Suprep bowel prep

PREPARATION FOR A COLONOSCOPY (SUPREP)

Per Inova policy, all patients have to complete a brief health history (One Medical Passport) on line or by phone prior to their procedure. If this is not done before arriving, your procedure will be delayed at the center, which inconveniences you and your ride, and generally makes the process run more inefficiently. Please go to www.onemedicalpassport.com to do this as soon as possible. If you are unable to do this, please call 703-922-0088 and someone may assist you from our pre-op office.

You have been scheduled for a colonoscopy procedure at the Inova Healthplex Franconia/Springfield (2nd floor, 6355 Walker Ln, Alexandria, VA 22310). 

Please arrive one hour before your scheduled procedure time. The procedure is a simple outpatient procedure which examines your colon (large intestine) using a colonoscope. The procedure will be performed by Dr. Charles McBride, M.D. Please ensure that you bring an ID, your insurance information, and have arranged for a ride home, as the precedure requires sedation. If needed, medical ride services are available to transport you.

If you need to cancel or reschedule, please call our office at 703-455-5556. If you believe this message is in error, or if you feel this is the wrong procedure, please notify us immediately.

Important information for patients undergoing procedures:

If you are 70 or older, diabetic, or have any heart condition, an EKG within approximately 1 year of your procedure is required at all Inova facilities. This prerequisite is mandated by Inova, not our practice, and allows Inova to meet standards required by the state of Virgina and Anesthesia guidelines. Please request your primary physician or cardiologist to fax your most recent EKG to 866-829-4773. If you do not have a primary doctor or cardiologist, we would be happy to order an EKG at a convenient center to meet this pre-procedure requirement. We encourage patients to obtain the EKG as early as possible to avoid cancellation of your procedure. If you have questions about this, don't hesitate to call our office at 703-455-5556.

Diabetes Medicine: All Oral medications (i.e. pills) should be taken on the day before the procedure, but do not take on the day of your procedure.

Special instructions for GLP-1 agonists for diabetes such as Ozempic, Trulicity, Victoza, or Mounjaro ---No milk products are allowed the day before, and you must have a completely empty stomach the day of the procedure. You should not take any of these products within 1 week of your procedure!! These medications may delay stomach emptying, and increase the chance of vomiting and/or aspiration. If on these agents, you should not eat or drink on the day of your procedure.

Insulin is not included in this recommendation; you can follow the normal instructions below if your only injectable is Insulin.

Insulin: You will be given special instructions regarding insulin by Dr. McBride. Generally, 1/2 dose of insulin on day prior to procedure, and hold insulin on day of procedure until after the procedure. Check your blood sugar on the day prior periodically to ensure levels are not too high. We use 1/2 of the normal dose the day before as we are concerned that your blood sugar may be too low with the restricted diet for the colonoscopy.

Go to your local pharmacy and fill your SuPrep Prescription

BRING PICTURE IDENTIFICATION TO PROCEDURE APPOINTMENT.

You will receive IV sedation for this procedure, so it will be necessary to arrange for a responsible adult to transport you home.  The Surgery Center will NOT release you to a transportation service such as URTA or a taxicab.  You can anticipate being at the Surgery Center for approximately 3 hours.

RESTRICTIONS:

Aspirin:  Stop taking aspirin 7 days before your procedure, unless directed otherwise.  Try to avoid aspirin, Advil, Motrin, Aleve, arthritis medications, or any similar medications for 1 week prior to your procedure.  Tylenol is permitted.

Coumadin/Plavix: Stop Coumadin/Plavix 3 days prior to your procedure unless otherwise directed.

Blood pressure medicine:  Continue blood pressure medications, including the day of your procedure.  You may take it with a small sip of water.

Diabetes medicine:  please see above section about diabetes medicines.

3 DAYS BEFORE THE EXAM:

Do NOT eat beans, collard greens, corn, dried fruit, kale, nuts, popcorn, raisins, seeds, or spinach.  You may eat canned fruit, or fruits without a peel.  Please avoid fiber supplements and iron preparations as well during this time.

Items Needed for Laxative Prep:

1 SuPrep Kit- the kit contains 2 bottles of liquid prep and a disposable cup for mixing.

DAY BEFORE THE EXAM:

This is the day you prepare for your procedure. Starting from when you wake up, drink only clear liquids all day. NO SOLID FOOD ALLOWED.

Clear liquids that you may have include water, coffee, tea, carbonated beverages (i.e. Coke, Ginger Ale, 7-Up, etc.), Jell-O gelatin without food particles, ices and Popsicles, clear fruit juices, broth, bouillon, Gatorade, and Powerade as long as they are NOT RED in color.  You may also have milk and vanilla milkshakes, but only the day before, not the day of the procedure.  No yogurt is permitted. Place the two SuPrep bottles in the refrigerator to cool them for mixing.

At 6:00 PM the evening before your procedure, follow the below steps 1-4.

STEP 1:

Pour ONE (1) 6-oz bottle of SuPrep liquid into the mixing container.

STEP 2:

Add cool drinking water to the 16-oz fill line and mix.

STEP 3:  

Drink all the solution, slowly over 30 mins- DO NOT CHUG.

Step 4:

You MUST  drink TWO more 16-oz containers of water of the next hour.

It is very important that you provide us with the cleanest colon you can. Please drink the entire prep.

MORNING PROCEDURES: Please repeat Steps 1-4 with the second bottle of SuPrep solution at 10:00PM. Do not eat or drink anything after midnight.  You may take time sensitive medications with a sip of water the morning of your procedure.

AFTERNOON PROCEDURES (Arrival time of 11AM or later): Please repeat Steps 1-4 with the second bottle of SuPrep solution FIVE HOURS prior to your procedure time, complete the prep and stop clear liquids within three hours of your procedure time. Please do not drink any milk products on the day of your procedure. You may take time sensitive medications with a sip of water the morning of your procedure. 

Tips to help with the prep

Everyone tolerates the bowel prep differently.  While some patients report the prep being "easy" and well-tolerated, the majority consider it unpleasant, and the most difficult part of a colonoscopy. 

 The following are suggested tips to help tolerate the preparation for a colonoscopy procedure:

 1. Refrigerate the liquid.  People feel it is better tolerated cold.

 2.  Use a straw, and place the straw in the back of the mouth.  Patients claim it lessens the taste.

 3.  Suck on a lemon just before and after sipping the Moviprep.  If you don't have lemons, you can try mouthwash.

 4.  If you get nauseated, take a break.  Drinking times suggested on the instruction sheet are only  guidelines.  It sometimes helps nausea to slow down a bit between doses.

 5.  If you are prone to nausea, ask for an anti-nausea prescription to take before starting the prep.

***Due to the necessity of staffing requirements for an outpatient procedure, if you have to cancel for any unforeseen circumstance, it is mandatory that you give at least 3 day notice prior to your scheduled procedure time***. If a procedure is cancelled within 48 business hours of the procedure, there will be a $125.00 charge for the late cancellation.