PEG Solutions

The content on this website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

Due to the challenges of booking colonoscopies (i.e. dealing with complicated health problems such as diabetics needing to have tests in the morning, patients with heart problems and urgent cases) we will not be giving you a specific time for your appointment; at this time you are given only the date on which the procedure will be performed.  You will receive a phone call approximately 3 weeks prior to the date of the procedure to confirm and to give you the time of your procedure. It is important that we have telephone numbers where we can contact you during the day 3 weeks prior to the procedure. If you do not receive a telephone call from us approximately 3 weeks prior to your procedure this means that we could not contact you and your procedure will be canceled if you do not get in touch with the office.  If you believe it is possible that we do NOT have phone numbers at which you can be contacted, PLEASE CALL 739-7753 and give us this information. 

If you need to cancel an appointment, it is necessary to do so at least 72 hours prior to your procedure date - if you cancel with less than 3 business days’ notice there will be a $250.00 charge.

PATIENT INSTRUCTIONS FOR PEG SOLUTIONS

The day before a colonoscopy it is necessary to clean all stool out of the colon and large intestine in order to get a good view of the area.  This procedure is called bowel preparation (prep.).   It is important to follow directions. If the bowels are not properly cleaned it is more difficult to transverse (get around) the colon and, more seriously, it is possible to miss something like a CANCER.  Also, if the bowel is not properly cleaned out it will be necessary to repeat the colonoscopy at a later date.

Varying approaches for taking the prep. depend upon what time has been scheduled for your colonoscopy (i.e. early in the morning, before noon, afternoon.)

PREPARATION PRODUCTS

Polyethylene Glycol (PEG) is sold under various names including Colyte, Peglyte, Kleenprep and Lax-A-Day PEG 3350 and can be obtained from most pharmacies without a prescription.

PREPARATION CALENDAR

Four (4) days before your colonoscopy:

    •    Read all prep. instructions;

    •    Do not eat any foods containing seeds or grains such as kiwi, berries, grapes, tomatoes, whole grain or multigrain breads, Red River cereal, flaxseed etc. as they can remain undigested in the colon for several days and plug the scopes during the procedure;

    •    Be certain you have stopped taking any medications that you have been told are necessary to discontinue;

    •    Arrange for a driver to take you home after your procedure (it is illegal to drive for 24 hours after receiving sedation). 

    •    Obtain your bowel prep. product from your pharmacy.

FOR COLONOSCOPY SCHEDULED IN THE MORNING  (Before 11:00 a.m.)

The day before your colonoscopy:

    •    DO NOT HAVE ANY SOLID FOOD OR ALCOHOL; and 

    •    DRINK CLEAR LIQUIDS ALL DAY (see clear fluid diet**.)

Plus:

    •    between 9:00 a.m. and noon drink at least 1 L (4 cups) ofclear fluids.

    •    between noon and 4:00 PM drink 2 L (8 cups) of PEG at a rate of 1 L (4 cups) per hour.

    •    between 4:00 and 8:00 PM drink 1 L (4 cups) of clear fluids.

    •    between 8:00 and 11:00 PM drink 1 L (4 cups) of PEG at a rate of 1 L (4 cups) per hour followed by 2 cups of clear fluids before bedtime;

    •    4 hours before your colonoscopy time drink 1 L (4 cups) of PEG. and

    •    continue to drink clear fluids until 2 hours before your arrival at the clinic.

If you think the prep. is not working as expected, notify your doctor.  Do not take more than the prescribed dose of laxative.                    

FOR COLONOSCOPY SCHEDULED IN THE AFTERNOON (After 11:00 a.m.)

The day before your colonoscopy:

    •    have a light breakfast if desired before 9:00 a.m.;

    •    after 9 a.m, DO NOT EAT ANY SOLID FOOD. DRINK ONLY CLEAR LIQUIDS (see clear fluid diet**);

Plus:

    •    between 9:00 AM and 8:00 PM drink at least 2 L (8 cups) of clear fluids. and

    •    between 8:00 PM and 11:00 PM drink 2 L (8 cups) of PEG at a rate of 4 cups per hour.

