Durham Gastroenteroloy David Tendler, MD

www.durhamgi.com Scott Brazer, MD Durham Gastroenteroloy David Tendler, MD 919/806-8322 COLONOSCOPY PREPARATION INSTRUCTIONS Bowel Preparation with Miralax and Dulcolax

You have been scheduled for a colonoscopy at Durham Regional Hospital / Triangle Endoscopy Center Suite 210 on ______at ______am/pm. A colonoscopy is a visual examination of the lining of your large intestine. A colonoscope, a long flexible telescope, is passed through the rectum and around the colon. It is extremely important that your bowel be empty so that you will have a successful exam. Any stool left in the intestinal tract can hide important conditions that may be present. Please follow the preparation instructions exactly as given. An examination as important as this requires careful preparation. We realize no laxative preparation is fun. However, this solution has been developed to make your preparation as simple and effective as possible. PLEASE READ ALL INSTRUCTIONS.

TEN DAYS BEFORE EXAM  Do not take aspirin or aspirin products; NSAIDS (such as Motrin, ibuprofen, Advil, Aleve); Plavix; iron supplements; Ginkgo or vitamin E.  If you are a diabetic or on anti-coagulants (Coumadin, heparin, Lovenox) please call our office to receive instructions for your medication dosage.  Please notify us if you have an internal defibrillator device or latex allergy.

FIVE DAYS BEFORE EXAM  Maintain a high fiber diet.  Avoid corn, peas, beans, popcorn, nuts, seeds and roughage.  Avoid foods processed in Olestra or Olean. (for example: Fat Free Pringle potato chips)

ONE DAY BEFORE THE EXAM You will need to purchase from the pharmacy: (4) Dulcolax 5 mg oral laxative tablets (not suppositories), one 238 gram bottle of Miralax (available without a prescription), and a 64 oz bottle of Gatorade or Crystal Light . Refrigerate the bottle of Gatorade or Crystal Light, as the solution is more palatable if cold. **Diabetic Patients please use Crystal Light** Drink only clear liquids for breakfast, lunch and dinner. Clear liquids include strained fruit juices without pulp (apple, white grape, lemonade), water, clear broth or bouillon, coffee, tea, Gatorade, sodas, jello, and ice popsicles. Not allowed: Solid foods , milk or milk products, red or purple liquids. 3:00pm -Take 4 Dulcolax 5 mg oral tablets 5:00pm -mix 238 gram bottle of Miralax in 64 oz of Gatorade or Crystal Light. Shake or stir the solution until the Miralax is dissolved. Drink an 8oz glass every 10-15 minutes until the solution is gone. If you become nauseated, please slow down drinking the solution and the nausea should pass. 7:00pm – 9:00pm-drink at least 8 fl.oz of clear liquid every hour Please note that the more clear liquid that you are able to drink, the more likely you are to have a good preparation. Nothing To Eat Or Drink After Midnight, unless your appointment is after 1:00 PM, in which case you can have clear liquids up until 4 hours prior to the examination.

DAY OF EXAM You may take Heart Medications including Blood Pressure Medication as directed by your Physician. If your exam is after 1:00 pm, you may drink clear liquids up until 4 hours prior to the examination. Come with a responsible adult over 18, to drive you home and stay with you during colonoscopy. Arrive one hour before your scheduled time. The procedure itself takes 30-45 minutes. You should plan to be at the endoscopy unit three hours. OVER  NOTICE TO MEDICARE PATIENT

Medicare guidelines state that a screening colonoscopy less than 47 months (3 years, 11 months) after a screening flexible sigmoidoscopy or screening colonoscopy in an individual not at high risk will not be paid for by Medicare.

If you have any questions please call Durham Gastroenterology Consultants, PA (919)806-8322 Durham Gastroenterology consultants, PA will bill your physician fee. One of the below facilities will bill for your facility fee.

FOR YOUR PROCEDURE PLEASE REPORT TO

Triangle Endoscopy Center Durham Regional Hospital 249 East NC highway 54 3643 N. Roxboro Road Suite 210 Durham, NC 27704 Durham, NC 27713 (919) 470-4000 (919) 544-4887

Triangle Endoscopy: Durham Regional: The current entrance is 1 Please report to outpatient registration. block north of highway 54. Off Fayetteville Road turn onto Crooked Creek Parkway (at the Walgreen’s). Take the first driveway on the right. Follow the driveway around to the front of the building. Enter the main entrance in the center of the building. Proceed past the elevators, turn right and enter suite 210 on the right.

For additional location information refer to Website www.triangleendoscopy.com Or Call: (919) 544-4887

6/2008