Colonoscopy Prep Instructions (SUTAB)

Please read below your full prep instructions.

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 are required to schedule a follow up visit at the office to discuss the results of the procedure with the physician.  (It is usually scheduled when you schedule your procedure)

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.

A thorough cleansing of the colon is essential and the examination is most successful if you follow the directions for preparation completely, as outlined below. If you have any questions about the test or preparation, please do not hesitate to call our office.

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 Sutab bowel prep 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.
  • Consider obtaining a protective ointment such as Preparation H, Desitin, or Vaseline to protect the anal area during the prep. You can start to apply it after the first laxative is taken.
  • 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.
  • 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.
  • Please call us with any questions.
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.

DO NOT FOLLOW THE INSTRUCTIONS ON THE PACKAGE!

FOLLOW THESE STEPS ONLY:

No Food - Only Liquids – All Day

4 p.m Open 1 bottle of 12 tablets. Fill the provided container with 16 ounces of water (up to the fill line). Swallow each tablet with a sip of water and wait 2 minutes before proceeding to the next tablet, and drink the entire amount of water over 15-20 minutes.

Approximately 1 hour after the last tablet is ingested, fill the provided contained again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.

Approximately 30 minutes after finishing the second container of water, fill the provided container with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.

(IMPORTANT: If you experience preparation-related symptoms (for example, nausea, bloating, or cramping), pause or slow the rate of drinking the additional water until your symptoms diminish.

12 a.m. Open 2nd bottle of 12 tablets. Fill the provided container with 16 ounces of water (up to the fill line). Swallow each tablet with a sip of water and wait 2 minutes before proceeding to the next tablet, and drink the entire amount of water over 15-20 minutes.

Approximately 1 hour after the last tablet is ingested, fill the provided contained again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.

Approximately 30 minutes after finishing the second container of water, fill the provided container with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.

Remember to remain close to toilet facilities!

NOTHING BY MOUTH 6 HOURS FROM SCHEDULED PROCEDURE TIME

ATTENTION PATIENTS PLEASE READ:

***Absolutely all piercings must be removed prior to procedure***
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.
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.

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

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.
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.

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

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.
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.
To clean the area, avoid rubbing. Gently pat with a wet washcloth. Apply Vaseline, Preparation H, or Desitin liberally.
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.
Yes, but nothing with soft centers or red color.
Please do.
Yes, you may wear your dentures to the endoscopy suite. However, you may be asked to remove them prior to the procedure.
You may take Tylenol as directed.
You can only have the broth; no noodles, chicken, or vegetables allowed.
Yes, the procedure can still be performed. We ask that you use a tampon if possible (not absolutely necessary).

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 Sutab is not covered by your insurance follow these instructions:

Gatorade Prep Instructions

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

  1. Purchase 64oz. of Gatorade   (or other clear liquid)
  2. One 238 gram bottle of Miralax Powder
  3. 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.

Stop clear liquid diet 6 hours prior to your check in time.

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.

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