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Digestive health: Successful prep for colonoscopy

thank you for joining us for this

colonoscopy preparation course

the main goals of this slideshow art

explain why you were referred for a

colonoscopy and what a colonoscopy is to

talk about the risks involved and other

choices you have and to review how to

prepare for the colonoscopy in order to

get the most accurate results your

primary care provider may have referred

you for a colonoscopy for one of these

reasons you are 50 years old or older

which means you are at higher risk for

colon cancer you have seen blood from

your rectum or have had a stool blood

test that was positive you have a

personal history or family history of

colon cancer or a certain kind of polyps

your provider wants to find out why

you're having other symptoms there are

several reasons why you may have blood

in your stool or bleeding from your

rectum these pictures show common stool

tests let's talk about why these tests

may show positive results for blood one

possible cause of blood in the stool is

inflammation of the lining of the colon

this is called colitis blood in the

stool can also be caused by hemorrhoids

these are enlarged veins that can be on

the outside of the rectum or on the

inside sometimes these veins can bleed

an anal fissure is a cut or a tear in

the skin of the rectum this can cause

bleeding from the rectum if you have an

anal fissure you may feel pain in your

rectum when you have a bowel movement

colon polyps may cause blood in the

stool a colon polyp is a small growth of

cells on the lining of the colon we

don't know why some people get colon

polyps and others do not if we see a

colon polyp during your colonoscopy we

will remove it if we can a polyp can

sometimes grow into colon cancer if a

polyp is removed it cannot grow and we

may have prevented colon cancer

colon cancer can also cause blood in the

stool we can treat colon cancer

especially if we find it early before it

has grown too much colon cancer is the

third most common kind of cancer and the

second leading cause of cancer-related

death it affects men and women of all

races people who are age 50 or older are

at higher risk for colon cancer as well

as people with a personal or family

history of certain kinds of polyps or

colon cancer obesity can also increase

your risk other risks include a diet low

in fiber and high in fat an inactive

lifestyle and smoking a colonoscopy is

the best test to look for problems in

the lining of the colon to screen for

colon cancer and to find out why there

is blood in the stool the procedure

takes 30 to 45 minutes to complete and

is usually very safe first you will get

sedative medicine to make you sleepy and

comfortable the procedure uses a camera

that is at the end of a flexible tube

the tube is about 5 feet long and about

as wide as a pointer finger we place the

tube in your rectum and gently push it

all the way through your colon as it

moves the camera allows us to look

carefully at the entire lining of your

colon

as with any medical procedure a

colonoscopy has risks you could have a

bad reaction to the sedation medicine

bleeding if we take tissue samples

called biopsies or remove polyps there

is a small chance less than one patient

in 1,000 that the doctor accidentally

pokes a hole in the large intestine

during the colonoscopy if this happens

it may require surgery to repair there

is a small chance of infection there is

also a small chance that we may not see

something that is there colon problems

can hide in a fold of the colons lining

but this usually only happens if there

is stool still left in the colon that is

why it is so important to carefully

follow all the instructions you receive

about preparing for your colonoscopy we

want to get a good view of your colons

lining however we will stop your

colonoscopy if the procedure becomes too

risky for any reason having a

colonoscopy is up to you you could also

choose not to have a colonoscopy if you

choose not to have a colonoscopy there

are no risks from the procedure but we

may not find colon polyps cancer or

another problem that needs treatment you

could also have a sigmoidoscopy instead

of a colonoscopy this procedure looks

only at the lower two feet of the colon

if there are problems higher up in the

colon the sigmoidoscopy would not find

these we recommend colonoscopies as the

most thorough way to look for colon

problems and to screen for colon cancer

having this procedure is your choice and

you do have other options when we do

your colonoscopy we need to be able to

clearly see the lining of the colon so

that we can find any problems it is very

important that you properly prepare your

bowels and colon for your tests you will

need to start preparing seven days

before your colonoscopy some patients

have general anesthesia instead of

sedation for their colonoscopy if you

were having general anesthesia I may

also need to follow other instructions

we will give these instructions to you

for your procedure

if you take blood thinning medicines

such as coumadin warfarin plavix

clopidogrel eviant or Pradaxa please

tell us as soon as possible and at least

seven days before your colonoscopy we

will work with you and your doctor to

adjust your medicines to lower the risks

