Colonoscopy Prep Instructions (SUPREP)

Please read below your full prep instructions.

If your procedure is scheduled at Mohawk Surgery Center, located at 201 Mohawk Rd, Suite 200, Clermont FL 34711. They will contact you the day before your procedure to give you an arrival time. If you have not heard from them by 3 pm the day before your procedure, please contact them at 352-758-2540.
If your procedure is scheduled at South Lake Endoscopy Center, located at 2040 Oakley Seaver Dr. Clermont, FL 34711. They will contact you the day before your procedure to give you an arrival time. If you have not heard from them by 3 pm the day before your procedure, please contact them at 352-536-8895.
If your procedure is scheduled at South Lake Hospital, you will need to call the hospital after 5 pm the day before your procedure for your arrival time. 352-241-7159.
If your procedure is scheduled at Heart of Florida Hospital, located at 40100 Highway 27, Davenport, 33837. They will contact you the day before your procedure to give you an arrival time. If you have not heard from them by 3 pm the day before your procedure, please contact them at 863-419-4067.
If your procedure is scheduled at Davenport Ambulatory Surgery Center, located at 107 Park Place Blvd, Davenport FL 33837. They will contact you the day before your procedure to give you an arrival time. If you have not heard from them by 3 pm the day before your procedure, please contact them at 863-419-2812
If your procedure is scheduled at Advent Health Outpatient Surgery Center (Winter Garden), located at 2000 Fowler Grove Blvd. Winter Garden, FL, 34787 they will call you to give you an arrival time. If you have not heard from them by 3 p.m. the day before your procedure, please call them at 407 614-0500 Ext 115-1003.
If your procedure is scheduled at Orlando Health Horizon West Hospital, located at 17000 Porter Rd Winter Garden Fl 3478; they will call you to give to an arrival time. If you have not heard from them by 3 p.m. the day before your procedure, please call them at 407-407-1995 or 407-407-2000.
***There will be a $100.00 charge each time a procedure is cancelled or rescheduled within 2 weeks of your scheduled date. If you choose to cancel, no show or reschedule within 2 weeks of your scheduled date, this fee must be paid to South Lake Gastroenterology prior to your procedure being rescheduled.***
***To inquire about your financial responsibility, please contact the facility in which your procedure is scheduled***

You are scheduled for a colonoscopy, an examination of the colon (large intestine) with a lighted flexible scope. During the colonoscopy, if an abnormality is seen, it is usually biopsied at that time. This involves removing a portion or all of the abnormal area for processing and subsequent examination under a microscope.

Risks of the procedure:

It is very rare that these complications occur but in the event that you have any of the following you should go directly to the Emergency Room:

You must have an adult over the age of 18 stay with you and drive you home after the procedure, due to sedation. Plan for you and your ride to be at the surgery center for a total of three to four hours. Your ride must stay at the center the entire time you are there. When you arrive, you will need to complete your paperwork and then change into a patient gown. The nursing staff will perform a brief assessment, place an I.V., and take you into the procedure room where you will be sedated and undergo the colonoscopy. The colonoscopy itself takes about 30 minutes.

After the colonoscopy you will rest in the recovery area while the sedative wears off. Due to the sedation, you may not remember your conversation with the doctor after the colonoscopy. Please have a family member or friend stay with you that can speak with the doctor and nurses after the procedure.
By law, you cannot drive the rest of the day of the colonoscopy. We advise you to take the entire day off work.

It is important to notify us of all prescription medications and non-prescription products (over-the-counter, anti-inflammatory, herbal, vitamins, etc) you are taking and a list of any medications you are allergic to.

Pick up prescription Suprep Bowel Kit from the pharmacy.

Colonoscopy Preparation Timeline

***IF TAKING OZEMPIC (Semaglutide) or MOUNJARO (Tizepatide) injection. Or ANY other GLP-1 type medications? You need to stop ONE WEEK (7 full days) prior to your scheduled procedure to prevent cancellation. Ozempic/Mounjaro GLP-1 medications slow the emptying of your stomach contents, putting you at greater risk of aspiration during your procedure.

