An Important Exam Requires Careful Preparation
Your doctor has decided that colonoscopy is necessary to better evaluate your colon, or large intestine. An important examination such as this requires careful preparation. The results obtained from this exam are dependent on your lower bowel (colon) being carefully cleansed and empty. An improperly prepared bowel may mean that the exam will have to be repeated at another time. More importantly, fecal matter (stool) left in the intestinal tract can hide important conditions that may be present. Therefore, it is very important that you follow these instructions as carefully as possible. If the test is worth doing, it deserves the best possible preparation.
A couple of hints... To fully evacuate the colon, this preparation will cause you to have many liquid bowel movements. Note that individual responses to laxatives vary widely. Plan to remain within easy reach of toilet facilities. Many patients find that Charmin Plus toilet tissue minimizes anal irritation from repeated wiping. Also. rubbing a small amount of hydrocortisone cream, such as Cort-Aid, around the anal area after each bowel movement can lessen the irritation. On the day of your exam, wear comfortable easily-removable clothing and leave jewelry and other valuables at home. If you are having a menstrual period, it is OK to wear a tampon.
No laxative preparation is fun. However, this new preparation in tablet form has been developed to make the process as simple and effective as possible. Please follow each instruction exactly as given. If you have any questions, call our office - (412) 262-1000 option #2.
Visicol™ Preparation Instructions
What is Visicol™?
Visicol™ is a new prescription laxative from Inkine Pharmaceuticals used to cleanse the colon in preparation for colonoscopy. This is the same laxative medication as Fleets Phosphosoda, but in tablet form. It is offered as an alternative to the usual "gallon jug" preparation that is most often used (Golytely, Colyte, Nulytely, PEG). It was approved by the FDA for general use September 2000 and became available January 2001. Thirty-Two (32) tablets of Visicol™ are taken in two doses approximately 12 hours apart. The first dose consists of twenty (20) tablets taken over a 90 minute period and is taken the night before your examination. The second dose consists of twelve (12) tablets taken over 30 minutes the morning of your test. Each administration induces a diarrhea lasting 1 to 3 hours which rapidly and effectively cleanses the entire colon. The primary mode of action is thought to be through osmotic action of sodium, causing large amounts of water to be drawn into the bowel, promoting bowel evacuation. To prevent dehydration, it is very important to drink the specified amount of fluid during the preparation - at least eight ounces glasses with each dose of tablets for a total of 10 glasses of clear fluid.
Who Should NOT Take Visicol™
Visicol™ is not for everybody. It is not safe for use by certain individuals:
- Those with electrolyte disturbances (sodium, potassium, calcium, phosphorus) of the blood seen in dehydration or secondary to the use of diuretics (fluid pills).
- Kidney disease - Visicol™ contains a large phosphate load.
- Heart disease - congestive heart failure, unstable angina pectoris (heart pain), and within 3 months of heart attack or heart surgery.
- Liver disease - especially those with ascites (fluid accumulation in the abdomen).
- Some intestinal diseases - such as acute ulcerative colitis, Crohn's disease, severe constipation, intestinal blockage, or slow intestinal function as seen in underactive thyroid or scleroderma.
- Difficulty swallowing - Visicol™ tablets are quite large and may be difficult to swallow for some patients. They should not be used by individuals who have a swallowing disorder or who have problems swallowing large tablets. They are scored and can be broken in half.
- Pregnancy - Safety in pregnancy has not been studied.
- Children - Safety in children has not been studied. Visicol™ has been approved only for those over 18 years of age.
Visicol™ is a prescription drug. A few days before your appointment, take your prescription for Visicol™ to your pharmacy. You should receive one bottle of Visicol™ containing 40 tablets. (With this preparation, you will take only 32 of them.) This is a new preparation and not all insurance plans cover the cost which is about $40. In that instance, you have the option of paying for the prescription yourself, or contacting our office for an alternative that is covered.
The Day Before the Examination:
 |
Because of the mechanism of action of Visicol™ tablets, you should be on a clear liquid diet for at least 12 hours prior to beginning taking the tablets.
FIRST HALF: The evening before the colonoscopy procedure, take the first 20 tablets over 90 minutes - 3 Visicol™ tablets should be taken with at least 8 ounces of clear liquids every 15 minutes (the last dose will be 2 tablets) for a total of 20 tablets. Wait a full 15 minutes before each dose. Be sure a clock is nearby or wear a watch. [DO NOT EXCEED 20 TABLETS.] No additional enema or laxative is required, and you should NOT take additional agents, particularly those containing sodium phosphate. |
Examination Day
SECOND HALF: No solid food or milk products. On the morning of your test, take just 12 more tablets over 30 minutes - 3 Visicol™ tablets should be taken with at least 8 ounces of clear liquids every 15 minutes for a total of 12 tablets. Wait a full 15 minutes before each dose. Be sure a clock is nearby or wear a watch.[DO NOT EXCEED 12 TABLETS.] Begin a minimum of 3 hours before your scheduled appointment time. Do not eat or drink anything for the four hours before your appointment. You may take all of your regular medications unless otherwise directed. No Insulin. No Coumadin unless your doctor told you to do so.
You should plan to arrive at least 15 minutes before your scheduled appointment. We will complete your registration, have you change clothing, perform any pre-operative orders which might be required by your physician, and answer any questions you might have. Please be on time so that you don't cause a delay which could affect many other patients within the same day.
Since sedation is utilized, YOU MUST BRING A COMPANION WITH YOU who is responsible and is able to drive you home after your procedure and to assist you with follow-up care. Only one companion is necessary, and we ask that they remain at Three Rivers Endoscopy Center during your procedure and recovery which totals about 2 hours. You must go straight home after your procedure. You will not be able to drive a car, operate any machinery, or go to work until the following day.