You will have been sent 2 sachets of Picolax or a prescription for Picolax to obtain from your local pharmacist. Picolax is a strong laxative used to clear the bowel before your colonoscopy. It is designed to empty the bowel and will cause diarrhoea like watery bowel movements. The first of these liquid bowel movements should occur within 1-2 hours of drinking the solution. Good bowel preparation is essential for the endoscopist to view the lining of the bowel in detail. If the bowel is not completely clear, the endoscopist will not be able to obtain a good enough view and the procedure may have to be abandoned and repeated at a later date.

 

Bowel preparation for your colonoscopy

 

Please follow these instructions carefully

 

If you have a MORNING APPOINTMENT, please follow the instructions below:

 

• On the day before your appointment the following must be done at the following times:

 

• 6:30am to 8am - Eat a light breakfast – for example a slice of toast, hot beverage without milk or fruit squash

 

• 12:00 midday - Take your 1st sachet of Picolax. Empty the contents of one sachet of Picolax into a cup of cold tap water and stir until the particles are completely dissolved. Drink the solution. It is important that you drink plenty of fluids in between taking the sachets.

 

• 15:00 (3pm) - Drink a bowl of clear soup. This must not contain solids within it.

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• 18:30 (6.30pm) - Take your 2nd sachet of Picolax. Drink plenty of clear fluids until 2 hours before the procedure the following day.

 

If you have a AFTERNOON APPOINTMENT, please follow the instructions below:

 

• On the day before your appointment the following must be done at the following times:

 

• A very light breakfast may be taken i.e. tea without milk and a slice of white toast.

 

• 12:00 midday drink a bowl of clear soup. This must not contain solids within it.

 

• 18:00 (6pm) - Take your 1st sachet of Picolax. Empty the contents of one sachet of Picolax into a cup of cold tap water and stir until the particles are completely dissolved. Drink the solution. It is important that you drink plenty of fluids in between taking the sachets.

 

• 06:00 (6am) on the actual day of your appointment take the 2nd sachet of Picolax. Drink plenty of clear fluids until 2 hours before the procedure.

 

Handy Hints

 

• If you feel sick from drinking the Picolax, try drinking the solution at a slightly slower rate.

 

• You can drink clear soup, lucozade, tea or coffee without milk, lemonade, Bovril, tonic water, soda water, fruit squash but not blackcurrant juice.

 

• Forbidden fluids to take include tomato juice, orange juice, grapefruit juice, consommé, jelly, milk or any drinks containing milk.

 

• Do I keep taking my normal medication?

 

• If you are diabetic and taking medication (either tablets or insulin) you should test your blood or urine for glucose before you start your bowel preparation and then at least every four hours until you leave home for your appointment. If the result is higher than 10mmol/L, continue with your medication. You may drink sugary drinks to maintain you blood sugar level up to two hours before your appointment time. If it is lower than 10mmol/L, delay your medication until you start eating again. You may need to readjust your normal dosage according to the blood sugar level.

 

• If you take iron tablets please stop these 5 days before the examination.

 

• Stop constipation preparations 2-3 days before the examination.

 

• If you are taking warfarin we will advice you when to suspend your treatment until after your examination. Your blood clotting time will be checked prior to your procedure at the hospital.

 

• Take all other medication as prescribed by your general practitioner (GP).

 

Attention

 

• If you are being sedated, please ensure you have an escort home as the procedure may not be performed if you do not.

 

• You will also need someone to stay with you overnight if you are having sedation.

 

• Please do not bring children with you if you have no-one to look after them during the examination as they cannot accompany you into the examination room.

 

What happens during the examination?

 

• You will be attached to a monitor and oxygen will be administered.

• You will then be asked to lie to your left side with your knees bent towards your chest.

• Intravenous analgesic and sedative will usually be given via the small cannula in your hand or arm. The mixture of medications will relax you and may make you drowsy but will not put you to sleep. You will be able to hear and respond to any instructions given to you.

• The colonoscope will then be inserted into your rectum and guided along the bowel. Air is introduced to make the lining visible which may give you the sensation that you want to go to toilet. Just relax as your bowel should be empty.

• During the procedure, we may take some biopsies of the bowel lining for investigation. If we find some small polyps which can be effectively treated, we will remove these or biopsy them and send the specimen to the pathologist for analysis.

 

How long does it take?

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The actual procedure takes about 30 - 45 minutes, but please be prepared to remain with us all morning or afternoon depending on your appointment time. If someone has accompanied you, they are welcome to stay or we can contact them later when you are ready to go home.

 

What happens after the procedure?

 

• You will have to stay with us for 1-2 hours as the sedation will make you a little sleepy.

• You may experience some mild abdominal discomfort from the air that was introduced into your colon. This will soon disappear.

• As soon as you are ready you will be offered tea or coffee and a snack.

• When you have recovered from you procedure you will be discharged home but before doing so we will inform you about follow-up arrangements.

• The effect of the sedative can last up to 36 hours so you should not drive, operate machinery or drink alcohol during that time.

• You must be accompanied home by a responsible adult and have someone with you overnight.

• If any polyps are removed or any biopsies taken, you may notice a small amount of blood next time your bowels open. You may wish to limit your general activity for a day or two.