Colonoscopy Patient Preparation

If you have made an appointment with us for a colonoscopy procedure, you will need to follow the prescribed preparation instructions below. Proper patient preparation is very important for the procedure to be successful and safe.

Cancellation Policy

Please note that we require two full business days notice to be eligible for a refund of your procedure.
There will be a cancellation fee for appointments cancelled or not attended with less than two full business days notice.

General Preparation Instructions

Ozempic and any other GLP-1/GIP agonists must be withheld for two weeks prior to your procedure
The following is a requirement of all endoscopy patients.

Someone MUST Collect You after the Test

Due to the use of anaesthetic during our endoscopy procedures, the effects will make you drowsy and incapable of legally driving yourself home.
Please arrange for a friend or relative to collect you about one and a half hours after the test, as you cannot drive or leave the hospital on your own. Your procedure will be cancelled on the day if you do not have a friend or relative to pick you up and you will still be liable for the out of pocket costs of your procedure.
You are not able to take a Taxi or Uber/Rideshare home.

What to bring with you:

Referral from your Doctor
Medicare card (Please inform staff when booking if you have no Medicare card, Interim card or reciprocal card)
Private insurance card (if applicable)
Pensioner/health care card
Account payment (Direct Endoscopy accepts MasterCard, Visa or cash and provides EFTPOS facilities to facilitate easy payment of accounts on the day)
List of medications
Reading glasses (if necessary)

Wear Loose Clothing and Leave Valuables Behind
Please wear light casual clothing and do not bring valuables with you.

Remove Lipstick and Jewellery
Please do not wear lipstick or jewellery.

Remain Under Competent Supervision For 12 Hours
For 12 hours after the procedure, you should remain in the care of a responsible adult and not drive or operate machinery.

Specific Preparation for Colonoscopy

The following are specific preparation instructions for patients with an appointment for the colonoscopy procedure.

Consult Your Doctor about Current Medication
If you are on IRON tablets, these should be stopped four days prior to the test.
If you take WARFARIN, PRADAXA, XARELTO or ELIQUIS please consult your Doctor.
You must stop all other Diabetic tablets the day before and the morning of your procedure. Bring your diabetic medication with you to your appointment.
If you take INSULIN, please contact your Doctor to adjust dosage.

If you are Diabetic and take any of the following medications listed below, you must stop those tablets for TWO days prior to your colonoscopy as well as on the morning of the colonoscopy procedure. Please speak to your Doctor/GP/Endocrinologist about an alternative oral hypoglycaemic as required:

FORXIGA (dapagliflozin) Tablets
XIGDUO XR (dapagliflozin and metformin hydrochloride XR) Tablets
QTERN (dapagliflozin and saxagliptin) Tablets
JARDIANCE (empagliflozin) Tablets
JARDIAMET (empagliflozin and metformin hydrochloride) Tablets
GLYXAMBI (empagliflozin and linagliptin) Tablets
STEGLATRO (ertugliflozin) Tablets
SEGLUROMET (ertugliflozin and metformin hydrochloride) Tablets
STEGLUJAN (ertugliflozin and sitagliptin) Tablets

Special Notes:

Patting instead of wiping, using flushable moistened wipes, warm washcloths or a warm bath, and applying a barrier cream such as Vaseline or Bepanthen if needed can help relieve rectal discomfort or irritation.

Refrigerating the solution and sipping with a straw may make it more tolerable. Take a break if you experience nausea, vomiting or cramping; however, you will need to complete the entire prep as instructed to get the best results from your procedure.

Wear Loose Clothing and Leave Valuables Behind
Please wear light casual clothing and do not bring valuables with you.

Please do not wear lipstick or jewellery.

Remain Under Competent Supervision For 12 Hours
– For 12 hours after the procedure, you should remain in the care of a responsible adult and not drive or operate machinery.

MORNING (before 1pm) Colonoscopy Procedure Instructions for MoviPrep

For a successful colonoscopy, it is particularly important that the bowel be totally clean. A totally clean bowel is best achieved by following the White Diet then taking the MoviPrep^® bowel preparation following these instructions. These instructions 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:

* Please note: If you suffer from constipation or have had a failed procedure due to inadequate bowel preparation, please inform the pre-admission nurse when confirming your appointment and you will be provided with alternative bowel preparation instructions.

	7 days before your colonoscopy Stop taking anti-diarrhoea medications and iron tablets (4 days before your procedure) if you are on them. Avoid pips, seeds, grains and skins in your diet
	2 days before your colonoscopy Start following the White Diet instructions (see below “What you can eat”) Only eat foods from the White Diet Drink plenty of permitted Clear Fluids (see below “What you can drink”)
	1 day before your colonoscopy Continue eating the White Diet for breakfast and lunch Stop eating any food after 6pm; keep drinking *Clear Fluids. You cannot eat again until after your procedure, but you can drink clear fluids only At 6pm, drink the first 1.5 litres of MoviPrep* over the next 1-2 hours Drink at least 3 cups of additional Clear Fluids after the MoviPrep
	The day of your colonoscopy Do not eat any food. 4 hours prior your procedure, drink the last 500mL of MoviPrep over the next hour Drink 1-2 cups of additional *Clear Fluids* after the MoviPrep Once you have finished, continue fasting completely, 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.

