Please read and follow ALL instructions carefully from the given sheet and put [x] on your accomplishments below:
Several days before your procedure you must fill your prescriptions
[ ] SUTAB (sodium sulfate, magnesium sulfate, potassium chloride) 24 tablets in 2 doses (12 tablets each)
Note: Medication works differently with each person. This medication will cause multiple bowel movements; this medication often works within thirty (30) minutes, but may take as long as three (3) hours; Please stay near toilet facilities.
The day before your procedure:
[ ] You may have “CLEAR LIQUIDS” ALL day. Nothing else!
What is considered a “clear liquid”?
Strained Fruit Juices (you can see through) (apple, white grape, lemonade), water, clear soup or bullion, coffee or tea (WITHOUT milk or non-dairy creamer), Gatorade, carbonated and non-carbonated soft drinks, Kool-Aid ( or other flavored drinks). Plain Jell-O (without added fruits or toppings), ice Popsicles.
REMEMBER..DO NOT EAT OR DRINK ANYTHING RED! The red dye in foods will cause changes in the color of your intestine, which may cause a problem with the test.
[ ] At 4:00 PM, open 1st bottle of SUTAB (12 tablets), fill the provided container with 16 ounces of water (up to the fill line). Swallow 1 tablet every 1 to 2 minutes. You should finish the 12 tablets and the entire 16 ounces of water within 20 minutes.
[ ] Approximately 1 hour after the last tablet is ingested, fill the provided container again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.
[ ] Approximately 30 minutes after finishing the second container of water, fill the provided container with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.
The Day of Procedure: 5 to 8 hours prior to your colonoscopy and no sooner than 4 hours from starting the 1st Dose
[ ] Swallow 1 tablet every 1 to 2 minutes, and finish the 12 tablets with the entire 16 ounces of water within 20 minutes.
[ ] Approximately 1 hour after the last tablet is ingested, fill the provided container again with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.
[ ] Approximately 30 minutes after finishing the second container of water, fill the provided container with 16 ounces of water (up to the fill line), and drink the entire amount over 30 minutes.
[ ] My bowel preparation quality is clear and I am ready for the Colonoscopy!
[ ] After the preparation, DO NOT EAT OR DRINK until after the colonoscopy procedure is finished.
If your mouth is parched/ dry, the best way to help is to brush your teeth. This will help you feel more comfortable.
If you have any questions at all, no question is a “dumb” question, please call Ambulatory Surgery (718) 883-2331 and we will help you and clarify your questions.
