S. Saeed Zamani, M.D.
Colonoscopy Preparation Instructions
You are scheduled to have a colonoscopy on_____________at____________________.
Please report to the above facility registration department at ____________________.
Colonoscopy is a procedure to examine colon (large intestine) with a flexible instrument.
Please follow these instructions to prepare for the procedure. Please be aware that if
your bowel is not clean, we may have to reschedule your procedure.

How do I prepare for the colonoscopy?
7 days before the colonoscopy
5 days before the colonoscopy
DO NOT take COUMADIN. Please inform us if you have an artificial
heart valve or history of endocarditis
3 days before the colonoscopy
DO NOT take MOTRIN, ADVIL, IBUPROFEN, ALEVE, or NAPROXEN, or CELEBREX. Diabetic patients’ insulin or oral medications to be adjusted as per instructions.
The day BEFORE the
All day, take only CLEAR LIQUIDS, e.g. clear broth, water, tea, black coffee, apple juice, white grape juice, any soda, ice popsicles, strained lemonade, Gatorade, Jell-O (avoid red or orange Jell-O). No solid food, milk, milk products, or Ensure.
Start drinking the prescribed chilled NuLYTELY (or equivalent brand) at 4 pm. Drink one glass every 15-20 minutes until finished. Please finish content in 3-4 hours. Some patients may become nauseated or vomit. Please drink solution slowly if you become nauseated. However, you have to finish drinking the solution BEFORE midnight.
Take your medications especially blood pressure and heart medicines (except as above) with sips of water.
You MUST have somebody drive you home because you will be sedated
or your procedure will be cancelled. You cannot go home by Taxi. Do
not drive or operate any machines the day of the procedure.
What happens during the procedure?
○ A nurse or doctor will give you medicine to relax you and make you sleepy.
○ Your doctor will put air into the colon and this may feel like “gas pain”.
○ Your doctor may take a biopsy or remove a polyp. This does not cause pain.
What happens after the procedure?
You will be taken to a “Recovery” room where you will remain until you are awake. If you need
to cancel, please call our office at least 3 days before the procedure. Charge for cancellation of a
scheduled procedure if not cancelled 3 days prior to procedure is at least $200. We understand
that emergency situations are out of your control. Please contact us if you have any questions
about the procedure or the preparation. Please read some more information for the above
medication on the back of this page.
112 La Casa Via, Suite 320 Walnut Creek, CA 94598 Phone : (925) 939 5599 Fax: (925) 939 4099 Note: Please refer to the package insert for your medication. For the (PEG-electrolyte)
solution, the following should be considered:
Contraindications: PEG-Electrolyte solution is contraindicated in patients known to be
hypersensitive to to any of the componenets. It is contrindicated in patients with ileus,
gastrointestinal obstruction, gastric retention, bowel perforation, toxic colitis, and toxic
Pregnancy: studies on effects in pregnancy have not been done in either humans or
animals. Before taking the PEG-electrolyte solution or having a colon examination, make
sure your doctor knows if you are pregnant.
Breast-feeding: It is not known whether PEG-electrolyte solution passes into breast
milk. Although most medicines pass into breast milk in small amounts, many of them
may be used safely while breast-feeding. Mothers who are taking this medicine and who
wish to breast-feed should discuss this with their doctor.
Older adults: This medicine has been tested and has not been shown to cause different
side effects or problems in older people than it does in younger adults.
Other Medicines: Although certain medicines should not be used together at all, in other
cases two different medicines may be used together even if an interaction might occur. In
these cases, your doctor may want to change the dose, or other precautions may be
necessary. Tell your health care professional if you are taking any of the following:
Any other oral medicines—Any medicines taken within 1 hour of the PEG-electrolyte solution may be flushed from the body and not have an effect Proper use of this Medicine: Take the PEG-electrolyte solution exactly as directed .
Otherwise, the test you are going to have may not work and may have to be done again.
It will take close to 3 hours to drink all of the PEG-electrolyte solution. The first bowel movement may start an hour or so after you start drinking the solution. Continue drinking all the solution to get the best results , unless otherwise directed by your doctor.
Side effects of this Medicine: Along with its needed effects, a medicine may cause some
unwanted effects. Side effects are included but not limited to abdominal or stomach
cramps, bloating, nausea, irritation of the anus, vomiting, skin rash, or electrolyte
Remarks: _______________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 112 La Casa Via, Suite 320 Walnut Creek, CA 94598 Phone : (925) 939 5599 Fax: (925) 939 4099


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