Beverly Hills Colonoscopy Instructions
Colonoscopy Prep
Dr. Nowain utilizes the latest in low-volume prep to make your experience more comfortable. The low-volume bowel preparation cleans the bowels, allowing the doctor to better visualize the bowel during your colonoscopy – lowering the risk of missing polyps.
PLEASE NOTE: In an effort to improve the quality of colonoscopy, the American College of Gastroenterology guidelines for colonoscopy recommend that bowel preparations be given in split doses (one dose taken the evening before your procedure and one dose taken the morning of your procedure) and that this regimen be considered the standard of care. Suprep is to be taken in split doses.
When Suprep is taken as directed, and the entire preparation is completed, it provides a successful bowel cleanse approximately 98% of the time. It is imperative that you complete the entire preparation.
Be sure to tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
5 Days Prior to Your Colonoscopy
Have your prescription for Suprep filled at your pharmacy.
3 Days Prior to Your Colonoscopy
Begin avoiding nuts, seeds, whole wheat bread, beans, corn, raw vegetables, or fruits with seeds or skin as they may adversely influence the quality of your exam. Discontinue these foods until after your procedure.
1 Day (24 Hours) Prior to Your Colonoscopy
Clear fluids ONLY. DO NOT have any solid foods, milk, or milk products. Nothing colored RED, PURPLE, AND PINK. No fruits, vegetables, cookies, crackers, or frozen concentrated liquids. No alcoholic beverages.
Clear liquids that are safe to consume include:
- Water
- Chicken broth
- Soft drinks (Sprite, orange soda, ginger ale)
- Strained fruit juices (without pulp): apple, white grape, or white cranberry
- Limeade or lemonade
- Kool-Aid (NO RED, PURPLE OR PINK)
- Gatorade
- Coffee or tea (DO NOT use any dairy or non-dairy creamer)
- Gelatin desserts without added fruit or topping (NO RED, PURPLE, OR PINK)
- Clear hard candies (example: Jolly Ranchers)
- Popsicles (No sherbet or fruit bars with pulp)
STAY HYDRATED! It is important to drink plenty of liquids to help flush out your intestinal tract.
Evening Before Your Procedure
Begin at about 7:00 – 8:00 pm (1st Dose):
- Step 1: Pour ONE 6-ounce bottle of SUPREP liquid into the mixing container.
- Step 2: Add cool drinking water to the 16-ounce line on the container and mix.
- Step 3: Drink ALL the liquid in the container.
- Step 4: You MUST drink two (2) more 16-ounce containers of water over the next 1 hour.
Day of Your Colonoscopy
Five hours before your procedure, repeat steps 1-4 from the previous night using the second bottle of Suprep.
You cannot drink anything in the four hours before your colonoscopy. It is very important that your stomach be empty for the anesthesia to be safely administered.
Before the colonoscopy, let Dr. Nowain know about:
- Any health conditions
- Allergies (medications, etc.)
- Previous surgeries (especially in the abdominal region)
- Medications you are currently taking
Please provide Dr. Nowain with a list of medications (over the counter and prescribed) – along with the dosages – you are currently taking, including:
- Herbal supplements
- Aspirin
- Vitamins
- Recreational drugs
- Insulin or pills for diabetes
- Arthritis medicine
- Blood thinners or heart medicine
- Vitamins that contain iron
Dr. Nowain may ask you to avoid blood thinning medication. However, Tylenol® is OK to take.
Your Colonoscopy Appointment
A colonoscopy takes about 30 minutes, but you should expect to be at the facility for about two to three hours. Upon arrival, you will go to a private area where a nurse will take your temperature, pulse, and blood pressure. They will also hook you up to some monitors and insert an IV. Next, you will meet your anesthesiologist and speak with Dr. Nowain before the procedure to go over any last questions you might have. The anesthesiologist will administer your sedation to ensure that you are comfortable and stable throughout the procedure. The anesthetic ensures that patients are safe and that they do not remember or feel anything during the procedure.
Once you are under anesthesia, a clean and lubricated scope is gently placed in your rectum. A tiny camera on the end sends video to a high definition TV screen so the doctor can see the inside of your colon. We prefer carbon dioxide to ambient air because patients experience significantly less bloating or discomfort after the procedure. The scope blows carbon dioxide into your colon, enlarging the space and making it easier to steer the scope to view the colon. The scope is moved all the way to where the colon meets the small intestine.
If Dr. Nowain sees anything (like a polyp or an area that looks abnormal) he’ll remove it and/or take a sample for pathology. Bleeding complications are rare (<1%), but should they occur special instruments and medications can be used to stop the bleeding. The scope is then slowly backed out of the colon for a second look, and finally, gently removed, concluding the procedure.
After Your Colonoscopy
Patients return home the day of the procedure. Because of the after-effects of anesthesia, you will need someone to drive you home. A responsible adult needs to come into the surgery center to sign you out. Taxi, Uber, or other ride services that will not come inside to sign them out will not be allowed. After the procedure, Dr. Nowain will talk with you about his findings and show you images of your colon should you wish to see them. If any biopsies, polyps, or samples were taken, you will set up a follow-up appointment one week after your procedure to go over your results.
We use carbon dioxide gas to distend the colon because this gets absorbed very quickly and patients rarely wake up feeling bloated or uncomfortable. Dr. Nowain always attempts to remove as much gas from your colon as possible, so that you do not come out of your procedure feeling excessively bloated. If you had IV sedation, you may feel a little groggy. You’ll need to rest for an hour or so until you’re fully awake, however, the anesthesia is very short acting and only the appropriate dose to ensure your comfort is used. In recovery, you’ll be watched closely and may be administered fluids through your IV.
You’ll want to take it easy for the remainder of the day after your colonoscopy. You may feel bloated, gassy, or have mild cramps, but most people do not. Be sure to drink plenty of water.
Make sure to contact the Center for GI Health if you experience:
- A fever of 100° F or higher
- Excessive pain, bleeding, or large blood clots when you go to the bathroom.
- A swollen, firm, or tender belly
If you have any other questions about your colonoscopy, feel free to contact our Beverly Hills gastroenterologist at (310) 657-4444.
