Date of Operation________________________________________
Time to report to 5th Floor Galter ASU (ambulatory surgical unit)________
For the purposes of safety, a thorough, cleansing of the colon is required. Early preparation consists of modifying dietary intake starting 72 hours before the procedure.
THREE DAYS PRIOR TO SURGERY: Date:____________
Begin to remove hard-to-digest items from your diet. Examples of such 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.
TWO DAYS PRIOR TO SURGERY: Date: _______________
Further decrease dietary intake of any roughage and begin to eat a more liquid diet. Foods such as jello, juices, cereals, breads and pastas or noodles are examples of such food.
4 PM: Eat a light meal.
6 PM: Drink the purgative as directed.
The names of acceptable preparation solutions:
a. Golytely [ ]
b. Nu-Lytely [ ]
c. Co-Lyte [ ]
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.
8AM: Fleets Phosphosoda (mix 1.5 oz in 4 oz water)
12PM: Fleets Phosphosoda (mix 1.5 oz in 4 oz water)
6PM: Fleets Phosphosoda (mix 1.5 oz in 4 oz water)
1-2 hours prior to exam: Administer disposable enemas
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.
ONE DAY PRIOR TO SURGERY: Date:__________________
8AM: Clear liquids for breakfast.
12PM: Clear liquids for lunch.
1 PM: Take two Neomycin tablets and one Flagyl tablet.
2PM: Take two Neomycin tablets and one Flagyl tablet.
6PM: Clear liquids for dinner.
11 PM: Take two Neomycin tablets and one Flagyl tablet. Drink two medium bottles of Gatorade® or other electrolyte containing sport beverage during the day.
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 exam, ask Dr. Vazquez about these issues.
In general do not take aspirin or aspirin containing medications for 2 weeks prior to your operation. Internal bleeding might occur if aspirin is in your system.
Clear Liquid Diet
These items are allowed:
- Water, Sodas, Tea or Coffee
- Clear Broths: Chicken broth, Beef broth
- Juices: Apple juice or cider, Prune juice, Grape juice, Grapefruit juice (strained), Cranberry juice, Tang, Hawaiian Punch, Lemonade (strained), Kool Aid
- Clear Jello (without fruit)
- Popsicles (without fruit/without cream)
- Italian Ices
- Salt, pepper, and sugar may be used.
These items are not allowed:
- Milk Orange juice Cream soups
- Cream Tomato juice Any soups other than clear broth
- Milkshakes Oatmeal
- Cream of Wheat
You are allowed unlimited amounts of clear liquids until 10:00 pm of the night prior to your surgery. You should drink as much fluid as possible until 10:00 pm to prevent dehydration from the laxatives prescribed.
Anything you can hold up to the light and see through is considered a clear liquid.