Sutab Modified 2-day Prep Instructions

You MUST have a driver with you. Public transportation such as Uber, Lyft and taxis are not suitable transportation after sedation.  If you do not have a designated driver, your procedure will be cancelled. While your driver is not required to stay during your procedure, we ask that they remain within 15 minutes of our facility.

 

IMPORTANT PERSONAL MEDICATION INSTRUCTIONS

  • Oral prescription Diet medications such as Phentermine must be held 10 days prior to the procedure.
  • Medications injected once weekly for Diabetes OR weight loss must be held the week prior to procedures.

5 DAYS PRIOR TO YOUR PROCEDURE:

  • Blood thinning medications such as Warfarin (Coumadin), Plavix (Clopidogrel), Pletal (Cilostazol) Heparin, Aggrenox (Dipyridamole), Eliquis (Apixaban) or Effient (Prasugrel) will need to be held up to 5 days prior to the procedure. Please refer to the text sent by your nurse for your exact stop date. Please call with any questions.

A notice has been sent to your prescriber of this medication informing them of our request to hold this medication. If they have any instructions other than holding for the length of time we require, they will contact you.  If you have any questions, please contact the prescriber to discuss.

  • Stop all vitamins, herbal supplements, and over the counter medications including Fish oil and Iron. Allergy medications and cold medications are ok if needed until the morning of the procedure. Avoid cold medications that contain Ibuprofen.
  • Stop all NSAIDS such as Ibuprofen, Meloxicam, Celebrex etc. Tylenol or Acetaminophen is ok to take.
  • Stop all flax, chia or other foods containing small seeds.
  • Aspirin, up to 325mg once daily, does not need to be stopped prior to your procedure. Review post-procedure instructions prior to resuming afterwards.

 

3 Days PRIOR TO YOUR PROCEDURE:

  • Stop any opioid antagonists such as Naltrexone.

 

HOW TO OBTAIN THE BOWEL PREP

  1. The prescription for your bowel prep has been sent to the pharmacy listed on your history form. Please contact your pharmacy in advance to ensure the prep is affordable for you.  If Sutab will not work for you, please call our office to discuss the options available.
  2. You will also need to purchase Magnesium Citrate. If this is not available, you will need to purchase Miralax, or any generic store-brand version of it. These are available over the counter without a prescription.

 

2 DAYS PRIOR TO YOUR PROCEDURE:

CLEAR LIQUIDS ONLY beginning at 5:00 PM. Clear liquids include water, broth, clear juices without pulp, black coffee, tea, sports drinks, flavored waters, Kool-Aid, soda and Jell-O (no fruit or toppings). Nothing red, blue or purple colored. NO SOLID FOODS, MILK OR DAIRY PRODUCTS.

  1. At 7:00PM, drink 1 bottle of Magnesium Citrate. If Magnesium Citrate is not available, mix 7 capfuls of Miralax in 24oz of any clear liquid and drink.

 

THE DAY PRIOR TO YOUR PROCEDURE:

NO alcohol or elicit drug use for at least 24 hours prior to your procedure.

  1. CLEAR LIQUIDS ONLY for THE ENTIRE DAY prior to your procedure. Clear liquids include: water, broth, clear juices without pulp, black coffee, tea, sports drinks, flavored waters, Kool-Aid, soda and Jell-O (no fruit or toppings). Drink as much as possible throughout the day. Nothing red, blue or purple colored. NO SOLID FOODS, MILK OR DAIRY PRODUCTS.

 

  1. Do not take any diuretics such as Furosemide, Lasix, Aldactone, Spironolactone, Hydrochlorothiazide

 

  1. SUTAB INSTRUCTIONS:
  • At 5:00 PM, open one bottle of 12 tablets. Fill the provided container to the fill line with water. Swallow each tablet with sips of water. Finish all 12 tablets and the water within 20 minutes.
  • One hour after finishing the tablets, fill the provided container with water again and drink within 30 minutes. Wait 30 minutes, then fill the container again with water and drink over 30 minutes.
  • Continue to drink clear liquids the rest of the evening to prevent dehydration.

