procedures. Strict adherence to infection control guidelines designed for the acute hospital setting may not always be appropriate for terminal y il patients. This article examines the management of meticillin (methicillin)-resis
Preventive Services Guidelines for Enrollees in HSA Plans Effective January 1, 2008 The following preventive services will be covered in full (plan pays 100%) when rendered by in-network providers and billed as routine preventive care. Age and frequency restrictions apply. Diagnostic tests performed to investigate existing symptoms or to monitor on-going conditions are not covered