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Questions:

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Why is it recommended to avoid seeds and nuts for several days prior to colonoscopy?

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Why avoid iron prior to colonoscopy?

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Why is avoiding red drinks or jello advised?

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What should I do on the day of my prep?

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What do I do about hypoglycemia?

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Are beer or wine clear liquids?

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I take warfarin (Coumadin), will I need to stop it?

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What should I do about the clopadogrel (Plavix) or aspirin I take because of a heart or other circulation problem?

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Will my chronic constipation allow me to be adequately prepared for colonoscopy?

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May I take my medicines before an endoscopy or colonoscopy?

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May I have fluids after midnight?

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What meals should I eat the day prior to an Upper Endoscopy?

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Do the sedative medications have any drug interactions?

 

 

Why is it recommended to avoid seeds and nuts for several days prior to colonoscopy?

The dense components of very high roughage foods such as

seeds and some skins tend to layer out at the bottom of intestinal

segments and thus may be more resistant to being flushed out

 by laxatives.  In most cases the preparation fluids will flush out the material anyway but an extra measure of assurance of obtaining an

optimal preparation comes from avoiding these foods a few days. 

We recognize that it is likely that many will inadvertently eat

some of these items and that’s okay.  We would put a priority on

avoiding the smallest densest seeds such those in tomatoes, kiwi fruit, blackberries, and raspberries. 

Why avoid iron supplements prior to colonoscopy?

Iron supplements in many people have a constipating effect,

making it more difficult for the laxative to clean out the colon.

In addition, retained iron frequently stains the walls of the colon

or the fluid, limiting the clarity of views.

Why is avoiding red or purple drinks or jello advised?

Even after an excellent preparation for colonoscopy a certain

amount of fluid and mucous is retained adhering to the walls

of the colon.  These will be tinted red or purple by natural and

artificial dies in beets, fruit punches (Hawaiian Punch, e.g.), and

jello, which can give an appearance similar to blood, which

increases the difficulty in reaching clear conclusions during the

procedure.

What should I do on the day of my prep?

Obtain the clear liquids that appeal the most to you in the days

leading up to the formal preparation day and have them well chilled

 (as appropriate).  Most people find that they are much less hungry

than they expected during the preparation day.  Take the formal

laxative at home as the time to its taking effect (“kicking in”) varies

greatly, from 30 minutes to 4 hours. Extra fluids are encouraged. 

Plan to do light activities such as reading, watching videos, or simple

chores at home. 

What do I do about hypoglycemia?

I can’t skip meals.  The sugar and protein containing fluids (including

jello) can sustain blood sugar very well for most people.  Again in

many cases patients who have had some trouble with “hypoglycemia”

in the past find that their preparation for the procedure goes better

than expected as the increased fluid intake that one hopes to

achieve during colonoscopy preparation and a restful day (without

fluctuations in activity or meals) avoids the circumstances that usually

bring on their symptoms.  On very rare occasions where the above

advice doesn’t work for a patient we’ve been able to in virtually

every case design a customized eating plan at an office appointment

to get through a successful colonoscopy preparation.

Are beer or wine clear liquids?

Beer and white wine are indeed qualifying clear liquids and therefore

can be taken during a colonoscopy prep in medically prudent amounts

(1-2 servings).

I take warfarin (Coumadin), will I need to stop it?

Advice about stopping and restarting oral anti-coagulants

(warfarin/Coumidin) is individualized and needs to come directly

from our office.  In most cases an office appointment will be

scheduled to review the specifics of your medical history before

making the final plan.

What should I do about the clopadogrel (Plavix) or aspirin I take because of a heart or other circulation problem?

Patients on these medications to treat a specific medical problem

will need to have their history reviewed either by our scheduling

coordinator or during an office appointment to get a specific plan

tailored to their individual circumstance.  After review sometimes

these medications are continued.

Will my chronic constipation allow me to be adequately prepared for colonoscopy?

If you believe you have significant constipation or have been told

that your preparation for prior colonoscopy wasn’t optimal, some

extra preparation may be advisable.  Please review your history with

our scheduling coordinator, nurse, or with the provider at your

office appointment.

May I take my medicines before an endoscopy or   colonoscopy?

In most cases, yes, routine medications can be taken with a glass of

water up to three hours prior to an endoscopic procedure.  This will

often mean waking up a little early and taking medications with clear

liquids such as water, non-red juices/purple (no pulp), tea, black

coffee.

For those with very early procedures an alternate plan is to bring

your medication bottles to the endoscopy suite to be taken after the

procedure. 

May I have fluids after midnight?

Yes, you may continue to have water, soda ,non-red/purple juices,

tea, and even black coffee up to 3 hours prior to the procedure.

What meals should I eat the day prior to an Upper   Endoscopy?

You may consume a  small to moderate evening meal completing it

prior to 9pm.  The traditional NPO (nothing per os) after midnight

works in most cases but sometimes a large rich meal consumed at

10pm or 11pm at night will still be partially present in the morning

interfering with the exam.

Once the small to moderate solid meal has been digested, clear

liquids such as water, non-red/purple juice, soda, tea, and black

coffee to satisfy thirst are fine.

Do the sedative medications have any drug interactions?

In general the sedatives used do not have any effect the body’s

handling (metabolism) of maintenance medications for most chronic medications.  If you are taking sleeping , anti-anxiety, or psychiatric medications your system may be some what more resistant to the

sedatives which can usually be handled by raising the dose.  The dose

of maintenance medication and other categories (blood pressure,

diabetes, gout, arthritis) need not be changed after an endoscopic

procedure has been completed.  Blood thinning medications such as

Warfarin, Coumadin, clopidogrel bisulfate (Plavix), or aspirin are a

special category and specific individualized advice is always needed

and is usually covered in the post procedure discharge instructions.

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This site was last updated 02/28/06