Are you also having a colonoscopy? Then let's learn more about SUPREP Bowel Preparation!

Is your doctor planning to have a colonoscopy soon? If so, your doctor has probably already explained to you that you need to cleanse your colon thoroughly before doing so. One medication used for this purpose is SUPREP. Many people get a little scared and nervous when they hear about this colon cleanse. You may think, "Oh, how do I do this?" But, when you actually learn the details, you will realize that this is not such a big deal. Let's talk about this in detail and simply.

What is SUPREP®? Let's take a closer look.

Okay, first let's look at what SUPREP® is. Simply put, SUPREP® is the brand name for a special medicine that is used to thoroughly cleanse your colon or large intestine. It comes in the form of a liquid. It mainly contains a chemical compound called `(Polyethylene Glycol)` or `(PEG)` and `(Magnesium Sulfate)`.

Now you're probably wondering how these cleanse the stomach, right? Here's how it works:

• (Polyethylene Glycol - PEG): This works like a sponge. That is, when you take this medicine, this ``(PEG)`` attracts water into your colon. Then your stool becomes loose and starts to pass easily.
• (Magnesium Sulfate): This works a little differently. It stimulates the nerves that control the movement of your intestines. When stimulated, the intestines become more active and the stool passes more quickly.

So when both of these functions are combined, everything inside your colon is thoroughly cleansed and comes out. It is extremely important to cleanse your colon in this way before a colonoscopy.

Why is Bowel Prep so important?

You may be thinking, "Why does Dad have to go to such lengths to clean out this bowel?" The reason is that in order for your gastroenterologist to be able to see the inside of your large intestine clearly, without any obstructions, it needs to be completely empty of stool.

Think of it this way. To the doctor, a clean colon is like driving down a road on a clear, sunny day, with no fog or clouds. Everything is clear. But if there is stool in the colon, it is like driving through a storm and not being able to see the road. What happens then? The doctor may miss small things in the colon, especially small growths (polyps) that can turn into cancer. That is why it is so important to do this bowel prep properly.

Remember: A properly performed bowel prep is the first step to a successful colonoscopy!

How to use SUPREP®?

SUPREP® comes in a kit. This kit usually includes two small bottles of liquid medicine and a large mixing container to mix the medicine .

The way to prepare the medicine is, you have to pour the medicine liquid from the small bottle into the big cup. Then, you have to fill the cup with cool water until it reaches the fill line. Before preparing the medicine, don't forget to read the instructions that come with it carefully and follow them exactly. If you are a patient of the Cleveland Clinic, you have to follow the instructions exactly. Otherwise, they will have to stop your colonoscopy.

These things are a must when preparing!

To make your colonoscopy successful, you must follow these steps exactly:

• Your bowels should be completely empty so that the doctor can see clearly. Follow your doctor's instructions carefully.
• Do not eat any solid food the day before your colonoscopy. You can only drink clear liquids. We'll talk about what those are later.
• Get your bowel preparation kit from the pharmacy at least five days before your colonoscopy. Don't wait until the last minute.

How a Colonoscopy Goes Around in a Day

This is a very important point. When you check in to the hospital/clinic for a colonoscopy , you must have a responsible adult driver with you. That person must stay with you until you are discharged after the procedure.

Most importantly: You are not allowed to go home alone after the test. If you don't have someone to take you home, your test may even have to be canceled. This is because the anesthesia you receive during the test can make you feel a little dizzy or drowsy. It is very dangerous to drive a vehicle at that time.

You need to be careful about the medicine you take!

For your safety, some medications may need to be stopped or the dosage adjusted a few days before the test. You should definitely discuss this with your doctor.

• Blood thinners: If you are taking these medications, talk to your doctor about them at least two weeks before the test . Examples include: `(Clopidogrel - Plavix®)`, `(Warfarin - Coumadin®)`, `(Ticlopidine Hydrochloride - Ticlid®)`, `(Anagrelide - Agrylin®)`, `(Rivaroxaban - Xarelto®)`, `(Dabigatran - Pradaxa®)`, `(Apixaban - Eliquis®)` and `(Prasugrel - Effient®)`. If you do not stop taking these medications, there is a risk of bleeding during the test.

