From the Guidelines
Before undergoing a gastroscopy and colonoscopy, Carrick should receive both verbal and written patient education instructions for all components of the colonoscopy preparation, including dietary modifications and bowel preparation regimen, as recommended by the US Multi-Society Task Force on Colorectal Cancer 1. To prepare for his procedures, Carrick should limit dietary modifications to the day before colonoscopy, including the use of low-residue and low-fiber foods or full liquids for the early and midday meals, when using a split-dose bowel preparation regimen 1.
- He should be instructed to follow a split-dose administration of bowel preparation purgatives, with the consumption of the second portion beginning 4–6 hours before the time of colonoscopy and be completed at least 2 hours before the procedure start 1.
- It is also recommended that Carrick receives some form of patient navigation, including telephonic or virtual navigation using automated electronic messaging to improve rates of adequate bowel preparation 1.
- Additionally, Carrick should be informed to stop eating solid foods and consume only clear liquids up to 2-4 hours prior to the procedure, after which nothing should be taken by mouth.
- He should also inform his doctor about all medications he takes, as some medications may need to be temporarily stopped before the procedure.
- Arranging for someone to drive him home afterward is also crucial, as sedation medications will impair his ability to drive safely.
- The selection of a bowel preparation regimen should consider Carrick's medical history, medications, and, when available, the adequacy of bowel preparation reported from prior colonoscopies 1.
- It is essential to assess bowel preparation quality only after all washing and suctioning have been completed, using reliably understood descriptors that communicate the adequacy of the preparation 1.
From the FDA Drug Label
(Bottle Only) (white section in cap) (17 g) (cold, hot or room temperature) then drink ensure that the powder is fully dissolved before drinking do not drink if there are any clumps (Packet Only) stir and dissolve one packet of powder (17 g) in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink ensure that the powder is fully dissolved before drinking do not drink if there are any clumps
The instructions for preparation are to dissolve the powder in a beverage, ensuring it is fully dissolved before drinking, and to not drink if there are any clumps. Additionally, the patient should not combine with starch-based thickeners and not use more than 7 days. For a gastroscopy and colonoscopy, the patient should follow the doctor's advice, which may include taking the medication once a day as directed. 2
From the Research
Pre-Procedure Instructions for Gastroscopy and Colonoscopy
To prepare Carrick for his gastroscopy and colonoscopy procedures, the following instructions should be given:
- Dietary Restrictions:
- A low-residue diet or clear liquid diet may be recommended for a certain period before the procedure, typically 1-3 days 3, 4, 5, 6.
- Avoid high-fiber foods, such as vegetables, beans, and whole grains, for at least 3 days before the procedure 5.
- Consider promoting the consumption of gelatin and avoiding red meat, poultry, and vegetables 1 day before colonoscopy 3.
- Bowel Preparation:
- A bowel preparation agent, such as polyethylene glycol (PEG) or sodium phosphate, will be prescribed to cleanse the bowel 7.
- The bowel preparation agent should be administered at least in part a few hours in advance of the colonoscopy 7.
- Split-dose bowel preparation regimens may be recommended to improve tolerance and efficacy 3, 7.
- Additional Instructions:
- Patients should be informed about the importance of good bowel preparation and its impact on the quality of the procedure 7.
- Special considerations should be made for patients with certain medical conditions, such as diabetes, heart or kidney disease, and inflammatory bowel disease 7.
- Patients should be advised to follow the specific instructions provided by their healthcare provider and to ask any questions or concerns they may have.
Key Considerations
- The quality of bowel preparation is crucial for a successful colonoscopy procedure 7.
- Patient tolerance and compliance with bowel preparation instructions are essential for achieving good bowel preparation 4, 6.
- The choice of bowel preparation agent and dietary restrictions may vary depending on individual patient needs and medical conditions 7.