BOWEL PREPARATION WITH PLENVU

For a successful colonoscopy, your colon must be clear of any stool. This allows your doctor to see your entire colon. For your doctor "A clean colon is like driving down a country road on a sunny day. A dirty colon is like driving in a hailstorm.” It is extremely important to follow these preparation instructions to clear your colon of any stool, otherwise the procedure may need to be repeated.

If you are unsure of any aspects of the preparation or you are having an adverse reaction ring 4321 0302 (Monday to Friday 9:00-16:30) or the Hospital that you will be having your procedure at (after hours).

Note: the procedure will usually be scheduled for the morning. The Hospital will advise you of your admission and fasting times the day before. 

• Arrange for a driver for your procedure.

• Purchase PLENVU from the rooms (or pharmacy).

• Purchase any clear fluids and low residue foods you might want leading up to the procedure (see list below). Also consider purchasing baby wipes and hard candies.

• Stop taking iron supplements. 

• Avoid foods with seeds. 

• Make sure you know what to do with your blood thinning, weight loss and diabetes medications.

• Avoid high residue foods for 1 week prior to procedure. 

• Start a clear fluids diet for 2 days prior to procedure.

• If your constipation is significant, have 2 sachets of Movicol daily starting 2 days prior to procedure (no prescription needed). 

Three Days Before Your Colonoscopy 

Avoid high residue foods, generally any foods that ‘crunches’ in your mouth.  

AVOID High Residue Foods

• Nuts
• Popcorn
• Seeds: chia, fennel, flax, poppy
• Whole grains or high fibre grains: brown or wild rice; whole grain bread, rolls, pasta or crackers; whole grain or high fibre cereal (granola, raisin bran, oatmeal); bread or cereal with nuts or seeds 
• Legumes: beans; lentils; dried beans, peas or lentils
• Fruits: raw fruit with seeds or skins; cooked or canned fruit with seeds or skin; raisins or other dried fruits 
• Vegetables: brussel sprouts; cabbage; corn; cucumbers; green peas; onions; potatoes with skin; tomatoes
• Other: coconut; fibre supplements; olives; pickles; salad dressing with seeds or nuts; soups with vegetables or legumes 

ALLOWED Low Residue Foods 

• Dairy: cheese; milk; yoghurt 
• Protein: chicken; eggs; fish; pork; shrimp; tofu; turkey
• Bread & grains: white bread or bagels (NO whole grain or any seeds); White rice (NO brown or wild rice); white pasta (NO whole grain)
• Condiments: peanut or almond butter (NO crunch); butter or margarine; vegetable oil; mayonnaise or sour cream
• Dessert: ice-cream; pudding; sorbet (NO pieces of fruit or seeds); cookies or cake made with white flour & NO seeds, fruit or nuts 

One Day Before Your Colonoscopy 

IF YOU TAKE THE FOLLOWING DIABETES AND/OR WEIGHT LOSS MEDICATIONS: Liraglutide (Victoza, Saxenda), Semaglutide (Ozempic, Wegovy), Dulaglutide (Trulicity) or Tizepatide (Mounjaro):  Have clear fluids from 6:00 AM. This is to ensure the stomach is empty by the time of your procedure, as the listed medications can slow down the emptying of your stomach. If your stomach is not empty, some of the food or drink still in it could come back up into your mouth during your procedure - this is unsafe. 

IF YOU DO NOT TAKE THE ABOVE DIABETES AND/OR WEIGHT LOSS MEDICATIONS: Have a light breakfast and lunch containing low residue foods. You must finish eating solid food at least 3 hours (3:00 PM) before you start taking PLENVU, then stay on clear fluids only. 

ALLOWED Clear Fluids i.e. any fluid you can see through: water, coconut water, black tea or coffee (NO milk or cream), carbonated beverages (soda or sparkling water), clear soup, cordial, fruit juice without pulp (apple, lemonade, orange), jelly, sports drinks (Gatorade, Powerade), popsicles. Avoid red or purple liquids as the remaining liquid in your colon can be tinted red or purple and be confused for bleeding. 

DO NOT take oral medication within 1 hour before the start of PLENVU

DOSE 1: Prepare Dose 1 (1 sachet) according to the leaflet in the PLENVU box. Chill if desired. At 6:00 PM drink your first dose of PLENVU over 30 minutes. Follow with 500 ml of clear fluids. Continue to drink clear fluids only. 

DOSE 2: Prepare Dose 2 (2 sachets) according to the leaflet in the PLENVU box. Chill if desired. At 9:00 PM drink your second dose of PLENVU over 30 minutes. Follow with 500 ml of clear fluids. 

You may continue drinking clear fluids until your NIL BY MOUTH time.

Tips For Bowel Prep 

Most people find the process of bowel preparation much worse than the actual colonoscopy itself. Here are 6 tips to make the process a little less uncomfortable.

• Ice: Chill the prep by adding ice or putting it in the fridge to make it more palatable.

• Straws: Use a straw to drink the prep as far back on the tongue as possible to reduce the amount of prep solution your taste buds are getting. Sipping is better than gulping.

• Hard candies: Suck on a candy (e.g. menthol candy) after drinking the prep. Or gargle mouthwash to “clear out” the bad taste. 

• Baby wipes: Use flushable baby wipes or extra soft toilet paper to reduce anal irritation.

• Books: Learn something new or entertain yourself while you spend more time than usual on the toilet.

• Elastic waisted pants: Wear clothes that are loose and easy to remove quickly, as the time between when you have the urge to poop and when you actually do can be quite short.

Instructions for Diabetes Medications

• Schedule your procedure for the morning if possible.

• If you take any of the listed medications below, stop them 3 days prior to your procedure: FORXIGA (dapaglifloxin), GLYXAMBI (linagliptin, empagliflozin), JARDIAMET (metformin, empagliflozin), JARDIANCE (empagliflozin), QTERN (saxagliptin, dapagliflozin), SEGLUROMET (metformin, ertugluflozin), STEGLATRO (ertugluflozin),  STEGLUJAN (sitagliptin, ertugliflozin) and XIGDUO (metformin & dapagliflozin). 

• If you control your diabetes with ORAL medications alone: take your normal medication dose on the morning of the day prior to procedure, then do not take any more diabetes medications until after the procedure is complete and you have eaten. 
  
  
• If you control your diabetes with INSULIN alone: take ½ of your normal insulin dose the day prior to procedure, then do not take any more diabetes medications until after the procedure is complete and you have eaten

• If you control your diabetes with BOTH INSULIN & ORAL medications: follow both set of instructions as above. 
  
  
• If you use an INSULIN PUMP: please contact your endocrinologist for specific instructions.