Five or more days prior to your colonoscopy

Arrange for a ride. If you do not have a ride, we will have to cancel the procedure.
Be sure that you have your preparation liquid and/or tablets.
If you are taking blood thinners, you must hold them before the colonoscopy. You must obtain a written procedure clearance from your prescribing doctor. Aspirin is stopped 5 days before the colonoscopy.
Please stop Fish Oil 5 Days before colonoscopy.
Check with your insurance carrier if you need pre-approval and that you understand your financial responsibility for the procedure. There should be a number on the back of your insurance card to call.
Stop taking iron and vitamins with iron five days before the colonoscopy.
Make any needed arrangements to be off work or school on the day of the colonoscopy. Please remember, by law, you cannot drive the rest of the day of the colonoscopy.
Read and familiarize yourself with the preparation instructions below.

Three days prior to your colonoscopy

Avoid eating fibrous foods such as large salads, nuts, seeds, popcorn, grapes, greens peas, and tomatoes. Fiber from these foods can clog the Colonoscope. Additionally avoid high fat foods such as red meats

One day prior to your colonoscopy

Start a Clear Liquid Diet when you get up and continue all day. See page for examples of clear liquids.
No solid food of any kind.
Throughout the day, make sure to drink at least eight glasses (two quarts) or more of fluids such as Gatorade, or a similar product, preferably not just plain water.

**If you are DIABETIC, please refer to the “Instuctions for Diabetic Patients” form and confer with your primary care physician (PCP) about adjustments while on a clear liquid diet***

Instructions for DIABETIC PATIENTS

THE DAY PRIOR TO PREP DAY:

If you take evening of nighttime gargine (lantus) or detimer (levemir), take ½ of usual dose at the usual time.
If you take NPH insulin with supper or at night, take usual dose at usual time.
If you are on an insulin pump, contact your primary care physician or Endocrinologist for further instructions.

PREP DAY: THE DAY BEFORE THE COLONOSCOPY

No food by mouth and only allowed clear liquids (see sheet)
Do not take oral diabetes medications (diabetes tablets)
Check blood sugar every 4-6 hours
Hold all “with meal” insulin (unless instructed otherwise by your primary care physician).
- Common “with meal” insulins:
  - Regular (Novalin R, Humulin R)
  - Lispro (Humalog)
  - Aspart
  - Glulysine (Apidra)

If you take morning glargine (lantus) or detimer (levemir), take ½ usual dose at usual time
If you take evening glargine (lantus) or detimer (levemir), take 1/2 dose at usual time
If you take NPH Insulin in the morning, take ½ of usual dose at usual time
If you take NPH Insulin with supper or at night, take ½ usual dose at usual time
Notify primary care physician if your blood sugar is >200 on two consecutive readings.
Notify primary care physician if you blood sugar is <60, see Hypoglycemia instruction
If you are on an insulin pump, contact your primary care physician or Endocrinologist for further instructions.

PROCEDURE DAY:

No food or liquid by mouth; if procedure is scheduled after 12:00 pm, you may have two glasses of allowed clear liquids (see sheet)
Hold all oral diabetes medications (diabetes tablets) until after the procedure
Bring your blood sugar testing equipment and your insulin with you
Hold all “with meal” insulin until AFTER PROCEDURE and AFTER you begin eating, then take usual dose at usual time
If you take morning glargine (lantus) or detimer (levemir), take ½ usual dose at usual time
If you take evening or nighttime glargine (lantus) or detimer (levemir), take usual dose at usual time
If you take NPH insulin in the morning, take ½ of usual dose at usual time
If you take NPH with supper or at night, take usual dose at usual time
If you are on insulin pump, contact your primary care physician or Endocrinologist for further instructions

Hypoglycemia Management:

What to do if your blood sugar gets low

Take three to four glucose tablets or
Drink 6 oz of apple juice, white grape or clear pineapple juice or
Drink 6 oz of non-diet soda
Repeat blood glucose in 20 min, if remains low repeat above and call your primary care physician.