of bleeding you will get more

instructions once we have a plan in

place

if you have diabetes and take oral

diabetes medicines or insulin talk with

a doctor who prescribed your medicines

tell them the date and time of your

colonoscopy and ask if there is anything

special you need to do with your

diabetes medicines on the day before or

the day of your colonoscopy check your

blood sugars as you normally do or if

you feel like you are having blood

sugars that are too high or too low

at least seven days before your

colonoscopy we want you to have a plan

in place for who will get you safely

home from the colonoscopy because of the

sedation or anesthesia it will not be

safe for you to drive or even to take a

bus or taxi home by yourself you will

need to arrange for a responsible adult

to drive you home or be with you on your

trip home five days before your

colonoscopy we also want you to stop

eating certain foods

these include raspberries nuts seeds

beans corn and peas

these foods take a long time to digest

so if you've eaten them within five days

of your procedure we may see these foods

in your colon and not be able to see the

colon lining five days before your

colonoscopy you will need to fill your

prescription for the laxative medicine

called bowel prep the medicine will come

in a one gallon container when you pick

up your bowel prep from the pharmacy it

should come with flavor packets attached

if there are no flavor packets on the

outside of the bottle ask the pharmacist

for them if the pharmacist is not able

to give you flavor packets you may buy

Crystal Light to add flavour to the

solution read the instructions carefully

so you know how to mix the solution ask

your pharmacist if you have any

questions about what to do

the day before your colonoscopy you'll

need to do two things to clean your

colon do not eat any solid food drink

clear liquids only you will also need to

take your laxative medicine let's talk

about clear liquids a clear liquid is

one you can actually see through good

examples of clear liquids are sports

drinks water tea apple juice sodas soup

Roth and jello black coffee and coffee

with sugar or clear liquids but you

cannot have coffee with cream in it also

do not eat red jello we do not want you

to have any liquids with red food

coloring because red food coloring can

look like blood in the colon during the

colonoscopy on the day before your

procedure you will need to drink at

least two quarts of clear liquids in

addition to the bowel prep this means

you will drink 8 8 ounce glasses of

clear liquids

because it is important to have a good

bowel preparation let's review what

clear liquids are okay to have the day

before your colonoscopy what do you

think are these top two pictures of

clear liquids yes this is a good example

of a clear liquid diet of chicken soup

broth green jello and water how about

these

yes apple juice and soup Roth are both

clear liquids what about the bottom row

of pictures is the soup in the first

picture clear liquid no there are many

pieces of food in the soup what about

the second bowl of soup no it has chunks

of food in it too and what about the

orange juice no do not drink juice with

pulp when you are on a clear liquid diet

in the morning on the day before your

colonoscopy you will need to prepare

your bowel prep to do this tear open one

of the flavor packets and add it to the

bottle if you do not receive flavor

packets you may use Crystal Light to add

to the mixture then add water up to the

line on the side of the container seal

the container and shake it well to mix

then put the mixture in the refrigerator

to cool when you drink the bowel prep it

should be cold

at 7:00 p.m. the night before your

colonoscopy start drinking the chilled

bowel prep mixture you prepared you

should drink 1 8 ounce glass of the

mixture every 15 minutes between 7:00

and 10:00 p.m. when you're done you

should have finished 3/4 of the bottle

bowel prep has an aftertaste so you may

want to drink sips of 7up sprite or

ginger ale after drinking each glass you

may also find the bowel prep easier

drink through a straw or over ice this

okay to keep drinking other clear

liquids while you are drinking the bowel

prep

after taking bowel prep it is normal to

have abdominal cramps bloating and

diarrhea some people even get chills you

should have your first bowel movement

about 1 hour after you start drinking

the bowel prep you should expect to

continue having loose bowel movements

for about 1 to 2 hours after you finish

drinking it your goal after drinking the

laxative is to have watery clear

diarrhea some people will need to take

extra laxative medicines to completely

clean their colon ask your doctor about

this before your procedure we will

review your medical records based on

this review your doctor may prescribe an

extended bowel preparation this may

include a combination of miralax and

magnesium citrate 2 extra laxatives if

you need to use these extra medicines

your doctor will also give you

instructions for using them the point of

the bowel preparation is to clean the

colon so that we can see it clearly on

the left is what we see during a

colonoscopy when there has been good

bowel preparation we can easily see any

problems in the colon the middle set of

