Your bowel needs to be empty for the colonoscopy, so that the doctor or specialist nurse can see the lining of your bowel. To achieve this you will need to alter your diet and take specific preparations, which are explained in this leaflet.

Please make sure you follow these instructions carefully. If you do not, your bowel may not be clear and your examination may have to be repeated. If you have any questions, please call Dr Campbell’s secretary.

If you take iron tablets, stop taking them. If you take warfarin tablets, have diabetes or an allergy to latex, please make sure that your doctor knows this before your appointment. You may have already received special instructions because of this.

Stop taking any constipating tablets such as codeine phosphate and loperamide. Continue to take any other regular medicines not mentioned above, including laxatives and painkillers as necessary.

Try to remove all the fibre from your diet, by eating only:

* Boiled or steamed white fish Boiled chicken (Skin removed)
* Eggs Cheese
* White bread Butter/ margarine
* Rich tea / plain biscuits Potatoes without the skins

Have plenty of fluids to drink, about two litres (8 - 10 glasses) per day. Do not drink milk or any fluids containing milk. Do not eat any high fibre food, such as fruit, vegetables, nuts, rice, pulses, wholemeal bread, red meat or pink fish.

Have a light, early breakfast. For example, have a boiled egg on toast (white bread). Do not have any further solid food until after your examination.

Drink plenty of clear fluids – water, squash or tea or coffee without milk. Alcoholic drinks are allowed in moderation, but best avoided. If you take bulk-forming laxatives, please stop taking these today as they can reduce how well the bowel preparation works. Bulk-forming laxatives are bran, methycellulose (for example Celevac), isphaghula (for example Fybogel) sterculia (for example Normacol).

You will have been given some sodium Picosulphate or “Picolax” bowel preparation. This comes with instructions inside the packaging, but we would like you to follow our instructions below:

1pm: mix one sachet of Picolax with water. Do this in a large glass or jug, as the mixture may fizz over. The solution may also become warm; allow it to cool and then drink it. You may dilute it further with more water if you wish.

5pm: take the second sachet of Picolax, preparing it in the same way. Stay within easy reach of a toilet once you have started taking the laxatives. You should expect frequent bowel movements and eventually diarrhoea, starting within three hours of the first dose. You may have some stomach cramps – this is normal. You can use a barrier cream, such as zinc and castor oil on your bottom, to prevent soreness during your frequent trips to the toilet. Remember to keep drinking clear fluids to stop you becoming dehydrated. As a guide, try to drink about one glass every hour.

If you vomit the preparation at any stage or you have any concerns regarding this preparation, please telephone Dr Campbell’s secretary*.

On the day of your colonoscopy, do not take any laxatives. Drink plenty of clear fluid. You can drink up to three hours before your examination. Please remember not to bring any valuables with you when you come for your colonoscopy, as we cannot be responsible for them. You may also wish to bring a dressing gown, slippers and something to read.

This is an alternative bowel preparation which may be used instead of the Picolax solution. Again instructions are provided in the box.

1pm – Mix sachet A+B into 1 litre (approximately 2 pints) of lukewarm water. This can be prepared earlier and refrigerated if required. Consume this over 1 hour.

5pm – Mix the next sachets A+B as above and again consume over 1 hour. You should expect frequent bowel movements and eventually diarrhoea, starting within three hours of the first dose. You may have some stomach cramps – this is normal. You can use a barrier cream, such as zinc and castor oil on your bottom, to prevent soreness during your frequent trips to the toilet. Remember to keep drinking clear fluids to stop you becoming dehydrated. As a guide, try to drink about one glass every hour*.

*Please note that if you are taking the contraceptive pill it may not be effective due to the bowel preparation, so you must take other precautions.

*Also note these instructions assume that you are having your procedure in the morning. If you are having the procedure in the afternoon take the first sachet at 5pm the day before and the second sachet on the morning of the procedure. If you are having the procedure in the evening, take the first sachet first thing in the morning (same day as the procedure) and the second sachet at 12pm.