Gastroenterology | Top Q&A

Colonoscopy can be difficult but with a little preparation and some knowledge the procedure will be easier to handle. That’s what this brief guide is about. It is divided into several sections so that you can refer to it when needed. The sections are:

  • General checklist of things to do in the weeks before the procedure
  • Materials for preparing colonoscopy
  • 7 days before endoscopy
  • 2 days before endoscopy
  • The day before your colonoscopy
  • Your endoscopy day

    • We’re also here to help, so please call Elliot Gastroenterology at (603) 314-6900 if you have any questions or concerns.Please Note: If you are having a colonoscopy AND EGD, these instructions include an EGD preparation section. We require one week’s notice for all cancellations. Please call 603-314-6904 in case you need to cancel or reschedule your procedure. Please note that you may be contacted by the procedures department on the date of your appointment to adjust your arrival time.

    Part 1

    Contents

    A general checklist of things to do in the weeks before the procedure: Check these at least 2 weeks before your appointment.

    • Check your Insurance benefits and make sure you know about your coverage. Contact customer service with your insurance company. Be sure to ask what is covered in the insurance plan, and what is not.
    • Diabetics – Make sure you contact your administering or prescribing physician for medication instructions.
    • If you are using prescription blood thinners – you must contact your administering physician or prescribing physician for instructions. If your administering or prescribing physician is at New Hampshire Cardio Consultants, you will be contacted by a nurse from their office approximately 2 weeks prior to the procedure to provide instructions.

    You will be sedated. You will receive intravenous sedation during your procedure. You will be monitored throughout the entire process. The drugs used during surgery, although relatively short-acting, have a long-lasting and subtle impact on your reaction and judgment times, thought processes, and alertness. For this, you will need a responsible adult to drive you home after your appointment.If you have children or are the primary caregiver for a family member: Full day care or dependent care should be arranged. Although the sedation you will receive during the procedure is mild, it can affect the decisions you make after the procedure is done. If possible, ask someone for help, even if you don’t think you’ll ever need it.What to bring to the appointment. Gather items from this list now and understand some basic requirements, which will save time and make things easier on your procedure day:

    • Bring your insurance card
    • Bring your Photo ID
    • Bring a list of all medications and dosages, and allergies to medications
    • Bring a list of conditions that may make you sensitive to sedatives.
    • Please wear glasses; DO NOT wear contacts.
    • Leave all jewelry at home, including body piercings.
    • Brushing your teeth and wearing dentures is fine.
    • Please wait two to four (2 to 4) hours at the facility *Please note that unexpected delays may occur*
    • Do NOT make any important decisions for your entire day of procedure.
    • Please have a responsible adult stay with you after check-in. You should not be left out.
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    We fully expect you will be able to return to your normal activities tomorrow your procedure. This includes driving and commuting to work. Read more: Why is my cat’s nose turning whiteWhat to know about your Coverage Please know your insurance instructions and check your insurance benefits. If your insurance requires a Primary Care Provider (PCP) authorization (insurance referral), please make sure our office has received it prior to your procedure. you to prevent any unnecessary out-of-pocket costs for you. Also, not all insurance policies cover colonoscopy. For example, if you are under age 50 and/or have Preferred Provider Organization (PPO) coverage, this procedure may not be covered. Every insurance plan is different; Please contact your plan’s customer service to check your benefit coverage. If polyps are found, some insurance will treat the procedure as a diagnosis (which may be deductible). Please be aware of your coverage.

    Part 2

    Preparatory colonoscopy with Nulyly:Nulyly (pronounced “new mild”) is a prescription enteric preparation. Your Nulyly prescription will be called to your pharmacy about a week before your scheduled procedure date. You can use flavors that are yellow, orange, or green. You are not allowed to use fragrances that are red, blue, or purple. equivalent:

    • Dulcolax tablets, 5 milligrams (mg). You will need 6 tablets. This is a laxative pill. DO NOT take suppositories or stool softeners.

    Part 3

    7 days before colonoscopy:

    • Stop taking Iron supplements and multivitamins that contain iron, Vitamin E, or fish oil.
    • Do not take supplements in the form of marshmallows.
    • Discontinue any fiber supplements such as Metamucil, Benefiber, or Citrucel. Check with your management provider for alternatives.
    • If you have diabetes, call your administrator or prescribing physician to determine how to take your diabetes medication on the day of the procedure.
    • If you are using prescription blood thinners, you must call the doctor who administers or prescribes and has a plan for these medications. These drugs include Coumadin, Warfarin, Plavix, Xarelto, Pradaxa, Effient or any equivalent.
    • If your cardiologist is a part of New Hampshire Cardiology Consultants, you will be contacted by a nurse from their office about 2 weeks before your appointment with instructions on how to use this medication.
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    You will receive a call from the nurse a few days before the procedure to review your health history and answer any questions you may have. This will help streamline the admission process on your check-in day. Elliot Hospital reservation phone number: 663-3193. Elliot One Day Surgery Center (ASC) reservation phone numbers: 663-5921 and 663-5968.If you develop a fever, rash, cough or flu-like symptoms in the days prior to your procedure, please notify our office immediately.

