How to prepare to a colonoscopy (Moviprep)?

This information should be read no later than 7 days before the planned examination !!!

The condition for the examination is proper preparation (purification) of the intestine. The preparation recommendations should be followed very carefully, as any deviations may result in the test not being performed or its reliability being narrow. In a small percentage of people preparing for colonoscopy, despite all the recommendations, the intestine is not completely cleansed and the whole procedure has to be repeated. Vaccination against hepatitis B is advisable but not obligatory before the examination. All available medical records and current results of the following tests must be presented prior to the examination

• blood group (oryginal result)
• morphology
• coagulogram (PT/INR, APTT)

In addition to the above tests, for general anaesthesia, please provide:

• ionogram (K, Na)
• EKG (EKG please perform the EKG at least one day before the examination)

Patients who take anticoagulants such as acenocumarol (e. g. Sintrom), clopidogrel (e. g. Plavix), warfarin (e. g. Warfin), rivaroxaban (Xarelto), etc. should replace the drug with low molecular weight heparin (e. g. Clexane) at an appropriate time determined by the doctor before the examination. At least 8 days before the examination, the type, dosage and the appropriate moment of treatment change should be agreed with the physician in charge of the examination.

Diabetic patients should inform the colonoscopy laboratory before the examination in order to set the date of the examination in the morning. Oral iron preparations should be discontinued at least 7 days before the examination. 5 days before the examination, you should limit yourself to a non-residuous diet.

Permitted are:

• meat and fish
• pasta, rice and white bread
• pudding, kissel and jelly
• water, coffee, tea and clear juices

You should completely refrain from taking any food containing:

• Fresh fruit and vegetables (especially those containing small seeds, e.g. kiwi, strawberries, raspberries, tomatoes, which block the working channels of the colonoscope and may make it completely impossible to perform the test – you should refrain from eating them for 7 days before the test)
• Bread with the addition of grains, poppy seeds and spices (except finely ground) – you should refrain from eating them for 7 days before the test

Preparation with Moviprep:

About 20 hours before the planned examination, you should stop eating completely and start preparing the intestine with Moviprep (a preparation sold in pharmacies on the basis of a prescription – the preparation should be purchased one week before the examination). The pack of Moviprep contains two sets of sachets (each set has two sachets A and B). One set of sachets A and B should be dissolved in 1 liter of water (pour one sachet A and one sachet B into the container, then pour one liter of water and stir until completely dissolved, which may take up to 5 minutes. After preparing the solution, you can cool it down) First liter the solution should be drunk on the day before the test in the evening (preferably around 10 p.m. at the rate of one glass (250 ml) every 15 minutes. After drinking the entire prepared solution, additionally drink 0.5 l of clear liquid (preferably water) in Within 30 minutes You have watery diarrhea immediately after you start taking Moviprep (this is the expected effect) If no bowel movement occurs 6 hours after drinking Moviprep, do not take another dose and contact your doctor urgently.

The remaining 2 sachets (one sachet A and one sachet B) should be prepared in the same way (pour one sachet A and one sachet B into the container, then pour a liter of water and mix until completely dissolved, which may take up to 5 minutes. After preparing the solution you can cool it) in the early morning hours on the day of the test and drink the finished solution (one liter of solution) at the rate of one glass (250 ml) every 15 minutes. After drinking the whole solution, drink an additional 0.5 liters of clear liquid (preferably water) within 30 minutes. The intake of Moviprep solution and an additional 0.5 liter of fluids should be completed 2 hours before starting the test.

The time to travel to the Medispace Medical Center should be taken into account when planning the time to take your morning dose of Moviprep. If the patient comes from a distance for the test, which prevents preparation in the morning, both portions of Moviprep should be taken in the evening one after another (after each liter of the solution, additionally drink 0.5 liters of clear liquids). It should be remembered that preparation with two divided doses (evening and morning) gives a greater chance of proper preparation of the intestine for examination than in the case of taking the whole in the evening.

If the examination is scheduled for the late afternoon hours, the first portion (one liter of the solution) can be drunk in the early morning at the rate of one glass (250 ml) every 15 minutes (remember to add 0.5 liters of water within 30 minutes of the end of the intake of the preparation), and the second portion to finish taking a liter of preparation and an additional 0.5 liter of water 2 hours before the start of the test (also take into account the time needed to reach the Medispace Medical Center.