ONE DAY PREP:
(The day before your colonoscopy)

Make sure you drink plenty of clear liquids throughout the day

NO FOOD – ALL DAY – ONLY LIQUIDS

Dulcolax: At 12 pm (noon) take 4 Dulcolax (over the counter –Not Stool Softeners) laxative 5mg tablets by mouth, all at one time.

Suprep:

4 p.m. Pour the first bottle of prep solution into the plastic cup given in the box. Add drinking water to the “FILL LINE” and stir. Drink the solution.
Make sure you drink another 32oz of clear liquids after drinking the solution.
12 a.m. Pour the second bottle of prep solution into the plastic cup given in the box. Add drinking water to the “FILL LINE” and stir. Drink the solution. Make sure you drink another 32oz of clear liquids after drinking the solution.

NOTHING BY MOUTH 6 HOURS FROM SCHEDULED PROCEDURE TIME

Golytely: If Suprep is not covered by Insurance:

Dulcolax: At 12 pm (noon) take 4 Dulcolax (over the counter) laxative 5mg tablets by mouth, all at one time.

Mix prep solution as directed in your medication package. Most people find the solution easier to drink when it’s chilled, but you may drink the solution at room temperature. If you receive flavor packets with your prescription, sprinkle small amounts of powder into glass of fluid to vary flavor (one packer of flavor is enough for 1 gallon of fluid)

4 p.m begin drinking the first half of the prep solution between 4-6 pm on the day prior to the colonoscopy. Drink a large glass (about 8 ounces) every 10-15 minutes until half of the prep is done.
12 a.m begin drinking the second finish half of the prep solution. All liquids need to be finished so that nothing by mouth 6 hours prior to our schedule colonoscopy time.

Please note: Sucking on lemon slices, as well as adding clear, sugar free, powdered flavored enhancers (such as Crystal Light) or lemon juice may help diminish the unpalatable taste of the prep.

TWO DAY PREP:
(Prep for 2 days for better results)

2 days before your colonoscopy:

At 8am, take 2 Dulcolax (over the counter) laxative 5mg tablets by mouth, all at once.
At 12pm (noon), take 2 Dulcolax (over the counter) laxative 5mg tablets by mouth, all at once.

One day before your colonoscopy:

Dulcolax: At 12 pm (noon) take 4 Dulcolax (over the counter –Not Stool Softeners) laxative 5mg tablets by mouth, all at one time.

Suprep:

4 p.m. Pour the first bottle of prep solution into the plastic cup given in the box. Add drinking water to the “FILL LINE” and stir. Drink the solution.
Make sure you drink another 32oz of clear liquids after drinking the solution.
12 a.m. Pour the second bottle of prep solution into the plastic cup given in the box. Add drinking water to the “FILL LINE” and stir. Drink the solution. Make sure you drink another 32oz of clear liquids after drinking the solution.

Golytely: If Suprep is not covered by Insurance:

Dulcolax: At 12 pm (noon) take 4 Dulcolax (over the counter) laxative 5mg tablets by mouth, all at one time.

4 p.m begin drinking the first half of the prep solution between 4-6 pm on the day prior to the colonoscopy. Drink a large glass (about 8 ounces) every 10-15 minutes until half of the prep is done.
12 a.m begin drinking the second finish half of the prep solution. All liquids need to be finished so that nothing by mouth 6 hours prior to our schedule colonoscopy time.

Please note: Sucking on lemon slices, as well as adding clear, sugar free, powdered flavored enhancers (such as Crystal Light) or lemon juice may help diminish the unpalatable taste of the prep.

Remember to remain close to toilet facilities!

ATTENTION PATIENTS PLEASE READ:

Frequently Asked Questions

Why do I have to drink so much?

This is a large amount to drink but it works by flushing out your system of waste material over several hours. The solution gently “washes” the bowel clean. Do not just sip the solution. It is important you drink eight ounces every 15 minutes. It does not absorb into your body, nor does it cause you to become dehydrated.

