elysium logoQ: I didn’t stop all my vitamins before my colonoscopy. What should I do?
A: Do not cancel your colonoscopy. We typically recommend holding vitamins (especially the ones containing iron), because iron darkens your stools or makes you more constipated and sometimes it makes it harder to clean out the colon. However, this is NOT a contraindication to doing your procedure. Just make sure you follow the rest of the bowel preparation instructions to try to make your colon as clean as possible.
Q: Can I take another bowel preparation?
A: In my experience, I have found that the 4 L of Peglyte and Dulcolax tablets provide the cleanest bowel preparation. The efficacy of a colonoscopy depends on the adequacy of the bowel preparation. Inadequate bowel preparation is associated with lower polyp/adenoma detection rates. Not detecting adenomas (polyps) can increase your risk for developing colon cancer. Inadequate bowel preparation can also result in repeat examinations at shorter intervals.
Cancer Care Ontario’s Bowel Preparation Best Practice Guidelines strongly recommend split-dosing regimens, which means that the preparation is administered in 2 doses over 2 days, starting the day before the colonoscopy. It has shown to have superior efficacy and better tolerability compared to drinking all of the preparation the day before.
If you cannot tolerate Peglyte, you can try Bi-Peglyte, but make sure you follow the instructions and drink adequate amount of fluids and make sure you split the bowel preparation (e.g. take the 3 tablets of Dulcolax at 4 PM the day before, then drink the first packet if Bi-Peglyte mixed with 1 L of water at 4 PM the day before and the second patcket of bowel prep mixed in 1 L of water 4 hours before your appointment).
Q: Do I really have to be on a clear fluid diet the day before a colonoscopy?
A: YES! I have found that in patients who eat breakfast the day before, the right colon is not as clean. If the colon is not very clean, we may have to repeat the colonoscopy at a short interval. However, if you accidentally ate a light breakfast the day before the test, we can still go ahead and do the test, but make sure you drink the entire 4 L of Peglyte. You can also have clear broth the day before.
FOR DIABETIC PATIENTS, you can take 1 can of GLUCERNA for breakfast, lunch and dinner. This can serve as a meal supplement.
Q: Do I need a ride after my test?
A: YES, if you receive sedation. Our anesthetist will not give IV sedation if you will be driving home. You can also take a taxi or bus as long as someone accompanies you home.
Q: I would like to try to get pregnant. Can I still get IV sedation?
A: Our anesthetists provide sedation with IV medications, typically propofol. If you are currently pregnant, please inform us as we would avoid giving sedation or we would postpone your elective procedure until after your pregnancy. However, if you are currently not pregnant, propofol can be safely administered. It is also a short-acting medication. If you have concerns, you can also discuss this with our anesthetist on the day of the procedure.
Q: Why is there a 72 hour cancellation fee?
A: Our office needs time to contact and book another patient in your time slot. Other patients whom we contact to take your time slot will need time to prepare for their procedure or to find a ride or to take time off work. If you cancel at the last minute, this slot will be left empty and it will delay other patients having their procedures. Thank you for your cooperation.
Q: Can I go back to work after my scopes?
A: If you received sedation, we recommend that you take the day off.
Q: What should I do with my medications?
A: If you are DIABETIC – take HALF of your diabetic medications (including insulin) the day before the colonoscopy. HOLD your diabetic medications on the day of your colonoscopy (but you can take it afterwards). We will try to book you for a morning appointment. If you have type 1 diabetes or if you have very hard to manage sugar levels during times of fasting, please see your family doctor or endocrinologist in advance for advice about insulin management in preparation for your colonoscopy.
Continue all essential medications.
Blood pressure medications should be continued the day before the test. You can also take it the day of your procedure, with sips of water 4 hours before the test.
If you take a bloodthinner (e.g. coumadin, apixaban, etc) – see Dr. Sam first in the office for a consult. Aspirin can be continued but it is also ok to hold it 7 days before. Plavix should be stopped 7 days before the test.
Anti-seizure medications should be continued and should be taken on the day of the procedure (with sips of water 4 hours before the test, if you typically take this in the morning).
Steroids (e.g. prednisone) should be continued.