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Colon cancer is the third most common cancer affecting men and women in the United States. Approximately 150,000 new cases are diagnosed yearly and 50,000 deaths occur annually. Colon cancer is preventable because it almost never starts growing in our body as cancer, but rather starts as a benign, small, precancerous polyp or lump. If these polyps remain undetected 30% of them will continue to grow into larger polyps and ultimately cancers. We know that 25% of healthy individuals around age 50 will develop these types of polyps called adenomatous polyps. They have no signs or symptoms until it is too late. Colonoscopy allows us to find those patients with polyps and safely remove them at the time of the procedure.
During a colonoscopy, a colonoscope (specialized instrument) is inserted into the colon through the anal opening. The colon is approximately four feet long and the entire colon is carefully inspected. Any polyps found during the procedure are removed and sent for pathological evaluation. The procedure usually takes thirty minutes to perform and most patients receive sedation to make the procedure more comfortable. After the procedure there is usually no discomfort and most patients can be taken home 30 minutes after the procedure is completed.
In order to carefully inspect the colon for polyps during a colonoscopy the colon must be purged and cleansed the night before the procedure. This involves a limited diet the day before the procedure and several doses of laxatives the night before and the morning of the colonoscopy. This is called "the prep" and will be discussed under the preparations section.
Suprep for Colonoscopy (Colonoscopy Prep)
Clear Liquids: Jello, Popsicles, Italian Ices, Soup (Clear soup only without vegetables or noodles. Plain chicken soup is fine.), Soda, Gatorade, Coffee, Tea, Water, and Juices (no pulp).
Full Liquids: Milk shakes, Creamy soups, Yogurt, Tomato juice, and Cream of wheat
Seven Days Before Colonoscopy:
Purchase a Suprep kit (prescription) and 4 dulcolax laxative tablets (over the counter) from your pharmacy.
Stop taking Motrin, Nuprin, Advil, Aleve, Gingko Biloba products or Vitamin E.
If you are taking Coumadin or Plavix, make sure you discussed this with your doctor.
Continue your other medications.
Purchase Clear Liquids such as jello, popsicles, Italian Ices, soup (clear soup only without vegetables or noodles. Plain chicken soup is fine), soda, Gatorade, coffee, tea, water, and juices (no pulp).
Purchase Full Liquids such as milk shakes, creamy soups, yogurt, tomato juice or cream of wheat.
Purchase Tucks or baby wipes.
*Make sure you have arranged for an adult driver to drive you home after the procedure who will accept responsibility for you, as you will not be able to drive home yourself.
Day Before Colonoscopy:
Breakfast: Have a light breakfast. Avoid vegetables, nuts, seeds, and high fiber products.
Lunch: Have as many Clear and Full Liquids as outlined on the left.
6 P.M: Take 4 Dulcolax pills (over the counter) with 16 ounces of Clear Liquids.
Dinner: Clear Liquids only.
8 P.M: Pour One (1) 6 ounce bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16-ounce line on the container and mix. Drink All the liquid in the container.
8:15 P.M: You must drink two (2) more 16-ounce containers of clear liquids over the next 1-hour. Drink as many clear liquids as want through the night.
Morning of Colonoscopy:
Do NOT eat ant solid food the morning of your procedure. Only Clear Liquids are allowed.
5 Hours before your procedure pour ONE (1) 6-ounce bottle of Suprep liquid into the mixing container. Add cool drinking water to the 16-ounce line on the container and mix. Drink All the liquid in the container. You Must drink Two (2) more 16-ounce containers of water over the next hour.
You may continue Clear Liquids up to 4 hours prior to the procedure. Take nothing by mouth, not even Clear Liquids Four (4) hours before your exam.
Do not wear any jewelry on the day of your procedure. Please bring a current list of your medications and allergies.
Plan to be at the facility a total of 2 hours check-in, procedure, and recovery.
*You must have a responsible driver take you home. You cannot take a taxi or bus home.
Suprep Instructions Diagram:
Question and Answer:
Q: Can I take my usual medications the morning of my procedure?
A: Usually we suggest that you withhold your usual medications the morning of the procedure and under most circumstances you will be instructed to resume them immediately after the procedure.
Q: Can I take my usual medications the day before the procedure?
A: Under most circumstances, yes. However, aspirin, Motrin, Advil, Nuprin, Aleve type products, and Vitamin E must be stopped before the procedure. If you are taking Coumadin and Plavix type medications make sure you discuss this with your physician.
Q: I forgot to stop my Motrin type products or Vitamin E 7 days before the procedure.
A: Do not take anymore and inform the nurse or physician at the time of the procedure.
Q: What should I expect from the colonoscopy laxative preparation?
A: The desired effect of the laxative preparation is to purge the colon so the final evacuations are nearly colorless or light yellow in color without formed stool or brown particles. It is unusual for the laxative preparation not to work. If you have suboptimal results after taking the preparation contact the physician by 6 A.M the morning of the procedure.
Q: What should I do if I stared the laxative preparation for my colonoscopy but feel too nauseous to continue?
A: Stop the preparation for about one hour, then try and resume, but lengthen the interval between doses by an extra 10-15 minutes.
Q: What should I do if I vomited after starting the Colonoscopy preparation?
A: Stop the preparation for one hour, then restart as outlined above.
Instructions Following your Colonoscopy
You have just had a colonoscopy. This webpage contains information about what to expect over the next week. Please telephone our office if you have:
Severe or persistent abdominal pain.
Bloody bowel movement(s)
Your doctor will speak with you and decide a course of action. If biopsies were taken from the colon or if a polyp was removed, please telephone your physician in approximately seven days to obtain results.
Bleeding may occur after taking a biopsy or after the removal of a polyp. A small amount of blood in the stool is not uncommon after colonoscopy, but the passage of an entire bloody bowel movement should be immediately reported. You will have been informed if there was any bleeding at the time of the procedure. Although rare, bleeding may still occur up to ten days after a polypectomy when a scab from the cauterized area falls off.
Sharp or persistent abdominal pain is uncommon after colonoscopy. If this occurs, please telephone our office. Many patients experience discomfort due to the air pumped in to the colon during the procedure, but this usually subsides over the course of a few hours.
The medications injected in your arm vein may cause local swelling and discomfort, which may last 1-2 weeks. Although this may become bothersome, it is almost never serious. Please contact your doctor if local redness, swelling or tenderness near the injection site worsens in the days following your procedure, as this may indicate a skin infection.
The bowel preparation has emptied your gastrointestinal tract. We recommend that you avoid heavy or fatty meals today. DO NOT DRINK ALCOHOL on the day of the procedure. A normal diet may begin tomorrow.
The sedation you receive will make you less alert than normal. DO NOT DRIVE or exercise the day of the exam. You may resume normal activities tomorrow. Strenuous exercise should not be performed for 24 hours unless your physician otherwise advises you.
You may resume all medications after your colonscopy. If a polyp was removed, your physician may advise you to avoid aspirin-containing medications for several days.
BECAUSE YOUR COLON HAS BEEN COMPLETELY CLEANSED, YOU MAY NOT EXPERIENCE ANY BOWEL ACTIVITY FOR THE NEXT 2 TO 3 DAYS.
778 Long Ridge Road, Suite 101
Stamford, CT 06902
Phone (203) 967-2100
Fax (203) 967-4872