How to prepare for your colonoscopy using Picolax and Senna bowel preparation - For Individuals with Insulin Treated Diabetes (Afternoon appointment)
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South of Tyne Bowel Cancer Screening Programme How to prepare for your colonoscopy using Picolax and Senna bowel preparation For Individuals with Insulin Treated Diabetes (Afternoon appointment)
How to prepare for your colonoscopy
using Picolax and Senna bowel
preparation
For Individuals with Insulin Treated
Diabetes
(Afternoon appointment)
Introduction
You agreed to take part in the National Bowel Cancer Screening Programme. As part of the screening
process you provided a stool sample for analysis in which traces of blood were found. A colonoscopy
examination is now recommended to investigate your large bowel further.
Colonoscopy - the inspection of the large bowel (colon) using a flexible camera (colonoscope). This
leaflet tells you how to prepare for your colonoscopy using two types of laxative. These come
as two sachets and six tablets. The laxatives will work together to cleanse your bowel. You must
also follow a special diet set out in the leaflet. The diet includes taking special drinks; these are a
complete diet in liquid form and need to be taken at the appointed times.
What is the bowel preparation?
The two sachets contain a sugar free powder, this is a strong laxative. The tablets are Senna
tablets, you will need to take six of these, they are also a laxative.
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www.qegateshead.nhs.ukWhy do I need bowel preparation?
The colonoscopy looks at the inside of the large bowel. To have a successful examination, the
bowel must be empty and clean. If the bowel is not empty and clean, it is not possible to see it all
adequately and this could mean the test needing to be repeated.
Before taking bowel preparation
Contact the Screening Practitioner (telephone number on back of leaflet) if you answer yes to any of
the health questions and they were not discussed at your pre-assessment appointment.
Are you allergic to any of the ingredients listed on the packets?
Are you taking any of the following tablets? Warfarin, Acenocoumarol, Phenindione,
Dabigitran, Apixaban, Rivaroxaban, Clopidogrel, Prasugrel or Ticagrelor.
Do you suffer from any kidney disease?
Do you have congestive cardiac failure?
Do you receive Victoza or Bydureon injections? If so, please contact your Diabetes
Team.
When do I start to prepare for my colonoscopy?
Seven days before your appointment
Stop taking iron tablets – Iron makes inside your bowel black, this makes it difficult to
see everything.
Four days before your appointment
Stop taking any medication that may cause you to be constipated, for example;
Lomotil, Loperamide, Codeine Phosphate or Dihydrocodeine.
Continue to take all other normal medications.
Two days before your appointment
Stop taking Fybogel or any other fibre products – The fibre content of these products
will work against the special diet you are about to start.
Start your special diet at breakfast – Eat from the foods on the diet list unless you are
allergic to or have been advised to avoid certain foods.
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www.qegateshead.nhs.ukDo not eat any foods or have any drinks that are not on this diet list.
No milk in any form
Diet list
Meat: lean meat for example; chicken, turkey, beef, ham and rabbit
Fish: white fish only (do not fry)
Eggs: boiled, poached or scrambled – no milk to be used
Fruit and Vegetables: no fruit or vegetables other than potatoes, boiled or mashed only - no milk to
be used
Cereals: white rice and pasta, boiled only – no wholemeal varieties
Bread: white bread and white bread rolls only
Fats: a daily allowance of 25g (1oz) butter or margarine
Other: sugar free plain jelly, artificial sweeteners and salt
Drinks: black tea or coffee, sugar free fruit squash (not real fruit juice), sugar free fizzy drinks,
marmite, oxo, Bovril, soda water, water, flavoured water, herbal/fruit teas
Supplement drinks: Supplied at your pre-assessment appointment
One day before your appointment
You are advised not to go to work on this day. You should expect frequent bowel actions within
three hours of starting your bowel preparation. Some abdominal cramping is normal, stay within
easy reach of the toilet.
Increase the frequency of blood glucose monitoring once bowel preparation is started.
At 12 midday – have a light lunch from the diet list. (This is your last meal, no more
solid food until after your examination).
Take insulin if normally taken.
At 2pm take six Senna tablets with plenty of water.
Drink fluids regularly – drink a glass of clear fluid, from the diet list, every hour throughout the
day until bedtime. No alcohol.
At 5pm dissolve the content of one sachet of the bowel preparation in a heat proof
mug with 200ml (8 fluid ounces) of cold water. Stir for two minutes and leave to stand
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www.qegateshead.nhs.ukfor 30 minutes (the mixture may become hot and needs to cool). Once cooled, drink the
solution.
At 6pm have a supplement drink, this should be sipped slowly.
Take insulin if normally taken. You may need to reduce your dose.
Bed time, have a supplement drink, this should be sipped slowly.
Take insulin if normally taken. You may need to reduce your dose.
If you feel unwell
If at any time you feel; dizzy, sweaty or irritable (hypo) take:
2-3 teaspoons of sugar dissolved in warm water
or 3-4 glucose tablets
or 150ml of lucozade
This should be followed by a starchy snack, for example, a plain biscuit or some white bread,
within 20 minutes; it is advisable to monitor your blood glucose levels regularly.
If you do not feel better almost immediately please contact your usual diabetic carer.
If you recover and feel your normal self, continue with the bowel preparation instructions.
What do I do on the morning of the colonoscopy?
At 7am dissolve the second sachet of bowel preparation as described above and drink
the solution once cooled.
8am have a supplement drink, this should be sipped slowly.
Take insulin if normally taken. You may need to reduce your dose.
For late afternoon appointments (after 3pm) have a supplement drink at 12 midday.
Take insulin if normally taken. You may need to reduce your dose.
You are allowed to drink fluids, from the diet list, until two hours before your
appointment.
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www.qegateshead.nhs.ukYou may receive sedation during your colonoscopy examination, it is important that you stop
drinking two hours before your appointment.
Attend the Endoscopy Unit at your appointment time.
Please inform the nursing staff on arrival if you are not passing clear liquid as you may require
an enema prior to your examination.
Please bring insulin and a snack into hospital for after the procedure.
What can I expect of the bowel preparation?
The bowel preparation can begin to work within three hours of taking it. You will open your
bowels frequently and eventually your motions should change from soft to loose to watery.
Stay close to a toilet all day as you will use it regularly.
You may experience some abdominal cramp – this is normal in some people.
The skin around your bottom can become red and sore due to frequent diarrhoea. A barrier cream
such as Vaseline or nappy rash preparations can protect the skin. The soreness is temporary and will
disappear in a few days.
Are there any side effects from bowel preparation?
You may experience headaches, nausea and sometimes vomiting. Abdominal bloating can occur
and, less frequently, abdominal cramps.
Most side effects are due to dehydration and can be avoided by drinking adequate amounts of fluid.
However, if you suffer from severe, prolonged or increasing abdominal pain, repeated vomiting
and/or if you are not opening your bowels please contact the Screening Centre on 0191 445 6179
or seek medical attention.
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www.qegateshead.nhs.ukIf you require any further advice or information regarding your bowel preparation contact: The Bowel Screening Centre 0191 445 6179 Monday to Friday (8.30am - 5pm) Accident and Emergency Department (QEH) 0191 445 2171 Queen Elizabeth Hospital 0191 482 0000 South Tyneside District Hospital 0191 404 1000 City Hospitals Sunderland 0191 565 6256 Data Protection Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible. In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics. Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email ghnt.ig.team@nhs.net. This leaflet can be made available in other languages and formats upon request NoIL89 Version: 7 First Published: 11/2007 Review Date: 04/2021 Last Reviewed: 04/2019 Author: Mary Ritchie
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