Hospital SIGMOIDOSCOPY PREPARATION

The day before your procedure:

Purchase two (2) Fleet’s Cleansing Enemas (not Fleet’s Phosphosoda) and one (1) bottle of Milk of Magnesia or its generic equivalent.

The night before your appointment :

Take 2 tablespoons of Milk of Magnesia.

On the day of your procedure: _____________________

• On the day of your procedure please arrive at:
  □ Frisbie Memorial □ Wentworth Douglass □ Portsmouth Regional □ York Hospital
  at _____:______ AM / PM



• 1. Take a Fleet’s Cleansing Enema two (2) hours before your appointment.
• 2. Take the SECOND Fleet’s Cleansing Enema one (1) hour before your appointment.


• AM (Morning) Prep - Nothing to eat or drink after midnight.
• PM (Afternoon) Prep - Clear liquids in the morning. Do not eat or drink four (4) hours prior to your procedure.

Clear Liquid Diet
(Do not eat or drink anything red or purple)

Broth	Sorbet (with no fruit pieces)
Popsicles ®	Jell-O ®
Water	Black Tea/Coffee (No milk or cream)
Soda	Crystal Light ®
Hard Candy
Fruit Juice without Pulp	White Grape Juice
White Grape Juice	Apple Juice
Grapefruit Juice w/o pulp
Gatorade ® / Sport Drinks

NOTE: Gatorade® or sports drinks result in better hydration than water alone.

DIABETES PREP FOR COLONOSCOPY / ENDOSCOPY

1. All efforts will be made to schedule your case in the early morning.  If not, consult your physician for specific instructions.
2. The clear liquid diet contains foods with sugar.  It is OK to drink these liquids!
3. Continue your blood sugar testing before your procedure; perform a test at home before leaving for your procedure and report the result to the nurse upon your arrival at the hospital.
4. If you are taking tablets that contain Metformin (Glucophage, Avandamet, Metaglip, Glucovance or generic forms of Metformin), discontinue the day before your procedure and resume the day after your procedure.
5. Other tablets for diabetes (including Glyburide, Glipizide, Actos, Avandia, Prandin, Starlix, Glyset, Precose) may be taken on the day and night before your procedure, but not on the morning of your procedure.  Resume the tablets when you return home.
6. If you are taking long acting insulin (Lantus), do not stop it.  If your long acting insulin is NPH, Lente or Ultralente, take your normal dose the evening before, but only 2/3 your usual dose on the morning of the procedure.
7. If you are taking a rapid acting Insulin (Regular, Humalog, or Novolog) do not take any on the morning of your procedure, unless your blood sugar is above 200 mg/dL in which case you should take ½ your usual dose.
8. If your blood sugar is high before, during or after the procedure, you may receive extra shots of insulin.

rev 11/5/07 form 106A