PICO-SALAX

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 PICO-SALAX

 A few weeks before the procedure, purchase  PICO-SALAX and DULCOLAX (four 5 mg tablets) from a Pharmacy (we keep these in stock in our office and sell them at a discounted rate of $20.00. CASH ONLY!)

It is important to take all of the Pico-Salax.  The test will go more quickly when the bowel is clean, and it will therefore be easier for you. Most importantly, if there is still stool in your colon/large bowel, significant lesions such as cancer or inflammation occasionally can be missed.

4 DAYS BEFORE THE COLONOSCOPY:   

    1.    Read all prep instructions.

    2.    Avoid foods containing hard seeds or grains such as kiwi, berries, grapes, tomatoes, watermelon, whole grain or multigrain breads, Red River cereal, flaxseed, etc. as they can plug the scope during the procedure.

    3.    Be certain you have stopped the necessary medications.

    4.    Arrange for a driver after your procedure (it is illegal to drive for 24 hours after receiving sedation). 

    5.    Obtain bowel prep products from your pharmacy.                  

1 DAY BEFORE THE COLONOSCOPY:

NO SOLID FOOD, NO ALCOHOL, CLEAR LIQUIDS ALL DAY (see Clear Fluid diet**)

    1.    At 8:00 AM take the Dulcolax laxative, 2 tablets; 

    2.    Between 8:00 a.m. and noon drink at least 1 L (4 cups) of sports drink.

    3.    At 3:00 p.m. take one sachet of Pico-Salax as directed;

    4.     Between noon and 8:00 p.m. drink 2 (8 cups) of clear fluids including 4 cups of a sports drink.  

    5.    At 5:00 p.m. take the Dulcolax laxative, 2 tablets;

    6.    Between 8:00 p.m. and bedtime drink at least 1 L (4 cups) more of clear fluids-sports drink.

The Morning of your Exam:

    •    4 hours before your arrival at the clinic take the last sachet of Pico-Salax.  If your procedure is scheduled early, you will need to get up as early as 3:00 a.m.;

    •    You may continue to drink clear fluids until 2 hours prior to your arrival at the clinic;

    •    You may take your usual morning medications as directed, both the day before and the morning of your procedure with sips of water.

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

**CLEAR FLUID DIET

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 *), Soda pop, 7-UP, Sprite, Ginger ale;

    •    Clear soup, broth or bouillon;

    •    Popsicles (no red *);

    •    Tea or coffee without cream;

    •    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 procedurePlease 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.