White Diet Instructions

	What you can eat: Milk (regular, low fat, skim) Regular white bread/toast, rice bubbles, white rice, regular pasta, potatoes (peeled), rice noodles, plain rice crackers, white flour Eggs, Chicken breast (no skin), white fish fillet (no skin) Cheddar, ricotta, fetta, cottage, parmesan, mozzarella or cream cheese, white sauce White yoghurt (no added fruit), mayonnaise, cream, sour cream, butter, margarine, oil Diabetic lollies or sweets; diet lemonade icy pole, diet clear jelly
	What you must not eat Anything not listed above INCLUDING white foods such pears, parsnip, cauliflower, onion, tofu, coconut, porridge, banana, mushrooms, semolina, couscous, popcorn
	What you can drink (clear fluids only) Transparent non-carbonated fluids (i.e. when held up to light can be seen through). They include water, clear cordial/juice (without pulp), tea or coffee without milk, pre-op carbohydrate drinks and clear oral nutrition supplements. They do NOT include sports drinks, jelly, broth, particulate- or milk-based products.

A Sample White Diet Menu

Breakfast	Glass of Milk (regular, low fat, skim), Rice bubbles with milk, Scrambled eggs and regular white toast
Morning Tea	Plain rice crackers with cheese
Lunch	White bread sandwich with sliced chicken breast, cream cheese or mayonnaise Diabetic lollies/sweets
Afternoon Tea	Plain vanilla yoghurt Vanilla Sustagen
Dinner	White fish fillet with white rice or mashed potato or Regular pasta with diced chicken breast and parmesan cheese or Chicken soup (clear chicken broth/stock) with rice noodles and sliced chicken breast

AFTERNOON (at or after 1pm) Colonoscopy Procedure Instructions for MoviPrep

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 and iron tablets (4 days before your procedure) if you are on them. Avoid pips, seeds, grains and skins in your diet
	2 days before your colonoscopy Start following the White Diet instructions (see below “What you can eat”) Only eat foods from the White Diet Drink plenty of permitted Clear Fluids (see below “What you can drink”)
	1 day before your colonoscopy Continue eating the White Diet for breakfast and lunch Stop eating any food after 6pm; keep drinking *Clear Fluids. You cannot eat again until after your procedure but you can drink clear fluids only Drink the first litre of MoviPrep* over the next 1-2 hours. Drink at least 3 cups of additional *Clear Fluids* after the MoviPrep.
	The day of your colonoscopy At 7am drink the 2^nd litre of *MoviPrep* over the next hour. Drink 1-2 cups of additional *Clear Fluids* after the MoviPrep. COMPLETELY FAST FROM 11am. 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 not take them).
	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.

White Diet Instructions

	What you can eat: Milk (regular, low fat, skim) Regular white bread/toast, rice bubbles, white rice, regular pasta, potatoes (peeled), rice noodles, plain rice crackers, white flour Eggs, Chicken breast (no skin), white fish fillet (no skin) Cheddar, ricotta, fetta, cottage, parmesan, mozzarella or cream cheese, white sauce White yoghurt (no added fruit), mayonnaise, cream, sour cream, butter, margarine, oil Diabetic lollies or sweets; diet lemonade icy pole, diet clear jelly
	What you must not eat Anything not listed above INCLUDING white foods such pears, parsnip, cauliflower, onion, tofu, coconut, porridge, banana, mushrooms, semolina, couscous, popcorn
	What you can drink (clear fluids only) Transparent non-carbonated fluids (i.e. when held up to light can be seen through). They include water, clear cordial/juice (without pulp), tea or coffee without milk, pre-op carbohydrate drinks and clear oral nutrition supplements. They do NOT include sports drinks, jelly, broth, particulate- or milk-based products.

A Sample White Diet Menu

Breakfast	Glass of Milk (regular, low fat, skim), Rice bubbles with milk, Scrambled eggs and regular white toast
Morning Tea	Plain rice crackers with cheese
Lunch	White bread sandwich with sliced chicken breast, cream cheese or mayonnaise Diabetic lollies/sweets
Afternoon Tea	Plain vanilla yoghurt Vanilla Sustagen
Dinner	White fish fillet with white rice or mashed potato or Regular pasta with diced chicken breast and parmesan cheese or Chicken soup (clear chicken broth/stock) with rice noodles and sliced chicken breast

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 fibre, as well as nuts, seeds, whole grain breads and beans and lentils.

5. What are some good options for low fibre foods?
Choose white bread and white rice for lower fibre options, as well as pastas made with white flour. Chicken, fish, dairy, and eggs are also low in fibre and good choices for foods 2-3 days before you begin your prep.

6. 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 difficulty in screening and require a need for re-screening. If you have eaten a large amount of seeds or nuts, you may want to contact the nurse or physician.

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

8. 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.

9. Why do I have to wake up so early for the 2^nd 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.

10. 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. 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 diarrhoea. 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.

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