Colon Prep

[milashka]

I have a colonoscopy coming up - my third one - have always used Fleet Phospha Soda but heard that it got pulled off the market, so my doctor wants me to I have problems swallowing pills and heard those are big ones. Overall, I am not comfortable with taking 32 laxative pills the night before.

I have chronic constipation so it is a tricky issue anyway, I just don't think I can do the pills...

I wonder what has worked for others? Pros, cons?

Thanks!

[mammo]

This is a very odd request of your doctor!  There are other preps out there.  I think I'd find a different GI, as this one doesn't appear to be competent.  Your chronic constipation has nothing to do with the prep.

[milashka]

Well, this IS my new doctor.

The first procedure 2003 went well with Fleet but doctor was really bad and I was urged to go to a better one.

So the second doctor (2006) is great but he said my Fleet prep was bad and he couldn't see all of my colon. I thought I did have a thorough prep but I guess not. He said next time he wants me to fast 3 full days, and clean out per HIS regimen two days before the procedure. That seems extreme. Not eating, just laxatives, for three days? More importantly, it is impossible to get an appointment with him - he is booked out 4-6 months in advance.

So this is the new doctor. He said Fleet no longer exists and I should do the pills, as women find them easier to handle than drinking gallons of liquids, and I thought, sure, no problem, until I research them. Hmmmm...

The constipation being a problem didn't come from the doctor, but from me - my colon is super sluggish and things just don't work as they work with others.

[mammo]

Having worked for 2 GI doctors for many years, and having 3 kids and a grandson that undergo yearly scopes, I have yet to hear of using this method.  Here are some examaples.

Golytely
This preparation will require a prescription from the doctor. It consists of a gallon jug with a powder mix inside. The patient will fill the jug with water to make a drink out of the powder. The instructions are usually to drink one 8 oz glass of the mixture every 10 minutes until the entire gallon is finished or eliminations are clear. After the first few glasses, bowel evacuation (in the form of diarrhea) will begin. Before the gallon is finished, many people find that their evacuations are totally clear and all the waste material is gone from the colon.

If eliminations do not become clear after the gallon is finished, an enema may be needed. Some people do experience nausea when drinking so much liquid, so the physician may prescribe an anti-nausea medication in case it is needed. Golytely now comes in several flavors to make it easier to drink.

Phospho-soda
Phospho-soda is a powder that is available over the counter either by itself or as part of a kit that also includes a laxative and an enema or suppository. The physician performing the colonoscopy will give instructions on which type of kit to purchase.

Three ounces of the Phospho-soda liquid is mixed with water, or if the physician allows, other clear liquids such as ginger ale. After drinking the Phospho-soda mixture, most patients are instructed to drink at least 3 glasses of another clear liquids. If part of a kit, the rest of the kit (laxative, enema, or suppository) will then be used according to doctor's instructions.

This preparation usually results in a bowel movement anywhere from 30 minutes to 6 hours after it is taken. Phospho-soda is also available in flavors to make it more palatable.

Most physicians will instruct patients to call their office if the preparation does not progress as expected (for example there is no bowel movement at all or the evacuations never becomes clear).

Sodium phosphate (Osmo-Prep and Visicol)
Sodium phosphate tablets are prescribed by the doctor doing the colonoscopy. There are two different brands, depending on which your doctor prescribes -- Visicol, a 40-tablet regimen, and Osmo-Prep, a 32-tablet regimen.

In Visicol, 7 doses are taken in 15-minute intervals: 3 tablets are taken for 6 doses, and then 2 tablets are taken for 1 dose (20 tablets total). The next morning, 3 to 5 hours before the test, the same dosage is repeated (3 tablets for 6 doses, and then 2 tablets for 1 dose in 15-minute intervals for a total of 20 tablets).

The prep begins to take effect about an hour after the first dosage of tablets is taken. A liquid diet is usually prescribed starting about 12 hours before starting the regimen. Potential side effects include bloating, nausea, vomiting, and abdominal pain.

In Osmo-Prep (the newer form), the tablets are taken on the evening before and the morning of the colonoscopy. The evening before the test, 4 tablets are taken with 8 ounces of a clear liquid every 15 minutes for a total of 5 doses (20 tablets total). The next morning, about 3 to 5 hours before the test, another 3 doses of 4 tablets are taken at 15 minute intervals (12 tablets total).