How to take a bowel prep for theatre

Why do I need to have this medicine?

You are due to have a procedure that requires a specialist doctor to have a look inside your colon (intestine) using an endoscope: a small, flexible camera. So that the doctor can see the lining of your intestine clearly, a special medicine is required to clear your bowel of stools (poo).

What medicine do I have to take?

There are 2 types of medicine that the doctor will have prescribed for you to take at home. The medicines are called Senokot and Picolax. These medicines have to be taken at specific times before the intended procedure. For a couple of days before you come to hospital, make sure that you eat a low fibre diet as this will help the medication to clear your bowels more easily. A few suggestions of foods which you are allowed to include are:

How will I feel when I take this medicine?

This medicine is to clear your intestine of poo. Therefore, within a couple of hours of starting your bowel prep, you will start to go to the toilet regularly. You may find that you have tummy cramps, this can be reduced by taking the Picolax at a slower rate. Sometimes the medicine makes you feel sick or even be sick. If for any reason you have not been able to take the full amount of bowel prep medicine, or have vomited after taking it, it is very important that you tell the nurse this when you arrive at hospital. In this instance you may be offered a different form of medication in hospital to clear your bowels out so that the procedure can go ahead.

What should I do if I haven’t got a prescription for my bowel prep medication?

If you haven’t been given a prescription for your bowel prep medications please contact the gastro nurses as soon as possible so that we can arrange this for you.

What should I do if I have been asked to come into hospital for my bowel prep?

For young patients, patients who have a long distance to travel or patients with other underlying medical conditions it may be necessary for you to come into hospital the day before theatre to have your bowel prep. If this is the case your doctor should have discussed this with you and you will receive an appointment letter to come into hospital from the waiting lists team. You can continue to eat and drink as normal until you get to the hospital. The ward nurses will give you your doses of bowel prep on the ward and give you instructions about when to stop eating and drinking (these will be at roughly the same times as listed in this resource depending on when you are going to theatre).

Do I have to stop any medications in preparation for my procedure?

If you are on any iron supplements, medicines containing codeine or Loperamide you may be asked to stop taking these before you start taking your bowel prep. Your doctor will advise you about when to stop these.

How do I take my medicine?

Picolax comes in 10mg sachets and Senokot comes in tablet form or syrup. You may find that when you add water to the Picolax powder, it becomes warm. Leave it to cool before taking it. You can add squash to flavour the Picolax if you would like to. The pharmacist dispensing you medicine will explain to you how much of each medicine you should take. If you get home and you need some more information, contact the gastroenterology nurses using the contact details at the end of this resource.

When do I need to take my Senokot and Picolax?

If you have been asked to come to the hospital for 8am

You need to make sure that you start your bowel prep medication the day before the procedure. This means you have to take a dose of Senokot and a dose of Picolax at approximately 2pm. You will need to repeat this again at approximately 10pm on the same day. Once you have taken the first dose of your bowel prep you must not have anything else to eat until after your procedure. However, it is very important that you drink plenty of clear fluids (water and diluted squash). You can drink clear fluids until 6.30am on the day of the procedure. After this time you can have sips of plain water until you arrive on the ward.

If you have been asked to come to the hospital for 12pm

In preparation for the procedure, you need to make sure that at approximately 6pm the day before your procedure, you take a dose of each medicine and repeat this the next day at approximately 6am on the day of the procedure. Once you have taken the first dose of your bowel prep you must not have anything else to eat until after your procedure. However it is very important that you drink plenty of clear fluids (water and diluted squash). You can drink clear fluids until 11.30am on the day of the procedure. After this time you can have sips of plain water until you arrive on the ward.