Is there any way that I can make this taste any better?

You can try sucking on hard candy or rinse your mouth with water or mouthwash. Do not eat or drink anything while you are drinking this solution.

Why avoid red liquids?

The red color can persist in the colon and potentially look like blood.

One of the medications I was instructed to take the morning of my procedure is red. Can I take it?

Medication for blood pressure, heart conditions, and seizures should be taken the morning of your exam regardless of the color, with small sips of water.

I feel like vomiting and do not think I can drink any more. What should I do?

It is important that you continue drinking the solution if possible. Remember, it is the large volume that helps to empty your bowel. Without a clean bowel, the doctor will not be able to see the inside of your colon to complete the examination. If you do vomit, wait 30 minutes, and begin drinking the solution again. You might try taking six ounces at a time, rather than eight ounces. If not improved, call us and have a phone number of an open pharmacy in case we need to call in a prescription.

I am taking the prep and having loose, watery stools. Do I still need the rest of the prep?

Yes, you may have solid stool higher in the colon that needs to be eliminated.

I already have diarrhea before taking the prep, do I still have to take the laxative?

Yes, you must take the prep as directed by your doctor. Your colon is approximately six feet long. The entire colon must be emptied for your physician to see the colon clearly.

I see yellow color in the toilet bowl and a few flecks. What do I do?

If you drank the entire solution or if your last bowel movements were clear enough that you were able to see the bottom of the toilet, you should be fine. It is okay if you have some flecks of material. The yellow color is a result of bile that normally colors the feces. This should not interfere with the examination.

My bottom is so sore. What can I do?

To clean the area, avoid rubbing. Gently pat with a wet washcloth. Apply Vaseline, Preparation H, or Desitin liberally.

Can I drink alcoholic beverages?

We strongly suggest you do not drink any alcoholic beverages prior to your procedure since they can cause dehydration and some wines may thin your blood.

Can I chew gum or suck candy?

Yes, but nothing with soft centers or red color.

Can I brush my teeth?

Please do.

Can I wear my dentures?

Yes, you may wear your dentures to the endoscopy suite. However, you may be asked to remove them prior to the procedure.

I have been instructed not to take anti-inflammatories or blood thinners several days before the procedure. What can I take for headaches and pain relief

You may take Tylenol as directed.

Can I have chicken soup?

You can only have the broth; no noodles, chicken, or vegetables allowed.

Can I have the colonoscopy if I am on my menstrual period?

Yes, the procedure can still be performed. We ask that you use a tampon if possible (not absolutely necessary).

Can my ride drop me off and come back later to pick me up?

No. Your driver needs to remain at the center for the entire time you are there. No exceptions.

NO RED, PURPLE OR BLUE LIQUIDS

YOU MAY HAVE THE FOLLOWING:

PLEASE CALL US IF YOU HAVE ANY QUESTIONS AT 352-242-1665

If Suprep is not covered by your insurance follow these instructions:

Gatorade Prep Instructions

Purchase the following over the counter supplies at your local pharmacy:

Purchase 64oz. of Gatorade (or other clear liquid)
One 238 gram bottle of Miralax Powder
Four (4) Dulcolax Laxative tablets…NOT STOOL SOFTNERS!

The day before the procedure please follow as directed:

10 a.m. Mixing the Prep: You will need to pour off a little of the 64oz Gatorade or any other clear liquids to ensure the miralax powder will fit. Mix the ENTIRE bottle of MIRALAX in 64oz of GATORADE (or other clear liquids). Shake the solution until the miralax is dissolved. Place mixture in refrigerator.

12 noon. Take two (2) Dulcolax tablets with a full 16 oz glass of water
Note: Bowel movement should start approx. 4-6 hours after taking tablets

4 p.m. Start to drink 8 oz of the prep mixture every 10-15 minutes until you have finished the half of the solution.

8 p.m. Take (2) Dulcolax tablets with 16oz of water.

12 a.m. Continue drinking 8 oz of the prep mixture every 10-15 minutes until you have finished the remainder of the solution.