Let's learn exactly about SUPREP, which cleanses the stomach before a colonoscopy!

If you are scheduled to have a colonoscopy , you probably already know that it is very important to thoroughly cleanse your stomach before it. So today we are going to talk about how to properly prepare for it using this medicine called `SUPREP`. This may seem a bit detailed, but it is very easy if you understand it properly. Let's see, shall we?

What is `SUPREP`?

Simply put, SUPREP is a brand name for a liquid preparation that is used to completely cleanse your colon, or large intestine, before a colonoscopy. It mainly contains two chemical ingredients: polyethylene glycol (PEG) and magnesium sulfate.

This is how these work:

• Polyethylene Glycol (PEG) draws water into your intestines , making your stool more watery and easier to pass.
• Magnesium sulfate stimulates the nerves that control intestinal motility, speeding up the passage of stool.

The action of both of these is what keeps your intestines clean.

Why is Bowel Prep so important?

You may be wondering why you're going to go to such lengths to clean your colon. The reason is that it's important for the gastroenterologist to have a clear bowel movement, so he or she can see the lining of your colon without any obstructions.

Think about it, a well-cleaned colon is like driving a car on a clear, sunny day. Nothing is hidden, everything is clear. But, an unclean colon is like driving a car in a heavy rainstorm, in fog. Nothing is clear.

So, if you can see clearly in this way, you can identify even small lumps (polyps) that could potentially turn into cancer early. Therefore, cleansing this stomach is something that must be done precisely, following medical instructions to the letter.

How to use `SUPREP`?

SUPREP comes in a kit that contains two small bottles of liquid medicine and a large mixing container.

To make the medicine, all you need to do is pour the liquid from one of the small bottles into the large cup. Then, fill the cup with clean water (room temperature or slightly cold) until it reaches the fill line. Then, stir well.

Before taking this medicine, you should read the instructions carefully and follow them exactly. Some hospitalsIn fact, if you don't follow these instructions exactly, your colonoscopy may even be canceled. So be very careful about this.

These are the things you must follow for a successful colonoscopy!

To make your colonoscopy successful, you need to do these things exactly:

• Your colon needs to be completely empty so the doctor can see it clearly. Follow the instructions in the leaflet that you are given, exactly as they say.
• Do not eat any solid food the day before your colonoscopy. Only clear liquids are allowed. We will discuss this further.
• Get your SUPREP kit from the pharmacy at least five days before your colonoscopy.

Be aware of moving around on the day of a colonoscopy

This is also very important. On the day of your colonoscopy, when you check in, you must have a responsible adult driver with you. That person must stay with you until you are discharged from the hospital after the procedure.

You will never be allowed to go home alone after the test. If there is no one to take you home, your test may not be done that day. So plan ahead for this as well.

Things to be aware of about the medications you take

For your safety, some medications may need to be stopped or the dosage adjusted a few days before the test.

Blood thinners

If you are taking blood thinners (e.g., `( clopidogrel (Plavix®))`, `(warfarin (Coumadin®))`, `(ticlopidine hydrochloride (Ticlid®))`, `(anagrelide (Agrylin®))`, `(rivaroxaban (Xarelto®))`, `(dabigatran (Pradaxa®))`, `(apixaban (Eliquis®))`, `(prasugrel (Effient®))`), you should definitely see your doctor at least two weeks before the test to get advice about these medications.

Insulin and diabetes medication

If you are taking diabetes medication or insulin, you should definitely ask your prescribing doctor how to adjust the dosage of these medications in the days leading up to your colonoscopy.

• Do not take diabetes pills the morning of the test (after midnight).
• If you take insulin (e.g. insulin glargine injection (Lantus®), insulin lispro (Humalog®), long-acting insulin (insulin isophane (HumulinN®, NovolinN®, ReliOn®)), or 70/30 insulin), you should take only half of your usual dose the day before the test. However, consult your doctor and follow his or her instructions.

Weight management medication

If you are taking any weight loss medication ((canagliflozin (Invokana®))), `(dapagliflozin (Farxiga®, Forxiga®))), `(dulaglutide (Trulicity®))), `(empagliflozin (Jardiance®))), `( ertugliflozin (Steglatro®))), `(exenatide (Byetta®, Bydureon®))), `(liraglutide (Victoza®, Saxenda®))), `(lixisenatide (Adylyxin®))), `(semaglutide (Ozempic®, Wegovy®, Rybelsus®))), `(tirzepatide (Mounjaro®, Zepbound®))), you may need to change the dose of those medications or stop them a few days/weeks in advance. Also, consult your doctor about this.

Iron pills

If you are taking iron pills, you should stop taking them a week before your colonoscopy.

Other medications

Medications such as aspirin, antibiotics , or diuretics can be taken with a sip of water on the morning of the test.

However, if you have even the slightest doubt about any medication you are taking, it is best to ask your doctor to confirm whether you should stop or continue taking it.

Stop eating these foods three days before a colonoscopy

For three days before your colonoscopy, avoid adding these high-fiber foods to your diet:

• Popcorn
• Beans - like peas, green beans
• Seeds - e.g. `(flax)`, `(sunflower)`, `(quinoa)`
• Multigrain bread
• Nuts - like peanuts, cashews
• Lettuce/vegetables (uncooked)
• Fresh and dried fruits

If you eat these, they can get stuck in your intestines and interfere with your bowel movements.

Your diet the day before your colonoscopy

The day before your colonoscopy (24 hours before the test), you should not eat any solid food.

You can only drink clear liquids.

You can drink these clear liquids up to three hours before your test begins.

What are these clear liquids?

