Have you had a colonoscopy ? If so, it's important to thoroughly cleanse your colon before the procedure. Today, we're going to talk about the liquid medicine MoviPrep®, which is often used for this purpose, how to use it properly, and what special precautions you need to take. Knowing and following these things will go a long way in helping you have a successful colonoscopy without any complications.
Why is Bowel Prep so important?
Simply put, a bowel prep is a procedure that completely removes all the stool from your colon and cleanses it. This is essential . Do you know what? Your gastroenterologist can then see the lining of your colon clearly. This allows them to see if there are any growths in your colon, such as polyps, or cancerous conditions.
Think of it this way, for the doctor to examine your colon, it's like driving a car on the road. A well-cleaned colon is like driving on a clear day, without any obstacles. But if your colon is not properly cleaned, it's like driving in heavy rain or fog. You can't see anything clearly. Therefore, it's very important to follow the instructions given to you exactly. Otherwise, you may have to cancel your colonoscopy.
What is MoviPrep®? How is it used?
MoviPrep® is a brand name for a medication. It mainly contains polyethylene glycol ( Polyethylene Glycol (PEG) and Ascorbic Acid (Ascorbic Acid), also known as Vitamin C. These are what help cleanse your colon. How do you know? This ingredient called PEG draws water into your colon. Then the stool starts to pass more easily. Ascorbic acid does the same thing, it draws water in and helps the stool move down the colon faster.
MoviPrep® comes in a box. It contains two pouches of medicine powder and a plastic container for mixing the medicine. All you need to do is put the medicine powder from one pouch into the container and add water to make a solution. You will need to drink one of these solutions the night before the test and the other the morning of the test. You should read and follow all the instructions carefully before making and drinking this solution.
Keep these things in mind before making the mixture:
To have a successful colonoscopy, it is important to keep these things in mind:
- Your bowels should be completely empty so that the doctor can see clearly. So follow your doctor 's instructions exactly.
- Do not eat any solid food the day before your colonoscopy. Only clear liquids are allowed. We will talk about that later.
- Get your Bowel Preparation Kit from the pharmacy at least five days before your colonoscopy.
Do I need to worry about transportation on the day of a colonoscopy?
Yes, absolutely. When you check in for your colonoscopy, you must have a responsible person as a driver. That person must stay in the waiting area until you are discharged from the hospital . You are not allowed to go home alone after the test. If you do not have someone to take you home, your test will have to be canceled. Also, you cannot drive any type of vehicle (such as a bicycle, car, scooter) or leave the hospital grounds alone until the end of the day after the test.
Things to know if you are using medications
For your safety, some medications may need to be stopped or the dosage adjusted a few days before the test. Let's take a look at what those are.
Blood Thinners
If you are taking blood-thinning medications (such as Clopidogrel (Plavix®), Warfarin (Coumadin®), Ticlopidine hydrochloride (Ticlid®), Anagrelide (Agrylin®), Rivaroxaban (Xarelto®), Dabigatran (Pradaxa®), Apixaban (Eliquis®), and Prasugrel (Effient®)), you should definitely see your doctor at least two weeks before the test to discuss whether to stop these medications or change the dosage.
Insulin and Diabetes Medication
If you take diabetes pills or insulin, always ask your doctor about adjusting your medication dosage in the days leading up to your colonoscopy. Do not take your diabetes pills after midnight on the day of your test. If you take insulin (such as insulin glargine injection - Lantus®, insulin lispro - Humalog®, long-acting insulins such as insulin isophane - HumulinN®, NovolinN®, ReliOn®, or 70/30 insulin), take half of your usual dose the day before your test.
Weight Management Medication
If you are taking any weight loss medications (e.g., canagliflozin (Invokana®), dapagliflozin (Farxiga®, Forxiga®), dulaglutide (Trulicity®), empagliflozin (Jardiance®), ertugliflozin (Steglatro®), exenatide (Byetta®, Bydureon®), liraglutide (Victoza®, Saxenda®), lixisenatide (Adylyxin®), semaglutide (Ozempic®, Wegovy®, Rybelsus®), and terzepatide (Mounjaro®, Zepbound®)), your dose may need to be adjusted or stopped a few days or a week before the test. It is essential to talk to the doctor who prescribed the medication for you and seek advice about this.
Iron Pills
If you are taking iron pills, you should stop them a week before the colonoscopy.
Other medications
Medications such as aspirin, antibiotics, or diuretics can be taken with a sip of water on the day of the test. However, if you are unsure which medications you can continue to take and which you should stop, please ask your doctor.
How should I eat and drink three days before a colonoscopy?
You should stop eating high-fiber foods three days before your colonoscopy. What are these high-fiber foods?
- Popcorn
- Beans
- Nuts (e.g. Flax, Sunflower, Quinoa)
- Multigrain bread
- Types of Nuts
- Salad/vegetables
- Fresh and dried fruit
Avoid eating these for three days in advance.
What should you do the day before a colonoscopy?
Starting the day before your colonoscopy, you should only drink clear liquids. Do not eat any solid foods.
You can drink these clear liquids up to three hours before your colonoscopy.