    Part 4

    Read more: Why is my cat clicking his jaws2 days before endoscopy:

    • REVIEW the guidelines for preparing for a colonoscopy.
    • Arrange and confirm your transportation to and from your appointment. You CANNOT drive yourself home after the procedure because of the sedation. Start a low-residue and low-fiber diet. Food with low sugar content will be quickly pushed through the colon, less left over. Foods you can eat: Turkey (skinless) Chicken fish (skinless) Eggs White rice White bread Crackers Plain yogurt Pasta (without red sauce) Potatoes without skin Gelatin Banana Bouillon Broth Any substance any liquid that has no red, blue, or purple dye in it. Foods you can’t eat: Fresh or dried fruit (except fresh bananas) Cooked and raw vegetables (all) Raisins (all) Seeds (all) Red meat Popcorn Beans Gum, silver candy mint or hard candy If there is no whitelisted food item, you should not eat it.
    • At 5:00 pm: Take 2 Dulcolax tablets with 8 ounces of water. This can cause you to have a bowel movement within 6 hours.

    Part 5

    The day before your colonoscopy: Drink only liquids throughout the day – DO NOT EAT SOLID FOOD TODAY. Drink at least 8 cups of water or fluids today, along with your Nulyly solution. It is important to drink plenty of fluids the day before the procedure. The preparation may be dehydrated. The more you drink, the better you will feel. You may drink clear liquids up to 3 hours before your procedure.Allow: Clear liquid is any liquid that you can see through. This includes water, clear broth or beer, black coffee or black tea (sugar may be added). Gatorade, PowerAde, or clear, yellow, orange, or green vitamin juice will do. Lemon juice, carbonated soft drinks (don’t drink dark soda like Coca-Cola, Pepsi, …), apple juice, white grape juice, white kumquat juice are okay. Jell-O and popsicles are allowed if they are yellow, green or orange.Away: All solid foods after 8 a.m., milk and dairy products, any drinks or foods with RED, GREEN or PURPOSE dyes. These items are NOT allowed to be used. Don’t drink a lot of coffee and tea as they dehydrate you. Avoid alcohol, it dehydrates you.Today you must do the following:

    • In the morning, refill your Nulyly bottle with water.
    • Add the flavor pack that came with your bottle of Nulyly, or you can add powdered Crystal Light (NO red, blue, or purple flavors).
    • Stir or shake the flask until the powder is completely dissolved.
    • Chill the Nulyly bottle. You will drink this later today.
    • At 1 p.m., take 2 Dulcolax tablets at a dose of 8 oz. glass of water.
    • At 3 p.m., take 2 more Dulcolax tablets at a dose of 8 oz. glass of water.
    • At 5 pm Start drinking Nulyly solution. You should drink half of the solution tonight over a period of 2 to 3 hours. Drink one glass every 10 to 15 minutes. Drink each cup quickly, not small amounts continuously.
    • Cool the remaining half of the solution. Tomorrow morning you will finish drinking.
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    Everyone responds to laxatives differently. You may feel bloated, nauseous, or have an upset stomach when you drink the solution. This is temporary and should improve once you start having a bowel movement. If you feel nauseous, stop drinking for 30 minutes and then continue drinking at a slower rate. Taking a walk between each glass can help reduce bloating. Bowel movements usually begin within 2 hours of starting to drink liquids, but can take longer.

    Part 6

    Date of your endoscopy:

    • No broth on the day of your procedure. Clear liquids can be used up to 3 hours before your procedure.
    • 5 hours before the procedure, shake the remaining half of the Nulyly solution.
    • Start drinking the rest of the solution. Drink the entire bottle within 2 hours.
    • 3 hours before the time of the procedure, you can take these medicines only with a small sip of water:
      • Daily anesthetic
      • Anti-anxiety
      • Blood pressure / heart medicine
      • Seizure drug
      • Asthma inhalers

      After taking the medicine, do not drink anything, EVEN WATER, 3 hours before your procedure, or your procedure WILL be cancelled!

    If you continue to have thick, loose, brown or thick stools, please call our office early in the day to discuss whether you are adequately prepared. For any questions, please call Elliot Gastroenterology at (603) 314-6900! Read more: why babies are hot and cold | Top Q&A

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