• Water
• Tea, coffee with or without sugar (no milk or cream)
• Clear fruit juice (filtered to remove fiber - e.g. apple juice, grape juice (white), orange water)
• Clear soup/broth - strained to remove any vegetable or meat pieces
• Jelly (non-red, non-pieced jelly)
• Ice pops (no dairy, no fruit pieces, no red/purple)

Things not to be afraid of:

• Milk and milk-based beverages
• Fruit juice with fiber
• Red, purple, or blue colored fluids (as these can look like blood in the intestines)
• Alcohol

Let's learn exactly how to prepare and drink `SUPREP` liquid.

The `SUPREP` liquid is to be taken in two doses. The prepared liquid can be refrigerated and drunk, but do not add ice, sugar, or any other sweeteners.

First dose: 6:00 PM the day before the colonoscopy

(The time on the instruction sheet you are given may be slightly different, so check that as well)

1. Take one of the small 6-ounce (about 177 ml) bottles of SUPREP liquid and pour the entire contents into the large mixing container.

2. Then add cool water until it reaches the 16 ounces (about 473 ml) mark on the cup and stir well.

3. Now drink the entire liquid mixture slowly. If it's difficult to drink it all at once, try to finish it within 30 minutes.

4. After you finish drinking it, within the next hour, you should drink two more cups of water (that's 16 ounces x 2 = 32 ounces, about 946 milliliters) from the same stirred cup. Drink this water little by little.

You will start to feel nauseous shortly after taking this first dose. This is normal.

Second dose: Six hours before colonoscopy

(This time may vary slightly depending on your instructions. Usually, you are told to drink this 4-6 hours before the test.)

1. Now take the other 6-ounce bottle of SUPREP and pour the liquid completely into the mixing cup.

2. As before, add cold water to the 16-ounce level in the cup and stir well.

3. Drink this liquid mixture completely, little by little.

4. After you finish drinking it, within the next hour, drink two more cups of water from the same cup.

• You can drink clear liquids up to three hours before your test. After that, don't drink anything (not even water!).

Some people with special circumstances may need separate advice.

Not everyone's body is the same, so some people may need different advice in addition to this general advice.

• Some people may have slow bowels.
• People with special medical conditions.
• People whose bowels were not properly cleaned during a previous colonoscopy (`poor bowel prep results`).
• Those who have had difficulty with anesthesia in the past.

In a situation like this,It is best to see your doctor and get personalized bowel prep instructions that are right for you.

Common questions and answers you may have (FAQ)

When using this medicine, you may have a few questions. Let's look at the answers to some of them.

Can `SUPREP` liquid be mixed with orange juice?

Oh no! `SUPREP` liquid should only be mixed with water. Do not mix with anything else (juice, tea, coffee).

How long does it take for the stomach to empty after taking `SUPREP`?

It varies from person to person. You will continue to have diarrhea until your bowel movements become completely watery (watery diarrhea).

What should I do if I have constipation?

If you are someone who is constantly constipated, you can take additional laxatives (` laxatives` ) as directed by your doctor for a few days before the day of the cleanse. Then, by the time the cleanse is over, the constipation will have reduced to a great extent.

What should I do if my stomach hasn't been properly cleansed before?

If you have such an experience, be sure to let your doctor know. He or she will then give you additional advice or an alternative method.

What should I do if I have motility issues due to a medical condition?

Some medical conditions (e.g., Parkinson's disease, multiple sclerosis (MS)) and some medications (narcotics, gabapentin, anticholinergic drugs) can cause delayed bowel emptying or constipation. This is especially true if you are a wheelchair user. If this is the case, be sure to tell your doctor about your complete medical history and medications you are taking. You may need to take extra time to empty your bowels or take additional laxatives.

What if I have difficulty drinking large amounts of fluids at once?

If that's difficult, you can start taking the stomach-cleansing medicine two or three hours earlier. Then you can take more time and drink the full dose.

What happens if I can't take all of this stomach-cleansing medicine?

If that happens, you will most likely have to postpone your colonoscopy because if your colon is not completely clean, the test will not give you the expected results.

I have had bariatric surgery. Do I need to take this entire medication?

Yes. Weight loss surgery affects the stomach and small intestine. The length of your colon does not change. But you may have difficulty drinking large amounts at once. So, take it slowly, slowly, and take the full dose over time.

What if I am on dialysis?

If you are on dialysis,Before scheduling a colonoscopy, you should meet with your nephrologist and get the appropriate advice. Patients on dialysis are usually given another bowel cleansing medication called Golytely. Also, the test is often scheduled on the same day as the dialysis (colonoscopy in the morning, dialysis in the evening).

How do you know exactly what a "clear liquid" is?

It's very simple. If you put the liquid you're drinking in a glass and you can clearly see the other side through the glass, it's a "clear liquid." That means it should be transparent, like water.

Can I use Uber®, Lyft®, a taxi, or a bus to get home?

From the time you are admitted to the hospital, the adult in charge of you must stay with you until you are discharged from the hospital. You can take a taxi home, but that adult in charge must travel in the same vehicle with you.

Can't I just sleep here for a while and then drive myself?

Oh, that's absolutely not possible. You must have an adult with you when you come for the test. That person must stay until the test is over and take you home. You are not allowed to drive for the rest of the day.

Definitely keep this in mind! (Take-Home Message)

Bowel preparation is a very important step before a colonoscopy.

• Follow the instructions given by your gastroenterologist exactly.
• The clearer your colon is, the easier it is for your doctor to spot small lumps (polyps) and other abnormalities.
• Before you start using SUPREP, if you have any questions, please do not hesitate to ask your doctor.

If you follow these instructions exactly, you will be able to have a successful colonoscopy!

` Colonoscopy, Suprep, Colon Cleansing, Colon, Medical Advice, Preparing for the Test, Diet Control