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Sutab Bowel Preparation Instructions

These instructions are for patients WITHOUT severe kidney and heart disease. If you have severe kidney or heart disease, please call our office for alternative instructions: 303-604-5000

This bowel preparation requires a little organization but is an extremely important part of your colonoscopy 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 and change your diet. If you do not follow these directions, your colonoscopy may be cancelled. Please note, it is your responsibility to contact your insurance company about coverage and cost for your upcoming colonoscopy procedure. Sometimes, colonoscopies result in a cost to the patient. You will need to tell your insurance company when your last colonoscopy was and if you are performing the colonoscopy because you have symptoms, a personal history or family history of colon cancer or polyps.

Key Information:

  • DO NOT EAT any solid food the ENTIRE DAY before your colonoscopy. Drink only clear fluids.
  • 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.
  • Your colon must be COMPLETELY EMPTY so that your doctor can clearly view your colon.
    Follow all instructions in this handout EXACTLY as they are written. If you have completed your prep, and your stools are not clear or yellow, please contact our office at 303-604-5000, even if after hours.

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.
    • All procedures that require sedation or anesthesia require patients to have a pre-arranged ride to and from the procedure—and a discharge signature from a responsible adult who can accompany the patient back home.
    • This requirement is based on Colorado state regulations.

Medications:

  • 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 medication: See instructions below.
  • ACE Inhibitor Blood Pressure medications: Do NOT take medications ending ‘pril’ the day of your
    procedure. Examples: lisinopril, benazepril, ramipril, captopril, enalapril, quinapril
  • ARB Blood Pressure medications: Do NOT take medications ending in ‘sartan’ the day of your
    procedure. Examples: losartan, irbesartan, candesartan, valsartan, telmisartan, olmesartan
  • Diuretics: Do NOT take “water” pills the day of your procedure. Examples: furosemide (Lasix),
    bumetanide (Bumex), torsemide, hydrochlorothiazide (HCTZ)
  • 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.

Checklist to Ensure Proper Bowel Preparation

To ensure the proper completion of your colonoscopy 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.

GROCERY STORE LIST: Purchase the items below at least five days before your procedure:

☐ 1 – Sutab Bowel Kit
☐ 4 – Gas-X tablets (simethicone) containing 125 mg of simethicone each.

5 days before your colonoscopy:

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 fiber supplements such as Metamucil, Citrucel, Psyllium or Benefiber.
DO NOT take products that contain iron such as multi-vitamins or iron supplements.

3 days before your colonoscopy:

Discontinue high-fiber foods – Please see Low Fiber Diet tips attached.

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).

Checklist: One Day Before Your Colonoscopy

No marijuana on the day of your procedure.
☐ If you have diabetes, please see Diabetes instructions on page1.
☐ Only drink clear liquids the ENTIRE DAY before your procedure. NO solid foods.
☐ Drink at least 8-ounces of clear liquids EVERY HOUR after waking up. The charts below will show you examples of what you can and cannot drink:

CLEAR LIQUIDS – YOU CAN DRINK:

  • 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

DO NOT DRINK:

  • 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

5:00 pm – the evening before your procedure:

5:00 pm: Take two tablets of simethicone/Gas X

6:00 pm – the evening before your procedure:

☐ Open one bottle of 12 tablets.
☐ Fill the provided container with 16 ounces of water (up to the fill line).
☐ Swallow each tablet with a sip of water and drink the entire amount of water over 20 minutes.
☐ Approximately one hour after the last pill is ingested, fill the provided container again with 16 ounces of water (up to the fill line),and drink the entire amount over 30 minutes.
☐ Approximately 30 minutes after finishing the second container of water, fill the provided container again with 16 ounces of water(up to the fill line), and drink the entire amount over 30 minutes.
Before going to sleep: Take two additional simethicone tablets.
Set your alarm! Make sure to wake up at least 4 hours before your procedure check-in time.
Discontinue mints, gum, hard candy, and chewing tobacco.

