Want to learn about the Two-Day Bowel Preparation to cleanse your colon?

Do you have a `(Colonoscopy)` test coming up soon? Then you must have heard about bowel preparation before it. Although this may seem like a bit of a hassle, it is essential to have a `(Colonoscopy)` test done properly. Today, we will talk about this two-day bowel preparation method, specifically how to do it using `( Magnesium Citrate )`, `(Dulcolax)` tablets and `(Golytely)`.

Why is this colon cleansing so important for a ``(Colonoscopy)''?

Simply put, your colon should be completely empty and clean when you have a colonoscopy. Imagine your doctor driving a car on a clear day. But if your colon is clogged with feces, it's like driving a car in a heavy rain or fog. You can't see anything clearly.

The most important thing is that only if the colon is thoroughly cleansed can the doctor clearly see even the slightest changes inside the colon, such as small growths (polyps), or the beginnings of cancer.

That's why it's so important to follow your gastroenterologist's instructions exactly. Otherwise, you may have to postpone the colonoscopy or have it done again at a later date. If that happens, it's uncomfortable for you.

How do you prepare for this two-day bowel prep?

There are a few small things that need to be done for this for a few days. Let's see what they are.

Things to take at least five (5) days before your ``(Colonoscopy)``:

You can buy these medications at a pharmacy. You don't need a prescription to get them. However, medications like `(Golytely)` do require a prescription, so have it ready in advance.

• A 296 ml (10 fluid ounce) bottle of `Magnesium Citrate` liquid. (This is a liquid that helps relieve constipation)
• A packet of four (4) Dulcolax tablets. Each tablet should contain 5 milligrams (5mg) of Bisacodyl. Important: Take the laxative type, not the stool softener type.
• In addition, you should also take the medicine `(Golytely/Nulytely®/Trilyte®/Colyte®)` prescribed by your doctor in advance.

Remember, follow these instructions exactly. Only then will you be able to have a successful colonoscopy and not have to do it again.

A few very important points:

• Your bowel needs to be completely empty so that the doctor can see inside clearly.
• Follow the instructions given by your gastroenterologist exactly as written on the label.
• Do not eat any solid food the day before your colonoscopy. Only clear liquids are allowed. We will discuss this further.

Do you need someone to come with you on the day of your colonoscopy?

Yes, this is mandatory. When you check-in for your colonoscopy, you must have a responsible adult with you. That person must stay with you until you are discharged. You will not be allowed to go home alone. Remember, you may feel a little uncomfortable or sleepy after the test. It is not safe to go home alone at that time.

If you don't have someone to take you home, your test will have to be canceled. You are not allowed to drive any vehicle, such as a bicycle, car, or scooter, or leave the institute alone that day. So it's very important to plan ahead for this.

You need to be careful about the drugs you take.

For your safety, some medications may need to be stopped or the dosage adjusted a few days before the test. It is important to discuss this with your doctor for advice.

Blood Thinners:

If you are taking this type of medication, be sure to see your doctor at least two (2) weeks before the test to discuss this medication. This is because any bleeding during the test may be difficult to control.

Some examples:

• `Clopidogrel (Plavix®)`
• `Warfarin (Coumadin®)`
• ``Ticlopidine hydrochloride (Ticlid®)''
• `Anagrelide (Agrylin®)`
• `Rivaroxaban (Xarelto®)`
• `Dabigatran (Pradaxa®)`
• `Apixaban (Eliquis®)`
• `Prasugrel (Effient®)`

Insulin and Diabetes Medication:

Talk to the doctor who prescribed this medication and get advice on how to adjust the dosage of this medication in the days leading up to your colonoscopy.

• If it's the day of the test, don't take your diabetes pills after midnight the night before.
• If you are taking insulin (e.g., long-acting insulin such as insulin glargine injection (Lantus®), insulin lispro (Humalog®), insulin isophane (HumulinN®, NovolinN®, ReliOn®), or 70/30 insulin), you should only take half (1/2) of your usual dose the day before the test. Also, consult your doctor about this.

Weight Management Medication:

You should lose weight.If you are taking medication, it may be necessary to change the dosage or stop taking it a few days (perhaps a week) before the test. Ask the doctor who prescribed the medication about this.

Some types of drugs that may need to be stopped include:

• `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®)`

Iron Pills:

If you are taking iron tablets, stop taking them one (1) week before your colonoscopy. Iron tablets can cause black stools and can build up in your colon, interfering with the examination.

Other types of beds:

You can take medications like aspirin, antibiotics, or diuretics with a sip of water on the day of the test. However, if you are unsure about which medications you can continue to take and which you should stop, be sure to ask your doctor.

About eating and drinking three (3) days before a `(Colonoscopy)`

You should stop eating foods high in fiber for three days before the test. These can remain in the intestines and interfere with the test.

• Popcorn
• Beans
• Grains (e.g. flax, sunflower, quinoa)
• Multigrain bread
• Nuts
• Salad/vegetables
• Fresh and dried fruit with skin peel

One (1) day before `(Colonoscopy)`

This is a day to be a little careful. From the day before the `(Colonoscopy)`, you should only drink clear liquids. Do not eat any solid foods.

You may drink clear liquids up to three (3) hours before your colonoscopy.

What are Clear Liquids?

Simply put, if you pour it into a glass and you can see through it, it's a clear liquid.

