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Colonoscopy Preparation using MoviPrep


 

Colonoscopy Preparation Using MoviPrep 2 Day PM/AM Split Dosing Regimen

The colon preparation is the most important step leading to the successful completion of a colonoscopy. We know it is inconvenient, but a clean colon will lead to an efficiently and safely performed colonoscopy that will lead to good gastrointestinal health.

SEVEN DAYS BEFORE THE PROCEDURE
Medication restrictions

  1. Diabetics taking insulin will need dose adjustment the day before the exam. Please ask for advice from the physician that prescribes your insulin. For diabetics only taking diabetic pills simply stop the pills the day before the procedure (see below).
  2. Blood thinners including Coumadin, aspirin, and Plavix type medicines. These can increase the risk of bleeding during endoscopic procedures to a varying degree. We recommend stopping Coumadin three days before the procedure, if possible. Please ask for advice from the physician that prescribes your Coumadin. If aspirin is used for preventative reasons and not for active cardiac or stroke prevention then it should be stopped for 7 days before the procedure. Discuss the use of other blood thinners, such as Plavix, with the prescribing physician.

Items to Purchase

  1. Fill the prescription for MoviPrep (check for rebate coupon in the office). MoviPrep contains NutraSweet/aspartame; if this is a problem, call us before filling the prescription.
  2. Fill the prescription for Tigan (anti-nausea) drug. 
  3. Any over-the-counter hemorrhoid ointment for anal discomfort (if needed). 

THREE DAYS BEFORE THE PROCEDURE
No seeds, nuts, popcorn or peels from fruits and vegetables

ONE DAY BEFORE THE PROCEDURE

  1. For breakfast and lunch you may choose one of the following:

2 eggs or 1 yogurt (any kind), or 1 ensure then clear liquids only for the remainder of the day.

  1. You cannot have milk or orange juice for the entire day.
  2. Drink as much as you can to prevent dehydration. You may have bouillon, broth, black coffee (sugar is okay), tea, juice (apple, grape, cranberry), Gatorade, lemonade, soda, water, Popsicles and Jell-O (any flavor or color). Red Jell-O and red Gatorade may turn your bowel movements red, but should be limited.
  3. You may have clear candy (such as Lifesavers, Jolly Ranchers).
  4. Do not take oral diabetic pills.

TIMING OF PREPARATION

EVENING BEFORE THE COLONOSCOPY
This is a 2 liter prep divided into two 1 liter sessions. You must drink the entire MoviPrep to ensure your colon will be cleaned out. A poor prep can mean missed lesions (flat polyps) and cancellation and rescheduling of your procedure.

Starting at 6:00 p.m. (first liter)

  1. Empty 1 Pouch A and 1 Pouch B into the disposable container. Add cold water to the top line of the container. To improve taste, add a squeeze of lemon or lime or iced tea (try it first, and then add small amounts gradually to taste if needed). Mix to dissolve. You may mix the solution in the morning and refrigerate. 
  2. The MoviPrep container is divided by 4 marks. Every 15 minutes, drink the solution down to the next mark (approximately 8 oz), until the container is empty. Drinking the solution through a straw to allow liquid to bypass your taste buds may help.
  3. Drink 16 oz or more of a clear liquid of your choice after the first liter dose.
  4. If you become nauseated, stop drinking the MoviPrep. Take one of the Tigan capsules. Resume drinking the MoviPrep after 30 minutes, or when the nausea passes.  If you do not use the Tigan, then it can be kept in case you have nausea in the future.
  5. Empty 1 Pouch A and 1 Pouch B into the disposable container. Add cold water to the top line of the container. To improve taste, add a squeeze of lemon or lime and some sugar or iced tea, same as in step 1. Mix to dissolve. Refrigerate until it is time to continue the preparation in the morning.

THE MORNING OF THE PROCEDURE (second liter)
Beginning 4-6 hours prior to your scheduled procedure time, repeat steps 2-3 as listed above for the second liter of your preparation. Use Tigan if needed for nausea; see step 4 above.

  1. You should take any necessary medications you normally use on the morning of the procedure with sips of water. Take nothing by mouth, including water, after completing the last MoviPrep dose.
  2. Take your regular medications on the morning of the procedure with sips of water.
  3. Arrive at your scheduled appointment time.
  4. Bring a list of your medications, insurance cards and photo ID.
  5. After the procedure you must have a responsible adult drive you home. It is best if your driver waits for you at the endoscopy center. You may be dropped off and picked up by a responsible person approximately one and a half hours later. Taking a cab home is not an option.
  6. You may not drive or work until the next day. 

IMPORTANT INFORMATION ABOUT SEDATION
Sedatives used for endoscopy include Propofol. These medications provide amnesia and pain relief. You are breathing on your own. It is not considered general anesthesia. The only reasons not to receive Propofol are pregnancy, egg allergy and soy allergy.

QUESTIONS OR PROBLEMS? PLEASE CONTACT SIG: 

  1. Daytime phone number is (314) 997-0554.
  2. After hours number is (314) 388-6578.
  3. Internet website address is www.gidoctor.net