Importance of Proper Preparation
In order to obtain images that are as clear and representative as possible, it is essential that the patient follows a good preparation for the colonoscopic examination; this translates into advantages even for the same examined, given that the discomfort and duration of the exam decrease.
In this regard, the digestive endoscopy center provides the patient with a series of instructions aimed at an optimal cleansing of the intestine; through a particular diet and the use of laxatives to be taken up until the emission of watery and limpid faeces, those fecal residues that would cover the intestinal mucosa will be removed, limiting the accuracy of the diagnostic investigation.
Remember to inform your doctor if ...
Upon delivery of the leaflet containing the instructions it is advisable to inform the doctor of any medicines taken, state of pregnancy or breastfeeding and the presence of any diseases or disorders (constipation, heart, kidney, metabolic, intestinal, allergic pathologies ...); in some cases, in fact, certain laxative preparations may be contraindicated.
How to prepare
The indications for a good preparation for colonoscopy vary slightly from center to center.
Diet
To learn more: Colonoscopy Diet
In general, starting from the 3/4 days preceding the exam, the person is invited to follow a diet free of slag and dairy products, increasing the water supply.
Plant foods, pasta, cheeses, milk, yoghurt and whole grains may therefore not be consumed, but only eggs, meats, fish, broth, juices, fruit juices, purées, baby foods and small quantities of white bread. The diet will become totally liquid on the day before the colonoscopy, where only broths of nut, water, tea, chamomile, herbal tea, sugar or honey, fruit juices without pulp, soft drinks, coffee and any kind of solid food will be granted. Some centers advise to suspend the intake of fruit and vegetables with the seeds (grapes, kiwi, figs, strawberries, aubergines, tomatoes etc) already in the 10 days preceding the appointment.
Laxatives
As anticipated, an essential element of colonoscopy is the use of laxatives, often in liquid form ( SELG-ESSE 1000, ISOCOLAN, MOVIPREP or equivalent, available in pharmacies with a doctor's prescription and used according to the instructions in the package insert). In many cases, the patient has to sip up to 3/4 liters of non-carbonated aqueous solution within 5 or 6 hours, which could cause nausea; this symptom, quite normal, can however be attenuated through the use of specific drugs, such as plasil tablets or syrup; in fact, it is important to strive to take all the preparation, perhaps in small sips to limit nausea.
In case of repeated vomiting and severe abdominal pain it is advisable to consult your doctor or the digestive endoscopy specialist.
Generally the first evacuation appears within an hour and a half - two hours from the beginning of the intake, which can be interrupted after the first 3 liters in case of emission of clear material.
On the contrary, if the preparation is not effective (evacuation of solid and liquid material even after the end of use), one or two enemas should be performed with Sorbiclis or an enema with 1.5 liters of warm water at least 2 hours before the exam.
However, from the two or three hours preceding the first intake of the laxative, up to the time of the colonoscopy, it is necessary to follow a totally liquid diet .
When to take laxatives
The schedule of the preparation of the preparations varies in relation to that of the exam; if the colonoscopy is performed in the morning, the laxative procedure should be performed starting from the late afternoon of the previous day, possibly reserving the last liter of the preparation very early in the morning before the colonoscopy. If instead the appointment is fixed in the afternoon, the purgative solution will be equally divided between the evening of the previous day and the morning of the same day. In both cases, the laxative preparation should be suspended at least four hours before the appointment.
Suspension of Pharmacological Therapies in place
For patients taking supplements or drugs containing iron, medicines for diabetes, aspirin or other anti-aggregants / anticoagulants (such as Sintrom / Coumadin), it may be required to vary intake dosages or discontinue use in the days preceding colonoscopy.
Preparation for Virtual Colonoscopy
Dietary approach therapy to the exam is also necessary for patients who intend to undergo virtual colonoscopy, for which - though - dietary patterns and less rigid laxatives are generally proposed.