Examples:

• Water
• Unsweetened tea (without milk)
• Coffee without sugar (without milk)
• Clear broths/soups (without vegetable pieces or meat pieces)
• Fruit juice (no chunks, e.g. apple juice, grape juice - no dark color)
• Jelly (not dark colored - no red, no purple)
• Light-colored sports drinks or sodas like Sprite, 7Up

Things not to be afraid of:

• Milk and dairy products
• Dark fruit juices (e.g. tomato juice, orange juice with chunks in it)
• Alcohol

How to do the two-day bowel prep?

This is the most important part. Before making the colon cleansing liquid, read and understand all the instructions carefully.

Two (2) days before the `(Colonoscopy)`:

• 1 p.m. to 5 p.m.: Drink a glass of clear liquid (about 8 ounces) every hour.
• 5:30 PM: Drink the entire bottle of Magnesium Citrate (10 ounces).
• 6pm to 9pm: Again, drink a glass of clear liquid every hour.
• 9:30 PM: Take all four (4) Bisacodyl (Dulcolax) tablets at once with water.

When you do these things, you will need to go to the bathroom more often. This is normal, so don't worry about it. It's wise to stay in a place with a toilet nearby.

One (1) day before `(Colonoscopy)`:

• You can only eat a clear liquid diet until 6 pm all day long. Do not eat any solid food.
• In the afternoon, prepare your `(Golytely/Nulytely/Trilyte Colyte)` liquid laxative mixture and keep it in the fridge. If it comes with a flavor pack, you can add that. But do not add ice, sugar, or any other flavorings.
• You should drink this liquid in two portions.
• 6 PM: Start drinking 8 ounces (a large glass) of the prepared liquid every 15 minutes. Continue drinking until you have consumed half (1/2) of the total liquid.
• Six (6) hours before your test: Drink the remaining half (1/2) of the fluid as before, an 8-ounce glass every 15 minutes.
• Continue drinking clear liquids until three (3) hours before your colonoscopy. After that, do not drink anything.

What do you do on special occasions?

Some people may have a slower bowel movement. These people may need different advice. If you have this condition, talk to your doctor and get advice that is right for you.

What if you have constipation?

You can also take a laxative a few days before your cleanse. This will help to relieve your constipation before the cleanse. Ask your doctor about this as well.

What if the previous bowel prep didn't go well?

Be sure to see your doctor. You may need additional advice or a different type of preparation.

What if some illnesses cause delayed bowel emptying?

Some diseases (e.g., Parkinson's disease, Multiple Sclerosis (MS)) or certain medications (e.g., Narcotics, Gabapentin, Anticholinergic medications) can delay bowel emptying. If you are a wheelchair user, this may also affect your bowel movements. Tell your doctor about your condition and any medications you are taking. You may need extra time to empty your bowels and additional medications.

What if you have difficulty drinking lots of fluids?

Start cleaning your stomach two or three hours in advance. That way, you'll have more time to drink the entire amount.

What if I can't complete the bowel prep?

If you are unable to drink the entire colon cleansing liquid, you will likely have to postpone your colonoscopy. The test will not be useful if your colon is not completely clean.

Have you had bariatric surgery?

Gastric bypass surgery affects the stomach and small intestine. It doesn't change the length of your colon. But you may have to drink water more slowly, more frequently. You still have to do the same thing as a full bowel cleanse, it just takes a little longer.

Are you someone who is on dialysis due to kidney disease?

You should definitely see your nephrologist for specific advice before scheduling your colonoscopy. Typically, dialysis patients take the colon-cleansing solution Golytely and have the test done on the same day as their dialysis (colonoscopy in the morning and dialysis in the evening).

Let's find out exactly what "Clear Liquids" means.

This is very simple. If you can pour a liquid into a glass and see through it, it is considered a "clear liquid." For example, water, clear soup, light-colored jelly (not red or purple), non-dairy tea, and coffee. Milk, dark fruit juice, and alcohol do not fall into this category.

Another reminder about a ride home

We've already said that you need to have an adult with you when you check-in for your colonoscopy. That person must stay with you until the test is over and you are taken home. You can only take an Uber®, Lyft®, taxi, or bus home if the adult accompanying you is also in the vehicle with you.

Don't even think, "I'll sleep here for a while and then drive away on my own." That's not possible. You must have a responsible adult with you when you enter, be there during the test, and drive you home. You cannot drive any vehicle until the end of the day. This is for your own safety.

The most important things to remember (Take-Home Message)

Okay, so from what we've discussed, I hope you've got a good idea of ​​the Two-Day Bowel Preparation process. Don't worry, if you follow these instructions carefully, everything will go smoothly.

• Follow the doctor's instructions exactly: This is the most important thing. If you miss even the slightest thing, the test can be disrupted.
• Be careful about what you eat and drink: Especially in the days leading up to the test and the day before, follow the instructions exactly. Do this when you are told to drink only "clear liquids."
• Ask your doctor about medications: Inform your doctor about all medications you take and make any necessary changes.
• Bring someone with you: Don't forget to bring someone who is responsible for taking you home on the day of the test.
• Ask questions: If you have any questions or don't understand anything about this ``Bowel Prep'' or ``Colonoscopy'', don't be afraid to ask your doctor or nurse.

Although this preparation may seem a bit challenging, it's worth getting it right because this is a very important test for your health. Good luck to you!

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