Colonoscopy: Bowel Prep
Mayo Prep for Colonoscopy Allows 4 Pills
One Mayo Clinic site is allowing patients to take 4 pills instead of 4 Liters of liquid prep for a virtual colonoscopy.
Nutra Prep Meal Plan
In addition to Nutraprep there is also a gourmet food prep. Nutraprep by E-Z-EM is an alternative meal plan to the usual clear liquid diet for colonoscopy. Nutraprep utilizes low residue foods in a self contained meal plan system.
NutraPrep, (E-Z-EM, Inc., Westbury, NY) ($30.00)
LoSo Prep System (E-Z-EM, Inc., Westbury, NY) ($30.00).
Dedicated preparation kits exist as well.
Such "dry preparations" are preferable to large volumes of electrolyte preparations commonly used for conventional colonoscopy
such as:
Colopeg (polyethylene glycol) Roche Laboratories, Gaillard, France
Colyte, Schwartz Pharma, Inc. Milwaukee, WI
GoLYTELY, Braintree Laboratories, Inc., Braintree, MA)
The prep for standard colonoscopy for PKD'rs is GoLYTLEY or polyethylene glycol (PEG). Avoid fleets phosphate soda with kidney disease.
With large fluid volumes, some residual fluid may be retained obscuring polyps on a CT colonography. Stool markers (mostly barium, Tagitol or TagitolV, E-Z-EM, Inc., Lake Success, NY) or iodine can be administered orally 24 to 48 hours prior to CT to improve differentiation of soft tissue intraluminal lesions and retained stool. This technique is called fecal tagging.
Clear Liquid Diet
Two (2) days prior to the exam it is recommended that we begin clear liquids; avoiding all red, purple, or pulp containing liquid foods and alcohol. To be safe, start a full liquid diet four days prior to the exam then switch to clear liquids two days before the exam. Unfortunately, I was unable to keep GoLytely down; with this modified prep the Radiologist was able to go ahead with my virtual colonoscopy done by CT.
Water
tap water
seltzer water
Tea
chamomile
mint
Juice clear without any pulp or red color
apple
clear apple cider
white grape
coconut water
Drinks
Kool-Aid powders
lemonade
Gatorade lime or white or yellow
Soda
ginger ale
sprite
7-up
Broth
chicken
vegetable
fat-free consommé
Jello
lemon
plain
Fruit ice
popsicle lemon
Italian ice
Sorbet
lemon
Candy
clear hard candies yellow white
Condiments
Himalayan salt
pepper
sugar
honey
E-Z-EM Inc.
E-Z-EM Inc. offers Lo-So Prep and NutraPrep. Lo-So Prep contains less than 35 mg of sodium, which makes it appropriate for patients on a sodium-restricted diet. It is low in volume -- only eight ounces of laxative must be ingested -- compared to other preps requiring consumption of several quarts of liquid. Lo-So Prep, with its citrus flavor and natural effervescence, can be dispensed from the office. Each Lo-So Prep kit contains three laxative agents: magnesium citrate effervescent granules (which yield a solution equivalent to 4.4 grams of magnesium oxide), four 5-mg Bisacodyl tablets USP, and one 10-mg Bisacodyl suppository USP.
The NutraPrep System, used in conjunction with Lo-So Prep, provides an alternative to the clear-liquid diet typically associated with bowel preparation and fulfills total nutritional requirements. The low-residue food is labeled as breakfast, lunch, dinner and snack, and is a simple program to help ensure compliance.
Visicol, OsmoPrep received an FDA Boxed Warning
FDA has received 20 reports of kidney injury associated with OsmoPrep since OsmoPrep's approval in 2006. Three of those cases were confirmed by biopsy. Some cases happened within hours of use; others were reported days or weeks later.
No Prep Colon Prep
"Virtual colonoscopy technology that eliminates the need for bowel preparation with laxatives appears similar to optical [instrument] colonoscopy at detecting larger adenomas but seems questionable for smaller lesions, a clinical trial determined."