4 hours – before your procedure check-in time – this may be in the middle of the night or early AM:

☐ Open the second bottle of 12 tablets.
☐ Fill the provided container with 16 ounces of water (up to the fill line).
☐ Swallow each tablet with a sip of water and drink the entire amount of water over 20 minutes.
☐ Approximately one hour after the last pill is ingested, fill the provided container again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.
☐ Approximately 30 minutes after finishing the second container of water, fill the provided container again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.

2 hours – before your procedure check-in time

2 hours before check-in: STOP DRINKING ALL LIQUIDS!

Congratulations, you have completed your prep!

Low Fiber Diet

A low fiber diet limits the amount of food waste that must move through the large intestine.

Approved Foods

Bread, cereal, rice, and pasta

  • White bread, rolls, biscuits, croissants, melba toast
  • Waffles, French toast, pancakes
  • White rice, noodles, pasta, and macaroni
  • Peeled cooked potatoes
  • Plain crackers, saltines
  • Farina, cream of rice
  • Puffed rice, Rice Krispies, corn flakes, Special K

Meat

  • Ground (beef, chicken, turkey)
  • Lamb
  • Pork
  • Veal
  • Fish
  • Poultry

Vegetables

  • Cooked carrots
  • Asparagus tips
  • Green or wax beans
  • Pumpkin
  • Lima Beans

Fruits

Bananas, Honeydew, cantaloupe

Milk/Dairy

  • Milk-plain or flavored
  • ​Yogurt, custard, ice cream, cheese, cottage cheese

Fats, snacks, sweets, condiments, and beverages

  • Margarine, butter, oils
  • Mayonnaise
  • Sour cream
  • Dressing
  • Plain gravy
  • Sugar
  • Clear jelly
  • Honey
  • Syrup
  • Spices/cooked herbs
  • Coffee, tea, carbonated drinks
  • Plain cake, cookies
  • Gelatin, plain pudding, popsicles
  • Hard candy or pretzels
  • Mustard, ketchup

Foods to Avoid

  • Breads or rolls with nuts, seeds or fruit: whole wheat, pumpernickel, rye, corn bread, chia seeds
  • Brown or wild rice, buckwheat, quinoa
  • Vegetables (raw or steamed, with seeds) – winter squash, peas, broccoli, brussel sprouts
  • Cabbage, onions, cauliflower, sprouts, baked beans, peas, corn, potatoes with skin
  • Sauerkraut
  • Fruits (raw or dried) – all berries, figs, dates/raisins, prunes, prune juice
  • Yogurt with nuts or seeds
  • Processed meat – hotdogs, sausage, cold cuts, tough meat with gristle

Colonoscopy Costs For The Denver Area

General guidelines for colonoscopy costs, please contact your insurance for exact benefits and costs.

Typically Free

Screening or
“Preventative”
Colonoscopy

Typically, insurance covers 100% of the costs. Performed on asymptomatic patients to test for the presence of colorectal polyps or cancer.

Criteria for patients:

  1. 45 years of age or older
  2. NO gastrointestinal symptoms: e.g., abdominal pain, diarrhea, rectal bleeding
  3. NO personal history of colon polyps, colon cancer or gastrointestinal disease
  4. NO screening colonoscopy within the last 10 years

Typically NOT Fully Paid

Diagnostic
Colonoscopy

Performed on patients to evaluate abnormal findings or symptoms.
Patient is responsible for any copay, coinsurance, or deductible.

* If you had colon polyps in the past, your colonscopy is diagnostic.

Criteria for patients:

  1. Had colon polyps in the past
  2. Have a gastrointestinal disease
  3. Have gastrointestinal symptoms: e.g., abdominal pain, diarrhea, rectal bleeding, or abnormal imaging of the colon (CT scan or MRI)

Questions:

If you had colon polyps in the past

If youhavegastrointestinal symptoms

If you havepersonal history of colon cancer or colon polyps

Answer:

Then a Diagnostic Colonoscopy

Then a Diagnostic Colonoscopy

Then a Diagnostic Colonoscopy

Contact your insurance to determine your specific benefits and possible out of pocket costs (deductible, coinsurance, facility copay) for the procedure. It is important to inquire about both the physician and facility costs, discuss any symptoms and/or personal history (including prior colonoscopy dates and findings), and family history related to your procedure.

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