Colonoscopy Patient Preparation

Instructions for a colonoscopy – MoviPrep

For a successful colonoscopy, it is very important that the bowel be totally clean. A totally clean
bowel is best achieved by taking the MoviPrep® bowel preparation following these instructions.These may be different to those on the box.

The MoviPrep will flush out the large bowel resulting in diarrhoea, which should become clear and watery when the large bowel is clean

If the bowel is not completely clean, then important abnormalities such as polyps could be missed.
You may have to repeat the procedure

Please buy MoviPrep (1 box) from your local pharmacy at least one week in advance. Follow these instructions:

	7 days before your colonoscopy Stop taking anti-diarrhoea medications 7 days before your procedure.
	4 days before your colonoscopy Stop taking iron tablets 4 days before your procedure if you are on them. Avoid pips, seeds, grains and skins in your diet.
	1 day before your colonoscopy You are to have no solid foods, milk products or orange juice. You may have clear fluids only such as water, cordial, clear fruit juice (no pulp), clear broth, black tea/coffee with sugar, clear jelly (not red), barley sugar lollies, soft drinks, Hydralyte drinks, lemonade icy poles and honey. Alternate your fluids as above. You must drink between 2–3 litres of the above liquids throughout the day. At 6pm add the first MoviPrep dose (1.5 litres) to water as directed, stir well and drink slowly over 1–2 hours.
	The day of your colonoscopy 4 hours prior your procedure, drink the last 500mL of MoviPrep over the next hour Continue drinking Clear Fluids 3 hours before your arrival Once you have finished, continue fasting completely and do not drink anything further. To fast means nothing more to drink – no water, chewing gum, lollies, ice, etc You may have your usual medication with a sip of water (unless instructed to withhold)
	Important information about going home It is preferable that a responsible adult escorts you home in a suitable vehicle and stays with you the night of the procedure. We will notify this person by phone when you are ready to be collected. A taxi is acceptable provided that a responsible person remains with you at all times—including during the taxi ride, and you must not drive yourself or use public transport.

Frequently Asked Questions

1.  What is a clear stool?
A clear stool can have a slight tint of yellow or brown. It will be completely transparent, and will not contain any solid matter.

2.  I am not having bowel movements, what should I do?
Bowel movements can take up to 5-6 hours after beginning the prep to start. Be patient, continue to drink liquids. If you have not had a bowel movement by midnight the night prior to your procedure, you will need to reach the on-call physician for further instructions.

3.  The prep is making me nauseous, what should I do?
If you develop nausea or vomiting, slow down the rate at which you drink the solution. Please attempt to drink all of the laxative solution even if it takes you longer. If vomiting persists, or you are not able to finish the preparation, stop the preparation and call your physician’s office for further instructions.

4.  What are some high fibre foods I should avoid?
Raw fruits and vegetables are typically high in fiber, as well as nuts, seeds, whole grain breads and beans and lentils.

5. If I eat popcorn or seeds 3 days before my procedure do I need to reschedule?
You will not need to reschedule your procedure, however the seeds or nuts may cause a difficulty in screening and require a need for rescreening. If you have eaten a large amount of seeds or nuts, you may want to contact the nurse or physician.

6. Can I drink ALCOHOL on the liquid diet?
Alcohol is not allowed as part of the liquid diet.

7. Can I continue to be on the liquid diet after I begin consuming the laxatives?
Yes, you may continue the liquid diet until you are directed to discontinue anything by mouth, which is typically 4-6 hours prior to the procedure.

8. Why do I have to wake up at so early for the 2nd dose, can’t I take it all the night before?
A split prep has proven to be the most effective for a successful colonoscopy. It is essential that you follow the directions provided with your prep medications.

9. If I weigh xx kg, do I need to take all of the prep?
The liquid amount is not weight dependent. It is important to finish the prep for a successful colonoscopy.

Safety and Risks

Complications of gastroscopy are very rare and may include bleeding or perforation. For inspection of the bowel alone, complications of colonoscopy are uncommon. Most surveys report complications in 1 in 1000 examinations or less.

Complications, which can occur, include an intolerance of the bowel preparation solution and scope disinfection solution used. Perforation (making a hole in the bowel), splenic injury or major bleeding from the bowel is extremely rare but if occurs, may require surgery. When operations such as removal of polyps are carried out there is a slightly higher risk of perforation and bleeding. Because of the risk of cancer, it is recommended that all polyps found at the time of colonoscopy be removed.

Even with a careful and thorough colonoscopy, there is still a small chance that some polyps or even early cancers may not be seen. This can happen because of the natural bends and folds in the bowel or if the bowel is not fully cleaned out before the test. Studies show that small polyps (less than 5 mm) can be missed in about 1 in 4 cases, medium polyps in about 1 in 10 cases, and larger polyps in fewer than 1 in 20 cases. Very occasionally, cancer may also be missed, which is why follow-up and repeat colonoscopies are recommended when needed.

However, it will not be possible to discuss the removal with you at the time of examination, as you will be sedated. If you have any queries or reservations about this, please inform your Doctor. In the unlikely event of hemorrhage occurring, blood transfusion may be necessary.

Before you have a colonoscopy, you need to make sure your bowel is as clear as possible. If your bowel is not clear, polyps or even cancers may be missed, or you may need to have the colonoscopy again. This means it is important for you to follow the instructions carefully and ask questions if you do not understand what to do. To get your bowel ready for the colonoscopy, you will be told what (and what not) to eat and drink, including when to drink extra fluids to stop you from getting dehydrated. You will be given or asked to buy medicine to clear out your bowel by causing diarrhea. Make sure you understand when to take the medicines, usually starting the day before the colonoscopy. Your doctor or nurse will explain how these medicines may affect you. You should tell them about any previous experience you have had with bowel preparation. Preparation for colonoscopy can also affect your other health conditions or medicines, such as medicines for diabetes or medicines to prevent blood clots. You may need to change the way you take your other medicines or follow special instructions in the days before your colonoscopy. Your Clinician will discuss with you any changes you may need to make. Some people may need extra personal or health support during bowel preparation and a few may need an overnight stay in hospital.

Our Gastroenterologists

Our gastroenterologists constantly strive to provide the highest standard of digestive health services and patient centred care. The easiest way to achieve the most accurate results and have the best patient experience is to ensure you follow all of the colonoscopy preparation instructions.