The consequence of taking the Moviprep solution is numerous bowel movements, in the final stage of preparation, with a clear liquid.

The basic condition for performing a planned colonoscopy is to follow the recommendations related to the preparation of the intestine for the procedure and to remain on an empty stomach, i.e. not taking food, thick liquids, coffee and tea for at least 20 hours. Before the planned colonoscopy, it is allowed to drink water in order not to feel thirsty for up to 2 hours before the procedure. The last liquid (still water) can be taken 2 hours before the procedure in an amount not exceeding a glass (250 ml). Performing a colonoscopy under anesthesia on a person with a full stomach may expose them to life-threatening complications related to aspiration and aspiration of gastric contents into the lungs.

Chronic medications should be taken with a glass of water (250 ml) not later than 2 hours before the procedure. In accordance with previous arrangements with your doctor, you should stop taking medications that affect the coagulation system (such as acetylsalicylic acid, clopidogrel, warfarin, acenocoumarol, dabigatran, rivaroxaban, etc.).

Diabetic patients should stop taking oral hypoglycemic drugs or insulin while fasting (food, thick fluids, coffee and tea). For patients taking insulin on an insulin pump or using continuous glucose monitoring systems, insulin should be discontinued if blood glucose drops below 100 mg/dL.

Patients with renal insufficiency or heart failure should discuss the individual preparation with a physician, as it may differ in the above-mentioned cases.

Additionally, you should refrain from smoking for 6 hours before the test and chewing gum. The patient does not have to take a change of clothes with him.

If you decide to undergo anesthesia for the procedure, you will be asked to arrive 30 minutes earlier in order to fill in the anesthesiology questionnaire regarding the health condition (document available for download in the tab – downloadable materials). A correctly completed questionnaire will allow the anesthesiologist to assess the risks associated with anesthesia and adjust the anesthesia to the current state of health. Anesthesia is designed to ensure comfort and will be adapted to the type of procedure and the individual needs of the patient and the doctor performing the procedure. If symptoms of an upper respiratory tract infection or elevated temperature appear before the procedure, please report this fact by phone to the clinic. This is a contraindication to anesthesia.

We would like to inform you that for safety reasons, after anesthesia, you must not drive a motor vehicle until 24 hours after the examination and you should leave the clinic with an accompanying person.

IMPORTANT: If the patient has been referred for the procedure and is 55+ years old, has a BMI above 35 (kg/m²) or suffers from a serious comorbidities, he or she should consult with one of our specialists about the the possibility of surgery and anesthesia.

For inpatient anesthesiology consultation, please prepare:

• medical records of the patient’s chronic diseases and medications taken,
• basic laboratory test results from the last 2 months (CBC, sodium, potassium, creatinine, APTT, PT, INR);
• blood group result;
• ECG result from the last 2 months;
• in case of concomitant thyroid diseases – TSH, FT3, FT4 results from the last 2 months;
• for cardiac conditions such as ischemic heart disease, heart defects, cardiac arrhythmias – the result of ECHO-heart from the last 6 months and a certificate from the attending physician stating that the disease is in a stable state and does not require modification of treatment;
• in the case of neurological diseases – a certificate from the attending physician with information that the disease is in a stable state and does not require modification of treatment;
• in the case of taking anticoagulants (so-called “blood thinners”)
• a certificate from the attending physician with recommendations for the patient regarding the possible discontinuation of these drugs or switching to low-molecular-weight heparins

For teleconsultation, please send scans of the documents according to the above guidelines before the date of the anesthesiology consultation and deliver the originals on the day of anesthesia!

Please be advised that even a positive qualification by the anesthesiologist during the anesthesiology consultation is not a 100% guarantee that anesthesia will be performed on the day of the examination/procedure. The final decision to perform anesthesia is made by the anesthesiologist present on the day of the examination/procedure based on the patient’s current condition and compliance with the recommendations indicated at the consultation and general recommendations, especially regarding food consumption and post-anesthesia care.

ATTENTION: We kindly inform you that the condition for reserving an appointment for endoscopic examination with or without general anesthesia is payment of the total prepayment within 24 hours of booking. In case of payment by bank transfer, please send confirmation to:

kontakt@medispace.pl

The fee is non-refundable unless the Patient cancels the examination no less than 48 hours before. The account number below to which payment should be made. Please include the Patient’s name in the title of the transfer.

mBank: 59 1140 2062 0000 5673 5500 1001