Telescopic examination of the colon (Colonoscopy) - PICOPREP/Citrafleet

If you take blood thinning medication, except Hjertemagnyl, please call us as quickly as possible at 7842 5520 between 9.00 am and 12.00 pm.

If you take insulin and need guidance in relation to the purging of your colon, you may contact us at 7842 5511 between 9.00 am and 12.00 pm.

Please bring a list of your usual medications.

If you are prone to constipation you can buy laxatives (e.g. Toilax) at the pharmacy. You must take 2 tablets before bedtime on the last 3 days before you have to start purging your colon.

• You must not eat food with visible seeds e.g. bread with seeds, linseed, sesame seeds, grapes etc. for 3 days before your examination. If you are unsure about certain foods then refrain from eating it. The small seeds stop our equipment and prolong the examination.
• Drink at least 2 liters of fluids per day.
• Take a break from vitamins and iron pills.
• You must refrain from dairy.
• If you are unsure about certain foods then refrain from eating it.

Your colon must be empty of faeces so the examination can be conducted. That is why you must use the purgative PICOPREP or Citrafleet before your examination.

You will receive the purgative in your mailbox in a couple of days. Follow the instruction as described below.

The day before your examination

For breakfast:

You must only eat a diet with a low content of fibres.

• Boiled eggs.
• White bread and with a little butter.
• Coffee or tea without milk.

For lunch at 12 pm:

• Boiled or grilled white fish or chicken.
• Boiled potatoes without peel, white rice or pasta.
• White bread.

The rest of the day:

• Do not eat solid food.
• Drink plenty of clear fluids, e.g. bouillon/clear soup without filling, water, cordial, soda, tea and coffee. But no dairy.
• Drink between 2-3 liters of fluids this day.
• Drink plenty of energetic and sugary fluids, but not juice with bits.

At 8 pm:

• Mix the first portion of the purgative (PICOPREP or Citrafleet).
• Take a glass with 1,5 dl cold water.
• Pour the powder from a packet into the water.
• Stir the mixture for 2-3 minutes.
• When the mixture stops fizzing the mixture is done.
• Drink the mixture within 15 minutes.
• Drink at least 1½ liters of clear fluids during the next 2-4 hours.

The purgative will work in 1-3 hours. Your faeces will become frequent and watery. You must be near a toilet.

On the examination day

5 hours before your examination:

• Mix the second portion of the purgative (PICOPREP or Citrafleet) as described above.
• Drink 1½ liters of clear fluids for the next 3 hours.

Up to 2 hours before your examination:

• Drink plenty of energetic and sugary fluids, but no juice with bits.
• Refrain from chewing gum, pastilles and sweets.
• We recommend not smoking.

After this you must not drink anything.

The day before your examination

For breakfast:

You must only eat a diet with a low content of fibres.

• Boiled eggs.
• White bread and with a little butter.
• Coffee or tea without milk.

For lunch at 12 pm:

• Boiled or grilled white fish or chicken.
• Boiled potatoes without peel, white rice or pasta.
• White bread.

The rest of the day:

• Do not eat solid food.
• Drink plenty of clear fluids, e.g. bouillon/clear soup without filling, water, cordial, soda, tea and coffee. But no dairy.
• Drink between 2-3 liters of fluids this day.
• Drink plenty of energetic and sugary fluids, but not juice with bits.

On the examination day

At 6 am:

• Mix the first portion of the purgative (PICOPREP or Citrafleet).
• Take a glass with 1,5 dl cold water.
• Pour the powder from a packet into the water.
• Stir the mixture for 2-3 minutes.
• When the mixture stops fizzing the mixture is done.
• Drink the mixture within 15 minutes.
• Drink at least 1½ liters of clear fluids during the next 2-4 hours.

The purgative will work in 1-3 hours. Your faeces will become frequent and watery. You must be near a toilet.

5 hours before your examination:

• Mix the second portion of the purgative (PICOPREP or Citrafleet) as described above.
• Drink clear fluids for the next hours.

Up to 2 hours before your examination:

• Drink plenty of energetic and sugary fluids, but no juice with bits.
• Refrain from chewing gum, pastilles and sweets.
• We recommend not smoking.

After this you must not drink anything.