 

THE DAY OF YOUR PROCEDURE:

  1. Five (5) hours before you leave for your procedure, open the 2nd bottle of 12 tablets. Fill the provided container to the fill line with water. Swallow each tablet with sips of water. Finish all 12 tablets and the water within 20-30 minutes.
  2. One hour after finishing the tablets, drink another container of water over 30 minutes. Wait 30 minutes, then drink another container of water over 30 minutes. Then STOP DRINKING.
  3. You must finish your morning prep regimen no later than 2 hours before your check-in time. If you drink anything after completing your morning prep, your procedure may be postponed or cancelled.

 

Take only the medications for high blood pressure, or seizures with sips of water at least 2hrs prior to checking in.

  1. Inhalers are ok to use any time prior to your procedure.
  2. Take no more than ½ your usual insulin dose the morning of your procedure. Contact the physician managing your diabetes for specific dose adjustments if needed. Do not take any oral diabetic medications the morning of your procedure.
  3. Please review your post-procedure instructions before resuming any medications.

 

FREQUENTLY ASKED QUESTIONS

Why do I have to drink my prep at two different times?

Recent studies have clearly shown split-dose preparation results in higher quality examinations with increased detection of precancerous polyps.

 

What if I feel like I am going to vomit if I drink another glass of prep or what if I start to vomit while drinking the prep?

Stop drinking prep for 30-45 minutes until symptoms subside, then resume prep.

 

What if I drink all the prep and I do not have a bowel movement?

If no stool by 9:00P.M., you will need take Miralax. Mix 7 scoops of Miralax in 24oz of any clear liquid and drink. This can be purchased over-the counter at any pharmacy. If still no results, call the doctor who will be performing your colonoscopy.

 

What should my bowel movements look like after I drink all of the prep solution?

Your bowel movements should be clear yellow liquid. They will look like urine or lemonade. If your bowel movements are still brown and haven’t been clear, please call our office at 402-465-4545. This line is answered 24 hours a day.

 

What if I have rectal discomfort?

You may apply petroleum-based product or diaper rash ointment such as Vaseline, A&D ointment or Balneol to the rectal area if you experience discomfort from frequent stools.

 

What if I am diabetic?

Please drink clear liquids that are not sugar free the day prior to your procedure. This will give you calories to assist with your blood sugar levels. Please contact the physician who manages your diabetes for any medication dose adjustments needed. Do not take any oral diabetic medications the morning of your procedure.

 

Do I take my morning medications the day of my procedure?

You can take any blood pressure and/or anti-seizure medications at least 2 hours prior to check-in. Inhalers can be used any time prior to your procedure. Hold all other medications until afterwards.

 

Will I be asleep for my procedure?

In the procedure room, you will be given medications through an IV to cause relaxation and sedation. Most patients will nap through the procedure, but you can breathe on your own and will wake up quickly. The sedation can affect your memory during the procedure, and during the times before and after. Many patients have no memory of their procedure at all.

 

Does my driver have to stay with me during the procedure?

If your driver does not wish to remain in the lobby, a contact number can be given to the nursing staff. These arrangements must be made during the check-in process, or your procedure will be canceled. Typically, the driver can return 1.5 hours after they drop you off or they can be called prior to your dismissal time. Public transportation can only be used if you are also accompanied by a responsible adult accepting responsibility at dismissal.

 

Can I eat after my procedure?

You may resume your normal diet unless otherwise instructed.

 

WHAT TO BRING TO YOUR PROCEDURE

  • The first and last name of all doctors you want to receive a copy of your procedure report.
  • A responsible adult to drive you home. It will be mandated and enforced that you have someone to accept responsibility for your dismissal and provide you transportation home. No exceptions will be made to the Center’s policy. Sedation is given during your procedure and impairs your ability to drive and make decisions. IF YOU HAVE NOT ARRANGED FOR SOMEONE TO DRIVE YOU HOME, YOUR PROCEDURE WILL BE CANCELED.
  • Your insurance card and photo ID.

 

WHAT TO WEAR TO YOUR PROCEDURE

  • Wear comfortable, loose-fitting clothing.
  • Wear flat shoes or tennis shoes.
  • Please leave jewelry and valuables at home.

 

If you have additional questions, please contact our office AT 402-465-4545.