Flexible Sigmoldoscopy

Patient’s Name:________________________________________________

Date of Operation:___________________

Time of Procedure:___________________

For the purposes of safety, a thorough cleansing of the colon is required. Early preparation consists of modifying dietary intake starting 48 hours before the Sigmoidoscopy procedure.

TWO DAYS PRIOR TO PROCEDURE: DATE:___________________

Begin to remove hard-to-digest items from your diet. Examples of such food items are corn, spinach, or other items of roughage which you have noted pass through your system only partially digested. Switch your diet to breads, pastas and other refined food items.

ONE DAY PRIOR TO PROCEDURE: DATE:___________________

Further decrease dietary intake of any roughage and begin to eat a more liquid diet Juices, jello) and a diet with more refined foods such as cereals, breads pastas and noodles.

Remember to take your regular prescription medications with some water. Such medications include hypertension medication, thyroid hormones and most other medications except those that affect blood coagulation such as Coumadin, aspirin, or ibuprofen. If you have questions regarding the taking of these medications around the time of your Sigmoidoscopy procedure, contact Dr. Vazquez to discuss your concerns.

Because internal bleeding may occur in your system, in general, DO NOT take aspirin or aspirin containing medications one week prior to your Sigmoidoscopy procedure.

Please contact Dr. Vazquez if you have a heart murmur, artificial heart valve, or implant. You may need to take antibiotics prior to the flexible sigmoidoscopy procedure.

Electrolyte Preparation:

Prescription required.

Most Effective Preparation:

4pm: Eat a light meal.

6pm: Drink a purgative as directed.

The names of acceptable preparation solutions:

a. Golytely [  ]

b. Nu-Lytely [  ]

c. Co-Lyte. [  ]

9 – 11pm: After the purge is complete, take one Dulcolax tablet by mouth (no prescription is needed for Dulcolax).
The purge should take effect in 4-6 hours. If this does not occur, administer a disposable enema, such a Fleets (R). If the purge seems ineffective or incomplete call Dr. Vazquez’s office.

Alternative Preparation:

7pm: Magnesium Citrate (Drink one 8 o.z. bottle. If the purge is incomplete repeat with one 8 o.z. bottle Magnesium Citrate)

1-2 hours prior to exam: Administer (2) disposable enemas and evacuate

The purge should take effect in 4-6 hours. If this does not occur, administer a disposable enema, such as Fleets (R). If the purge seems ineffective or incomplete call Dr. Vazquez’s office.

Content reviewed and updated on September 26, 2014.