Important: Remember, do not drink liquids that are dark in color, such as red, purple, or orange, as they may look like blood in the intestines.
What are these 'clear liquids'?
Simply put, if you can put it in a glass and look through it, it's a clear liquid. Here are some examples:
- Water
- Unsweetened light tea (without milk)
- Unsweetened light coffee (without milk)
- Clear broth or bouillon - without meat pieces or vegetable pieces
- Light-colored jelly (without pieces)
- Clear fruit juice (e.g. apple juice, white grape juice) - without pulp
- Soda water (Clear sodas like Sprite or 7-Up)
- Sports drinks - light-colored ones
Things not to be afraid of:
- Milk and dairy foods
- Dark fruit juices (e.g. orange juice, grape juice)
- Alcohol
- Soups containing solid foods
Time to prepare the bowel preparation
As we mentioned earlier, the MoviPrep® box contains medicine packets and a mixing container. Read the instructions on the box carefully and prepare the solution accordingly.
Important: Do not prepare the solution more than 24 hours in advance of use. If you wish, you can add the flavor pack that comes with the medicine kit to the solution. However, do not add ice, sugar, or any other sweeteners to the solution. The prepared solution can be stored in the refrigerator.
How to drink the stomach cleansing liquid
Before making the medicine, read all the instructions carefully. You should drink this medicine in two divided doses.
Step 1: 6:00 PM the day before the colonoscopy
- Drink an 8-ounce (about 240 milliliter) glass of the prepared medicine liquid every 15 minutes.
- In this way, drink half of the total amount of liquid prepared and drink until it is finished.
Step 2: Six hours before the colonoscopy
(For example, if your test is at 8:00 AM, you should start drinking this portion at 2:00 AM.)
- Drink an 8-ounce (about 240 milliliter) glass of the remaining liquid medicine every 15 minutes.
- Drink this way until you have finished all the remaining liquid .
- You can drink clear liquids up to three hours before the test.
Usually, diarrhea starts almost immediately after taking MoviPrep®, and most people experience diarrhea within an hour. How long this diarrhea lasts can vary from person to person.
What do you do on special occasions?
Some people have slow bowel movements and may need different instructions. If this is your situation, ask your doctor about it.
- If you have a medical condition that requires special care.
- If the results of a previous colon cleanse were not good enough, or if the colon cleanse was unsuccessful.
- If you experienced any discomfort during anesthesia in the past.
What if you have constipation?
If you are constipated, you can take additional laxatives for a few days before you start taking the laxative. This will help control your constipation to some extent. Talk to your doctor about this as well.
What if the previous bowel prep didn't go well?
If you have such an experience, be sure to inform your doctor, as you may need additional advice or a different approach.
What if you have motility issues in your intestines?
Some medical conditions (e.g., Parkinson's disease, multiple sclerosis (MS), or people who use a wheelchair) and some medications (e.g., narcotics, gabapentin, anticholinergics) can cause delayed bowel emptying or constipation. If you have any of these conditions, tell your doctor about them. Tell them about your medical history and any medications you are currently taking. They can give you extra time to empty your bowels and give you additional laxatives to help you.
What if it's hard to drink a lot of fluids?
If you have such a problem, start drinking the laxative two to three hours before the scheduled time. That way, you can take your time and finish drinking all of the liquid.
What if I can't drink all the liquid to cleanse my stomach?
If you are unable to drink all of the fluids, you will likely have to postpone your colonoscopy because if your colon is not properly cleansed, the test will not produce the desired results.
What if you have had weight loss surgery (Bariatric Surgery)?
If you have had something like Gastric Bypass Surgery, it affects your stomach and small intestine. It doesn't change the length of your large intestine. However, you may find it difficult to drink large amounts of liquid at once. So, drink little by little. Be sure to finish all the liquid. It will take a little longer.
What if someone is undergoing dialysis?
If you are on dialysis due to kidney disease, you should meet with your nephrologist before scheduling your colonoscopy to get specific advice. Typically, dialysis patients are given a bowel cleansing medication called Golytely and have their colonoscopy done on the same day as their dialysis (such as a colonoscopy in the morning and dialysis in the evening).
Find out about a ride home
Can I use a service like Uber® or Lyft®?
We mentioned earlier that you need to have an adult with you when you check in for your colonoscopy. They should stay with you until you leave the endoscopy area. You can use a taxi service (e.g., Uber®, Lyft®) to go home, but the adult who came with you must also ride in the vehicle with you.
Can I stay there for a while and then drive away by myself?
No. You must have a responsible adult with you when you come in. That person must stay at the endoscopy center until the test is over and drive you home. You are not allowed to drive any vehicle until the end of the day.
Finally, what to remember (Take-Home Message)
Bowel preparation is a very important part of your colonoscopy. So, follow your doctor's instructions exactly. When your bowel is well-cleaned, your doctor can more easily detect abnormalities like polyps.
Before you start using the MoviPrep® Colon Cleanse Kit, discuss any questions or concerns you may have with your doctor or healthcare team. Don't worry, this is all for your own good. If you follow the instructions exactly, you can do it successfully.
` MoviPrep, colonoscopy, bowel preparation, bowel cleansing, colon, polyps, clear fluid, digestive system
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