• You must drink clear fluids up till 2 hours before your examination.
• You must not eat solid food.
• You must take your usual medication (except for diuretic tablets and tablets for diabetes) with half a glass of water, no later than 2 hours before your examination.
• When you arrive at the ward you will be greeted by a nurse who will inform you. After that you must change into hospital pants and you will get a plastic syringe inserted in the back of your hand.

A coloscopy examination can show changes in the colon such as polyps, diverticulosis, tumours or inflammatory conditions. The examination is performed with a long flexible tube with a camera which is inserted through the rectum.

It is necessary to inflate the colon with air, which may cause the feeling of bloating and urge to have bowel movements. You may experience pain, but it is brief and caused by stretching of the colon.

If it is necessary during the examination to give medicine to help you relax or relive pain, you are not allowed to drive a car for 24 hours after the examination.

Biopsies can, if necessary, be taken from the mucous membrane, which is painless.

The examination lasts approximately 45 minutes. You must expect to spend time on preparation and maybe resting after the examination. This together with the examination will last two to three hours.

You will receive the result of your examination before you leave the clinic. If biopsies are taken, the results will be ready in 5-6 weeks

There is a very small risk of perforating the colon.

If you experience:

• severe abdominal pain
• bloody or black stools
• discomfort, nausea, or a tendency to sweat
• fever above 38 degrees Celsius
• shivers

you should contact the Emergency Medical Service in the first 24 hours after the examination.

After the first 24 hours you should contact your general practitioner.

I would like to cancel my appointment because my symptoms have disappeared. How can I do that?

• Send an e-mail with the reason why you want to cancel via the link in your admission letter or call us. We will let the referring doctor know that you have canceled your appointment.

Can I take my usual medications in the morning?

• Yes, but you may not take any diuretic tablets and tablets for diabetes.

I have eaten seeds in the days up to my appointment because I received my appointment with a very short notice. What then?

• We are aware of that you cannot always adhere to the rules when we call you in on a short notice. Refrain from seeds as long as you can.

May I take HUSK/SylliFlor (fibre supplement) as I usually do up to the examination?

• No, you have to refrain from fibre suppements from 4 days before your examination. If you are called in on a short notice, stop as quickly as possible.

Why can I not take iron tablets in the days before the colonoscopy?

• The iron will make it difficult to be sufficiently empty and it creates a green film on the mucous membrane. If you are called in on a short notice stop taking the iron tablets as quickly as possible.

Can I wear jewelry at the examination?

• We recommend that you do not wear jewelry at your examination since they are electrical conductors and can get stuck when you need to move around on the examination bed.

When does the purgative work?

• As described above it works after approximately 1 hour, and diarrhoea will be over approximately 1½-2 hours later. It is individual when the purgative works. If your faeces is watery then the purging is sufficient.

What happens if I take the purgative earlier than 8 pm and 5 hours before my appointment?

• From experience we know that 6-7 hours after you take the purgative, regular faeces will start coming down to the right side of the colon. That means the doctor/endoscopy nurse cannot see the mucous membrane and in the worst case scenario, you will have to do the purging all over and schedule a new appointment.

Is it possible to conduct the colonoscopy while I have my period?

• Yes, the examination can still be conducted. You can bring extra sanitary pads/tampons into the examination room.

Why am I not allowed to drive a vehicle or a bicycle after the examination? And when am I allowed to again?

• If you get medicine to help you relax or relieve pain during your examination, your power of concentration and reaction are reduced considerably. It corresponds to consuming alcohol or drugs. Out of consideration for traffic and work safety you must not drive a vehicle, work equipment and bicycles for 24 hours after your examination.

Can I go to work right after the colonoscopy?

• We recommend that you take the rest of the day off, so you/your body can recover from fasting and purging.

Why did I get a message about taking a break from blood thinning medication, when you usually can continue taking it?

• Some types of blood thinning medications can affect the bloods ability to coagulate enough, that severe complications can occur if we are not aware that you are taking that type of medication. That is why we sometimes ask you to take a break from your blood thinning treatment and if necessary give you something else in stead.

When will my stomach return to normal again after the examination?

• Some patients experience having different faeces (consistency and frequency) for some time after the purging - it varies from a few days to 1-2 weeks.

Is there a risk of me having faeces in my pants on my way to my appointment?

• We have studied this and the risk is very small - it rarely happens.