The day of your colonoscopy:

    •    DO NOT EAT ANY SOLID FOOD; DRINKCLEAR LIQUIDSUNTIL 2 HOURS PRIOR TO YOUR ARRIVAL AT THE CLINIC (see clear fluid diet**); and

    •    Take any morning medications you require as directed one hour prior to taking your laxative.

Plus:

    •    Drink 2 L (8 cups) of PEG at a rate of 1 L (4 cups) per hour, finishing 4 hours before your scheduled arrival at the clinic;

    •    Drink at least 2 cups of clear fluids after the PEG;

    •    Continue drinking clear fluids until two (2) hours prior to your arrival at the clinic or hospital; and

    •    Bring something to drink for after your procedure is over.

If you think the prep. is not working as expected, notify your doctor.  Do not take more than the prescribed dose of laxative.

**CLEAR FLUID DIET includes:

    •    Sports drinks (Gatorade, Powerade, etc.) are the preferred clear fluid (no red *);

    •    Clear fruit juices, white grape juice, apple juice, white cranberry juice;

    •    Water, Kool-Aid (no red *);

    •    Clear soup, broth or bouillon;

    •    Popsicles (no red *);

    •    Tea or coffee without cream;

    •    Soda pop, 7-UP, Sprite, Gingerale, orange soda (no red *); and

    •    Jell-O gelatin (no red *).

*Red fluids can sometimes look like blood in the bowel and make it seem as if you are bleeding internally.

HELPFUL HINTS FOR DOING BOWEL PREPARATION

    •    Keep the laxative in the refrigerator and drink at a cool temperature;

    •    Try drinking the laxative with a straw;

    •    Numb your mouth with an ice cube or Popsicle, or suck on candy to help remove the taste;

    •    Take all of your usual medications on the day of the colonoscopy at their usual times with a sip of water;

    •    Take morning medications (if required) on the day of the procedure with a small sip of water within 2 hours of your procedure;

    •    Take Gravol 25 to 50 mg for nausea if needed;

    •    Apply a barrier ointment such as zinc ointment, diaper rash ointment or Vaseline™ to the anus and surrounding area to minimize irritation.

MEDICATIONS

Bring all your medications with you the day of the colonoscopy; this includes puffers. 

In General: On preparation and scope days, take all regular medications with sips of water (even if ordinarily taken with food). If you have a condition that requires treatment with narcotics, please take your usual dosage (otherwise sedating you may prove difficult). 

Diabetes mellitus:

If you are on an oral hypoglycemic medication, consult with your Endocrinologist or Family Doctor regarding your dosage for the preparation day. Omit your morning dose on the day of the procedure. Please bring your medications with you.

If you are on insulin, consult with your Endocrinologist or Family Doctor regarding your dosage for the preparation day.  Please bring your medications with you.

Check your blood sugar frequently while taking your prep solution the day before, on the morning and on the day of your procedure. 

Sleep Apnea:

If you have sleep apnea and you use a CPAP machine, please bring it when you come for your colonoscopy, otherwise your colonoscopy will not be performed.

Blood thinners:

If you have had a heart attack or stroke, it is important to continue your medications for these problems before the procedure unless otherwise instructed by Dr. Bray.  These include Aspirin, Coumadin®/Warfarin, Plavix®/Clopidogrel and Xarelto®/Rivaroxaban.  If you are on Coumadin®Warfarin you will need a STAT INR 3-4 days prior to the colonoscopy.

If you have NOT had a heart attack or stroke and are on Aspirin, eg: are taking it preventatively, please stop the Aspirin 7 days prior to your colonoscopy unless otherwise instructed by your doctor.

Iron supplementation:

Discontinue 7 days before the procedure.

Anti-inflammatory medication:

These medications may safely be continued unless otherwise instructed. 

Other medications:

Take all your usual medications with water on the day of your colonoscopy unless otherwise instructed. Bring all your medications with you the day of the colonoscopy; this includes puffers. 

INFORMATION FOR DRIVERS OR ESCORTS

You will be given sedation for your test. You must not drive your car home from the office. You must return home accompanied by an adult.  You may not walk, take a cab or a bus home by yourself.  

The person who is providing your ride must be available to pick you up promptly about 1 hour and 15 minutes after your start time.   Your escort must actually come into the Waiting Room to walk you out after your test – you may not leave alone. Driving is illegal for 24 hours after sedation.