48 Hour colonoscopy prep

There are a few things that we ask all patients to do prior to your colonoscopy: 48 Hour colonoscopy prep

 – Please read through all instructions before your procedure. FOLLOW OUR INSTRUCTIONS, NOT WHAT COMES IN THE PREP BOX OR MIRALAX BOTTLE.  Call the office if you have any questions regarding the colon prep instructions.

-Please bring a list of medications and any allergies on the day of your procedure

If you are on anticoagulants such as Coumadin (Warfarin), Pradaxa(Dabigatran), Eloquis (Apixaban), or Xarelto (Rivaroxaban or are on anti-platelets such as Plavix (Clopidogrel), Ticlid (Ticlopidine, Effient (Prasugrel)or Persantine (Dipyrimadole) contact my office.   You will also need to contact your prescribing physician regarding any adjustment to your medications or additional blood tests prior to your colonoscopy.   Without my office knowing this information your procedure may need to be rescheduled.

If you take a daily aspirin, please let the office know.  You will not be asked  to stop this medication.

-If you have a pacemaker or defibrillator, call my office to verify we have this information.

-If you are a diabetic patient please call the doctor that manages your diabetes and let them know you will be prepping for a colonoscopy. They will advise you on instructions for adjusting your medications during your prep.

If you require a sign language interpreter or a foreign language translator, please let us know in advance.

Please contact my receptionist or leave a voice message if you cannot keep your appointment. 72 hour notification avoids the possibility of a $50 cancellation fee.

Make sure you have someone to drive you home or go with you in a taxi.   You will not be able to drive or return to work the day of your procedure.

Check with your insurance company prior to your procedure to assure that you understand your insurance benefits and coverage.  Your colonoscopy is considered to be a screening or routine if have you have no GI symptoms.  If you are experiencing GI symptoms (i.e. abdominal pain, bleeding, diarrhea, constipation, anemia) your colonoscopy is considered to be diagnostic.   If a polyp or tissue is removed during the procedure your colonoscopy may no longer be considered a screening but a surgical procedure.    Information on insurance claims adheres to your medical record.    

ATTENTION ALL UNITEDHEALTHCARE SUBSCRIBERS:  If you have a United Health Care Plan you may require an insurance authorization or insurance approval for your colonoscopy.  Your insurance may also direct you to the facility where your policy will cover your procedure regardless of your physician affiliation or your choice of facility.   Call your customer service dept. (phone number should be on the back of your insurance card. Tell the representative you are having a colonoscopy that will be billed using CPT code 45378 or 45380 or 45385 (depending upon findings at the time of your colonoscopy) and ask if your policy requires a UnitedHealthCare insurance prior authorization.  Also tell the representative the facility where your procedure is scheduled(Dr. Curran does procedures at Charles River Endoscopy Center which is a free standing ambulatory center or UMass Marlboro Hospital Outpatient Endoscopy Center or Marlboro Hospital Outpatient both hospital based facility.) Please then contact Doreen  at my office with the customer rep responses as your appointment will need documentation that an authorization for the procedure and place of service is or is not required. If authorization required, Doreen will then contact your insurance for the authorization necessary to confirm the date and place of your appointment and to submit a claim for your colonoscopy.

 At least one week prior to your appointment:

-Pick up your prescription prep kit at your pharmacy

-Miralax powder 8.3 oz (238grams) or a generic version (ask your pharmacist to be sure)  

– Plenty of clear liquids.  Clear liquids are liquids you can see light through such as water, ginger-ale, clear fruit juices: apple, white cranberry, white grape juice, beef  or chicken bouillon,  soda,  coffee or tea (no milk),  Gatorade, Kool-Aid, popsicles, and, Jell-O.  No red or purple coloring. Juices such as orange or grapefruit  are not a clear liquid as you cannot see through it.

Optional: Aloe baby wipes for comfort, straws for drinking your prep solution

FOLLOW OUR INSTRUCTIONS. Do not follow the instructions in the prep box or on Miralax  bottle.  The following instructions are for two day colonoscopy prep.  If you have any questions or concerns, please contact the office before you are due to start this prep.  

2 days before your exam: Mix ½ bottle of Miralax or its generic version with 32 oz of a clear liquid (not water), refrigerate. You may have a light high protein breakfast, lunch and dinner such as scrambled eggs, chicken and fish, refined white bread, biscuits , crackers or pasta.  You may have milk, ice cream, plain yogurt and cheeses. Avoid  all fresh fruits  and vegetables, only cooked fruit or vegetables without skins or seeds;  any foods with seeds, sprouts or nuts, whole wheat grains, oatmeal, fruit yogurts and  red meats.  Drink 64 oz of clear liquids throughout the day, 8-12 oz of clear liquids every hour, preferably not water.  Some of these should contain sugar, even if you are a diabetic. You may have gum and hard candies.  Avoid alcoholic drinks.   6-7PM drink the 32oz mixture of Miralax/generic version over an hour. Continue drinking 8-12 oz of a clear liquid, preferably not water until bedtime. 

1 day before your exam (the day before your exam): NO FOOD, clear liquids only.

From the time you wake up drink 8-12 oz of a clear liquid every hour, 64 oz over the course of the day.

SUPREP:

5:00 PM the day prior to your appointment: pour (1) 6oz. bottle into the supplied mixing cup. Add cold water to the red fill line. Drink the entire cup. Drinking  through a straw helps bypass the flavor of the prep.  Follow with 2 prep containers of  of water (32oz)  within the next hour. Continue drinking clear liquids until bedtime.  If you wake during the night, drink more clear liquids.  

6 hours prior to arrival time: repeat above steps with second bottle provided.

-4 hours prior to your colonoscopy stop all liquids.

FOLLOW OUR DIRECTIONS, NOT THOSE IN THE PREP KIT

 GoLYTELY, TriLYTELY, NuLYTELY or any 128oz Generic prep:

The morning prior to procedure: fill container provided with lukewarm water to the fill line, dissolve all powder.  Refrigerate the mixture. It is best to add flavor packets as you drink each glassful.  

6:00-8PM: begin drinking the solution at the rate of 8oz every 10-15 minutes until you have consumed half of the container or 64oz.  Refrigerate remaining prep.

-Continue drinking clear liquids until bedtime. 

-6 hours prior to arrival time: finish the second half of the prep mixture at the rate of 8 oz. every 10 -15 minutes until gone. This should take about 2 hours

-4 hours prior to your colonoscopy stop drinking all liquids.

 If the prep makes you feel queasy ,  STOP until the nausea passes. Then resume at the specified rate as best as you can.  You can take medications the morning of your colonoscopy with a sip of water except for diuretics (water pills), such as Lasix; hydrochlorothiazide; or any medication ending in HCT. Hold those medications until after your procedure. 

Please allow 3 hours from arrival to discharge though this estimate may vary from patient to patient.  Every attempt is made to adhere to the schedule though there are occasions when unavoidably the schedule may run behind.  Your patience and understanding are appreciated.