• Insulin and diabetes medication: If you are taking diabetes medication, be sure to ask your doctor how to adjust your medication dosage in the days leading up to your colonoscopy. On the day of your test, do not take your diabetes medication after midnight. If you are taking insulin, such as `(Insulin Glargine injection - Lantus®)`, `(Insulin Lispro - Humalog®)`, long-acting insulin `(Insulin Isophane - HumulinN®, NovolinN®, ReliOn®)` or `(70/30 insulin)`, you should only take half your normal dose the day before your test. Be sure to talk to your doctor about this as well.

• Weight management medication: If you are taking any medications to help you lose weight, you may need to adjust the dose of those medications or stop them a few days or even a week before the test. Talk to your doctor who prescribed them for more advice. Some weight management medications that you may need to stop taking include: (Canagliflozin - Invokana®), (Dapagliflozin - Farxiga®, Forxiga®), (Dulaglutide - Trulicity®), (Empagliflozin - Jardiance®), (Ertugliflozin - Steglatro®), (Exenatide - Byetta®, Bydureon®), (Liraglutide - Victoza®, Saxenda®), (Lixisenatide - Adylyxin®), (Semaglutide - Ozempic®, Wegovy®, Rybelsus®) and (Tirzepatide - Mounjaro®, Zepbound®).

• Iron pills: These should be stopped a week before the colonoscopy, as iron pills can cause the stool to turn black and remain in the colon.

You can take aspirin, antibiotics, or diuretics with a sip of water the day of the test. However, if you are unsure about which medications you can continue to take and which you should stop, please ask your doctor. It is safest to do so.

Days when you need to be careful about food and drink

Three days before the colonoscopy:

Three days before the test, you should stop eating these high-fiber foods:

• Popcorn
• Beans
• Seeds - e.g. flax seeds, sunflower seeds, quinoa
• Multigrain bread
• Nuts
• Salad/vegetables - especially those eaten raw and leafy greens
• Fresh and dried fruit

If you eat these, the fiber in them will stick to your intestines, making it difficult to cleanse.

The day before the colonoscopy:

This day is very important. You should only drink clear liquids from the day before your colonoscopy.Do not eat any solid food.

You can drink clear liquids up to three hours before your colonoscopy.

Here is a list of things you can and can't drink:

Things to drink (Clear Liquids):

• Water
• Unsweetened tea (without milk)
• Coffee without sugar (without milk)
• Clear broth or bouillon - without meat pieces or vegetable pieces
• Clear fruit juices (e.g. apple juice, grape juice - not dark colored)
• Jelly (Jell-O®) - not red, purple, or blue
• Clear ice popsicles - those without red, purple, or blue
• Clear sports drinks - those that are not dark in color

Things you can't drink:

• Milk and dairy products
• Dark-colored liquids (e.g., red, purple, orange fruit juice)
• Alcohol
• Soups with solids
• Solid foods

A simple tip: If you can see through a glass of liquid, it's considered a "clear liquid." But avoid anything with bright colors like red, purple, or blue. Those colors can linger in your intestines and cause your doctor to make wrong decisions when examining you.

Exactly how to drink SUPREP®

SUPREP® is to be taken in two divided doses. You may refrigerate the solution before drinking it. However, never add ice, sugar, or other flavorings to it.

First dose (Part 1): 6:00 PM the day before the colonoscopy

1. Take one of the two small bottles of SUPREP® liquid and pour the entire amount of liquid into the large mixing container.

2. Then, add cool water until the cup reaches the 16-ounce mark and stir well.

3. Now drink the entire amount of liquid you have prepared (all that is in the cup).

4. Then, within the next hour, drink two more 16-ounce glasses of water. That means you'll need to drink about a liter of water after you finish taking the medicine.

After taking this, you will need to go to the bathroom more often. That's normal, don't worry about it. It means the medicine is working.

