In order for the doctor to perform a colonoscopy, a bowel “cleanout” must be completed at home prior to the procedure. A bowel cleanout is a combination of a clear liquid diet and oral laxatives. The doctors prefer using NuLytely/GoLytely, it is the most effective and safe laxative for cleaning out the colon for better visual results when your procedure is being performed. There are 3 other options to bowel cleansing solutions/laxatives, which are MiraLAX(non-prescription), SUPREP and HalfLytely. If you have a reason to refuse the split dose NuLytely/GoLytely prep, then these 3 other options are available and are either prescription or non-prescription laxatives. However they may not clean the colon as well and they have not been as well tested for safety.
Miralax/Gatorade Colonoscopy Preparation
You have been scheduled for a Colonoscopy with Northern NM Gastroenterology Assoc. Your doctor has recommended these instructions to help prepare you for your colonoscopy. Please read all the instructions ahead of time so you can be adequately prepared for this procedure. SUPPLIES TO PURCHASE:
o MIRALAX laxative (238 gm bottle-over the counter) o Four Dulcolax tablets o Two 32oz bottles of sports drink-Gatorade/PowerAde (no red, purple or blue
colored) or Crystal Light if you are diabetic (no red, purple or blue colored) o Clear liquid items-broth, Jell-O, popsicles, clear juices (no red, purple or
blue), soft drinks, strained fruit juices without pulp, water, tea or coffee (no milk, cream or non-dairy creamer), hard candies, strained soup.
3 DAYS BEFORE YOUR COLONOSCOPY Discontinue any fiber supplements (Metamucil, Citrucel, Fibercon, etc) Do not take any iron pills or vitamins containing more than 15mg of iron 2 DAYS BEFORE YOUR COLONOSCOPY It is best to eat lightly for two days before your exam. It makes the cleanout easier and more effective. Try to avoid overeating. Avoid fibrous foods with skins, seeds, etc. DAY BEFORE YOUR COLONOSCOPY **NO SOLID FOOD ALL DAY** Follow the instructions below the day prior to your procedure:
1. A clear liquid diet should be started first thing in the morning.
2. Take 2 Dulcolax tablets at Noon with a clear liquid lunch
3. About 4 hours after taking the first two Dulcolax tablets, mix 119-grams (first
half) of MiraLAX with one quart of Gatorade/Crystal Light in a large pitcher. Stir
well, and add ice. Be sure to stir the solution until the Mira Lax is completely dissolved. Drink an 8oz glass every 10-15 minutes until the first half of the solution
is entirely gone. Remain near bathroom facilities for the remainder of the evening.
(If you feel nauseated, stop for one hour but you need to drink all solution within 4
4. At 8:00 PM, take the last 2 Dulcolax tablets.
5. Continue drinking clear liquids until bedtime.
6. Diabetics will need an adjustment of their medications this day, ask your
INSTRUCTIONS CONTINUE ON OTHER SIDE OF PAGE… DAY OF COLONOSCOPY No breakfast. At least 3 hours before leaving for your exam mix, 119-grams (second half) of MiraLAX with one quart Gatorade/Crystal Light in a large pitcher. Stir well, and add ice. Be sure to stir the solution until the Mira Lax is completely dissolved. Drink an 8oz glass every 10-15 minutes until the second half of the solution is ENTIRELY GONE. You must remain fasting for 2 hours before your exam. No food, drink, candy, gum, etc. You may take any important prescription medications with a small sip of water. (Diabetic medications and blood thinners such as Coumadin require special instructions, ask your PRESCRIBING doctor).
• Blood thinning medications (such as Coumadin, Lovenox, etc) may need to be
discontinued prior to your procedure. Please contact your prescribing physician for instructions well in advance; you may need to be off these drugs up to 10 days prior to your procedure. Ticlid, Plavix users you have the option of waiting until treatment is completed if you are scheduled for a screening colonoscopy; otherwise antiplatelet agents should be continued although they will increase risk of bleeding if biopsies are done.
• Unless prescribed by your physician, please avoid the following medicines if
possible: aspirin, aspirin products (e.g. Alka-Seltzer, BC powder, etc) or non-steroidal anti-inflammatory drugs (e.g. ibuprofen, Nuprin, Advil, Alleve, Motrin, etc) for 5 days prior to your appointment.
• Continue to take your other prescribed medications (e.g. blood pressure pills) as usual. If you have any questions about your medications, call your prescribing physician. Take AM doses the day of exam after you finish your prep.
• Diabetic patients, if you take an oral hypoglycemic (“sugar pill”) do not take it the day of your procedure. If you are taking insulin, you should only take half (1/2) of your usual scheduled insulin dose the night before but on the day of your procedure, wait until you eat after the procedure to take your usual AM dose.
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The role of hyperventilation - hypocapnia in theO papel da hiperventilação - a hipocapnia noAndras Sikter,1 Ede Frecska,2 Ivan Mario Braun,3A b s t r a c tObjective: The authors present a profile of panic disorder based on and generalized from the effects of acute and chronichyperventilation that are characteristic of the respiratory panic disorder subtype. The review presented attempts to in