Flexible Sigmoidoscopy Preparation Instructions

This bowel preparation requires a little organization but is an extremely important part of flexible sigmoidoscopy to ensure you have the highest quality exam. Bowel preparation starts days prior to your procedure, as you need to stop taking certain medications or supplements. If you do not follow these directions, your flexible sigmoidoscopy may be cancelled. Please note, it is your responsibility to contact your insurance company about coverage and cost for your upcoming flexible sigmoidoscopy procedure. Sometimes, procedures result in a cost to the patient. You may check with your insurance company to determine if you will have a cost.

Key Information:

  • DO NOT eat solid food for 9 hours before your arrival time.
  • Bring a list of all your MEDICATIONS (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.
  • DO NOT bring unnecessary belongings. We are not responsible for lost or misplaced items.
  • Stop all clear liquids two hours before your procedure arrival time.

Transportation on the day of your procedure:

  • A responsible adult MUST BE PRESENT (18 years or older) with you at check-in before your procedure and MUST BE ABLE to pick you up IMMEDIATELY when you are discharged. You are NOT ALLOWED to drive, take a taxi or bus, or leave the Endoscopy Center alone. If you do not have a responsible driver with you to take you home, your procedure WILL BE CANCELLED.
  • Because of the sedation, you are NOT ALLOWED to use a bus, taxi, Uber/Lyft, Access-a-Ride, walk home, etc. alone.


  • Blood thinners: including Coumadin (warfarin), Plavix (clopidrogel), Ticlid (ticlopidine hydrochloride), Brilinta (ticagrelor), Aggrastat (tirofiban), Agrylin (anagrelide), Xarelto (rivaroxaban), Pradaxa (dabigatran), Eliquis (apixaban), Lovenox (low molecular weight heparin), Innohep (heparin) or Effient (Prasugrel), You must follow the instructions provided by our nurses.
  • Diabetes/Weight Loss medication: See instructions below.
  • All other medications: Including aspirin, should be taken the day of the exam with a sip of water.​

Weight Loss/Diabetes Medications:

  • GLP-1 Agonists: including Mounjaro (tirzepatide), Trulicity (dulaglutide), Victoza, Saxenda (liraglutide), Adlyxin (lixisenatide), Ozempic, Wegovy (semaglutide subcutaneous), Bydureon BCise (exenatide extended-release), Byetta (exenatide), Rybelsus (semaglutide tablet), Stop the oral or injectable medication one week prior to your procedure.
  • Anorectics: including Adipex-P, Lomaira, Suprenza (phentermine hydrochloride), Qsymia (phentermine hydrochloride/topiramate), Stop 5 days prior to your procedure.​

If you have diabetes, follow these instructions:

  • Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Decrease basal rate by ½ the day before and the day of your procedure.
  • Rapid-Acting and Regular Short-Acting Insulin (ex. Lispro, Humalog, Admelog, Regular Insulin): If your blood sugar is high and you need to take a correction, take ½ or 50% of your usual correction. This applies to the day before and the day of your procedure.
  • Insulin Pump: Decrease basal rate by ½ the day before and the day of your procedure. Do not administer bolus doses.
  • Other Diabetic Oral & Injectable Medications (ex. Metformin, Glipizide, Sulfonylureas, Tradjenta, Dipeptidyl Peptidase IV (DPP IV) Inhibitors, Januvia, Janumet, Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors): Do not take the day before or the day of your procedure.
  • Check your blood sugar at same intervals as usual, and additionally, if needed: If your blood sugar is less than 60, please take glucose tablets at any time before your procedure with a sip of water.

Procedure Cancellation Notice Requirements:

– Procedure cancellations must be made three (3) business days prior to your appointment.

– Failure to provide the required advance notice will result in a $150 Total Cancellation Fee.

($50 Physician cancellation fee from Gastroenterology of the Rockies + $100 Facility cancellation fee from the endoscopy center).

Download Prep Instructions


Checklist to Ensure Proper Bowel Preparation

To ensure the proper completion of your flexible sigmoidoscopy preparation, we strongly suggest that you PRINT OUT this document and check off each of the instructions as you complete them. This will greatly help you in following the detailed instructions and help ensure you receive a proper colonoscopy.

Purchase preparation items below at least five days before your procedure:

☐ 3 – Plain Fleets Enema

5 days before your procedure:

☐ Make sure you have purchased your bowel preparation items! (listed above!)
☐ DO NOT take medications that stop diarrhea such as Imodium (loperamide), Pepto-Bismol (bismuth
subsalicylate) or Lomotil (diphenoxylate/atropine).
☐ DO NOT take products that contain iron such as multi-vitamins or iron supplements.
☐ If you have diabetes, please see Diabetes instructions on page 1.

9 Hours – before your procedure check-in time:

DO NOT eat solid food for 9 hours before your arrival time.
For example, if your arrival time is at 9 AM, do NOT eat after MIDNIGHT.
☐ Follow a clear liquid diet using the charts below:


  • Gatorade, Pedialyte, Powerade, Kool-Aid
  • Gatorade G2, Propel, Crystal Light
  • Popsicles
  • Jell-o, Juice without Pulp (ex. Apple Juice)
  • Black Coffee
  • Tea, Water
  • Clear Sodas (ex. Sprite, Ginger Ale)
  • Sparkling water


  • NO red or purple liquids
  • NO Milk or non-dairy creamers
  • NO Alcohol
  • NO Broth or soup
  • NO Juice with Pulp (ex. pineapple juice)
  • NO Liquid you cannot see through
  • NO Apple Sauce
  • NO Smoothies

Morning medications may be taken as usual except for above-mentioned medications.
No marijuana on the day of your procedure.
☐ Discontinue mints, gum, hard candy, and chewing tobacco.

2 hours – before your procedure check-in time

2 hours before check-in: STOP DRINKING ALL LIQUIDS!
2 hours before check-in: Give yourself the first enema, hold as long as possible (up to 20 minutes)
and then expel it. Repeat with the second enema, again holding for as long as possible (up to 20
minutes). Repeat a third enema if you have a tendency towards constipation.

Congratulations, you have completed your prep!

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