Second dose (Part 2): Six hours before the colonoscopy

1. Take the other SUPREP® liquid bottle and pour the entire amount of liquid into the large mixing cup.

2. Again, add cold water until it reaches the 16-ounce mark on the cup and stir well.

3. Drink the entire amount of liquid you have prepared.

4. Then, within the next hour, drink two more 16-ounce glasses of water.

To youYou can continue to drink clear liquids until three hours before the test begins.

Special occasions - be aware of these too

Some people have a slower bowel movement. These people may need different instructions. If you have any of these conditions, talk to your doctor to get personalized bowel prep instructions:

• If you have other medical conditions that require special care.
• If a previous colonoscopy had poor bowel prep results or failed completely (failed bowel prep).
• If you had any discomfort related to anesthesia during a previous examination.

What if your intestines are slow (Motility Issues)?

Some medical conditions and medications can slow bowel emptying or cause constipation. For example, people with conditions like Parkinson's disease, multiple sclerosis (MS), or those who use a wheelchair may experience this type of slow bowel movement. Also, medications like narcotics, gabapentin, and anticholinergic medications can affect this. If you have any of these conditions, be sure to tell your doctor about your medical history and any medications you are currently taking. They may give you more time to empty your bowels and possibly give you additional laxatives .

What if it's hard to drink a large amount of liquid at once?

For such people, you can start taking your medication two to three hours before the scheduled time. That way, you will have more time to take your medicine and water little by little.

What if I can't completely swallow the stomach-cleansing medicine?

If that happens, your colonoscopy will likely have to be rescheduled. Because if you don't take the medicine properly, your colon won't be properly cleansed. Then you won't get the results you expect from the test.

What if you have had weight loss surgery (Bariatric Surgery)?

Gastric bypass surgery affects your stomach and small intestine. It doesn't change the length of your large intestine. However, you may have difficulty drinking large amounts of liquid at once. People with this condition should drink small amounts of liquid at a time. You should definitely drink the full dose of medication. It will take a little longer.

What if you are on dialysis?

If so, before you schedule a colonoscopy, you should definitely see your nephrologist and get specific advice.Typically, dialysis patients are given a different type of bowel preparation called a "Glytely bowel prep." Also, their test and dialysis are often scheduled to be done on the same day (colonoscopy in the morning, dialysis in the evening).

Do you also have these questions (FAQs)?

Question: Can SUPREP® be mixed with orange juice?

Answer: No. You should only use water to mix the medicine. Do not add anything else.

Question: How long after taking SUPREP® will I need to go to the bathroom?

Answer: It varies from person to person. You will need to continue going to the bathroom until your stools are completely watery (watery diarrhea).

Question: What should I do if I have constipation?

Answer: You can take some extra laxatives ( laxatives ) a few days before the day of the cleanse. Then, by the time the cleanse is over, your constipation will have reduced significantly. Talk to your doctor about this as well.

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

Answer: Simple. If you can put a liquid in a glass and see through it, it can be considered a "clear liquid." However, as we mentioned earlier, you should definitely avoid those with strong colors like red, purple, or blue.

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

Answer: You must have an adult with you when you check-in for your colonoscopy. That person must stay with you until you leave after the procedure. You can only use a taxi service to go home if the adult who accompanied you is also going home in the taxi with you. You cannot do it alone.

Question: Can't I just sleep here for a while and then drive away alone when I'm sober?

Answer: Oh, no, that's not possible. You must have a responsible adult with you when you come for the test. That person must stay there until the test is over and drive you home. You are not allowed to drive a vehicle for the rest of the day.

Finally, remember this (Take-Home Message)

Bowel preparation is a very important part of your colonoscopy. Follow your doctor's (gastroenterologist's) instructions exactly. If your bowel is clear, they can easily find polyps and other abnormalities. That's very important for your own health.

If you have any questions about using SUPREP®, please ask your doctor before you start taking it. Don't be afraid or nervous. This is all for your own good.

` Colonoscopy, Colon Cleansing, SUPREP, Colon Cleansing, Health, Medical Advice, Digestive System