pictures show a bad bowel preparation

where stool inside the colon may be

hiding colon polyps or colon cancer the

slides on the right show how some colon

polyps or colon cancer can be very small

this makes them hard or impossible to

see if they'll preparation is poor

on the day of your colonoscopy five

hours before your procedure is scheduled

drink the rest of the bowel prep you

will drink the medicine just like you

did the night before one 8 ounce glass

every 15 minutes until it is gone do not

eat any food but you can keep drinking

clear liquids if you take blood thinner

medicines or diabetes medicines you

should have already been following your

doctor's instructions about what to do

to prepare for your procedure for all

other medicines on the day of your test

take them either 1 hour before or 1 hour

after you finish the rest of the

laxative medicine plan to arrive at the

endoscopy area 30 minutes to 1 hour

before your colonoscopy your specific

arrival time will be given to you when

you are scheduled for the procedure

on the day of the colonoscopy do not

take anything by mouth starting two

hours before your colonoscopy when you

come in for the colonoscopy you should

bring the person who is going to take

you home or a phone number where we can

reach that person when you are ready to

be picked up after the procedure a list

of all the medicines you are taking

right now you will not need to bring

anything valuable with you to the

hospital it is best if you leave

anything of value at home or with the

person who will take you home

let's review seven days before the

colonoscopy have your plan in place for

who will bring you home from the test

and please talk to your doctor about

medicine for diabetes and blood thinning

five days before the colonoscopy stop

eating nuts seeds beans corn and peas

pick up the bowel prep and flavor

packets from your pharmacy one day

before the colonoscopy start a clear

liquid diet mix your bowel prep in the

morning and put the bottle in the

refrigerator the night before the

colonoscopy from 7:00 to 10:00 p.m.

follow instructions about drinking the

bowel prep every 15 minutes on the day

of your colonoscopy finish the rest of

the bowel prep 5 hours before your

scheduled procedure take your normal

medicines at least one hour before

starting your laxative or one hour after

finishing starting two hours before your

colonoscopy do not take anything by

mouth

not even gum mints or water arrived at

the endoscopy unit 30 minutes to one

hour before the tests as instructed you

will be in the endoscopy unit for a

total of two and a half to three hours

we've a lot to take care of to get ready

for your colonoscopy you will sign in

meet the nurses change into a hospital

gown get connected to heart rate

monitors put on a blood pressure cuff

get oxygen through your nose and the

nourish will place a tube called an IV

into your vein you will receive

medicines and fluids through this IV

your doctor will talk to you about the

procedure so you can ask any questions

you may have

you will then sign and informed consent

documents that gives us permission to do

the colonoscopy the colonoscopy will

take about 30 to 45 minutes you may

sleep through the whole test where you

may be awake through parts of it

both of these are normal the colonoscopy

procedure does not hurt you may feel

some cramping in your stomach we put air

into the colon to inflate it so we can

see all of the lining more clearly and

this can cause some discomfort if we see

something abnormal in your colon like a

polyp we will remove it or take a small

tissue sample this sample is called a

biopsy taking a biopsy will not cause

pain we will send the tissue sample to

the lab where pathologists will look at

it under a microscope we will have the

results of the biopsy in seven to ten

days we will notify you of the results

after the colonoscopy you will be in the

recovery room for thirty to sixty

minutes you will talk with the doctor

and get pictures of what we saw during

the colonoscopy you will also get

written instructions to follow at home

and a phone number to call if you have

any problems or questions after the

procedure

let's review what is a clear liquid how

about the first one no rice is not a

clear liquid the next one no we can't

see through it and it contains small

seeds the burger and fries no this is

just food how about the first one on the

bottom row no the next one

nope it has pieces of food in it how

about the jello know most jello is okay

but not red jello because red food

coloring can look like blood in

colonoscopy pictures

how about coffee with milk no what about

black coffee yes black coffee is a clear

liquid and the last one no no chocolate

no milk and no marshmallows here are

some examples of colons in people who

did not follow the prep instructions all

these people had to reschedule a

procedure and drink another gallon of

Val prep in order to get clear results

on their tests we want you to have only

one procedure that gives the most

accurate results possible please closely

follow the instructions that we are

giving you thank you for watching this

slideshow we look forward to seeing you

at your colonoscopy appointment please

call us at to zero six five two zero

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