MoviPrep

If you have diabetes, ask your regular doctor for diet and medication restrictions.
If you take a medication to thin your blood and have not already discussed this with our office, please call us at 612-871-1145.
If you take aspirin, you may continue to do so.
If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.
You must arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled.
If you must cancel or reschedule your appointment, please call 612-871-1145 as soon as possible.

PREPARATION
To ensure a successful exam, please follow all instructions carefully.

Before your exam:
Fill out the Health History form to bring with you on the day of your appointment.

Fill your prescription for MoviPrep® at your local pharmacy.
• Please call our office if you did not receive a prescription. 
 
7 days before your exam:
Discontinue fiber supplements or medications containing iron. This includes multivitamins with iron, Metamucil® and Fibercon®.

3 days before your exam:
Stop eating all high-fiber foods and begin a low-fiber diet:
• No raw fruits or vegetables
• No whole wheat or multigrain foods
• No nuts or popcorn
• No bran or bulking agents
• Additional low fiber diet recommendations can be found at www.mngastro.com/lowfiber

2 days before your exam:
• Continue the low-fiber diet.
• Drink at least 8 glasses of water during the day
• Do not eat solid foods after midnight.

1 day before your exam:
Begin a clear liquid diet (NO red liquids; NO alcohol):
• Water: drink at least 8 glasses of water during the day
• Coffee or tea (no milk or non-dairy creamer)
• Clear broth or bouillon
• Gatorade®, Pedialyte® or Powerade®
• Carbonated and non-carbonated soft drinks
• Kool-Aid or other fruit-flavored drinks
• Strained fruit juices (no pulp)
• Jell-O, popsicles, hard candy

Mix first dose of MoviPrep®
• Empty 1 Pouch A and 1 Pouch B into the disposal container.
• Add lukewarm drinking water to the top line of the container.  Mix to dissolve. 
• If preferred, mix solution ahead of time and refrigerate prior to drinking.  The mixed solution must be used within 24 hours.
 
At 5:30 pm: 
• The MoviPrep® container is divided by 4 marks.
• Every 15 minutes drink the solution down to the next mark (approximately 8 oz.), until the full liter has been completed. 
• Over the course of the evening, drink an additional ½ liter of clear liquids.

The day of your exam
• You may take all of your morning medications.

Mix second dose of MoviPrep®
• Empty 1 Pouch A and 1 Pouch B into the disposal container
• Add lukewarm drinking water to the top line of the container.  Mix to dissolve. 
• If preferred, mix solution ahead of time and refrigerate prior to drinking.  The mixed solution must be used within 24 hours.

6 hours before your exam:
For example, if your colonoscopy is at 11 am, start at 5 am
• The MoviPrep® container is divided by 4 marks.
• Every 15 minutes drink the solution down to the next mark (approximately 8 oz.), until the full liter has been completed.  Time to complete = 1 hour
• Drink an additional ½ liter of clear liquids. Time to complete = ½ hour. This needs to be completed at least 4 hours before your exam.  

4 hours before your exam:
• Discontinue clear liquids

You are ready for the exam, if you followed all instructions and your stool is no longer formed, but clear or yellow liquid. If you are unsure whether your colon is clean, please call our office at 612-871-1145 before you leave for your appointment.
• Bring a list of all of your current medications, including any allergy or over-the-counter medications.
• Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
• Co-pays are required on the day of your appointment.
 
Colon Cleansing Tips
• Chill the MoviPrep® solution in the refrigerator. DO NOT add ice to the solution or your drinking glass.
• Set a timer every 15 minutes. Drink each 8 - oz. glass of solution quickly to help flush your colon.
• Stay near a toilet! You will have diarrhea.
• Even if you are sitting on the toilet, continue to drink the cleansing solution every 15 minutes. 
• Drink all of the solution until it is gone.
• If you feel nauseous or vomit, rinse your mouth with water, take a 15 to 30-minute break and then continue drinking the MoviPrep® solution.
• You will be uncomfortable until the stool has flushed from your colon (in about 2 to 4 hours). You may feel chilled.
• You may suck on a few hard candies (NO red).
• Alcohol-free baby wipes or Vaseline® may help ease skin irritation.
• Over-the-counter hydrocortisone creams, hemorrhoid treatments or Tucks may be used if desired.

DESCRIPTION OF COLONOSCOPY

What is a colonoscopy?
A colonoscopy is the most accurate test to detect colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

To produce the best and most accurate results, your colon must be completely clean. You will drink a special bowel cleansing preparation to help clean out your colon. You will also need to follow a special diet several days prior to your scheduled colonoscopy.

What happens during a colonoscopy?
Plan to spend up to two hours at the endoscopy center the day of your colonoscopy. The actual procedure takes about 20 to 40 minutes to complete.

Before the exam:
• You will change into a gown and robe.
• Your medical history will be reviewed with you, and you will be given a consent form to sign.
• A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:
• Medicine will be given through the IV line to help you relax and feel drowsy.
• Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
• The doctor will insert a flexible tube – called a colonoscope – into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
• During the procedure, you may experience some cramping. This is normal.
• If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?
• The doctor will talk with you about the initial results of your exam.
• The doctor will prepare a full report for the physician who referred you for the colonoscopy.
• You may have some cramping or bloating after the procedure. This is normal and should disappear quickly by passing gas.
• Medication given during the exam will prohibit you from driving for the rest of the day.
• Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
• You may resume your regular activities the day after the procedure.
• A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
• Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications with colonoscopy?
Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential risk warning signs with you before you leave the endoscopy center. Risks include:
• Perforation, or a tear through the lining of the colon
• Bleeding from a biopsy site
• Reaction to medications

12/21/2009