What Color Should Your Poop Be After Colonoscopy Prep

Elliot Endoscopy Center

Elliot at River's Edge
185 Queen City Avenue
Manchester, NH 03103

Phone: 603-663-4601

Hours: Monday through Friday: 7:00 a.m. to 3:30 p.m.

What To Expect:

Colonoscopy

Overview: The Basics
A colonoscopy is a visual examination of the entire large intestine (colon) using a lighted, flexible colonoscope. To be certain you are comfortable and relaxed, you will be sedated through an I.V. Most people are asleep during the entire procedure and remember little to nothing about it. Your heart rate, breathing and blood pressure are monitored throughout the procedure.

What to Expect: During the Screening
When it's time to start the screening, you will be asked to lie on your left side. Once sedation takes effect, the colonoscope is inserted through the rectum and navigated gently around the bends of the colon. As the colonoscope makes its way through the colon, the physician evaluates the lining of the colon for any abnormalities. Typically, the physician looks all the way to the end of the large intestine, and back, for anything unusual. The entire procedure generally takes between 15 and 30 minutes. When complete, your nurse will take you into a recovery area, where the sedation quickly wears off. Before you leave you will be made aware of your exam results and any pending pathology. The findings along with written discharge instructions will be sent home with you.

What can be found?
If polyps (abnormal growths of tissue) are found, your doctor can perform a biopsy immediately. Since most colon cancer starts as a benign polyp, when a polyp is removed the possibility of it turning into cancer is removed as well. The biopsy involves passing an instrument through the scope to remove the polyp, which is then sent to a laboratory to be analyzed.

You will feel nothing when a biopsy or polyp is taken, and there will be no residual pain afterwards. While the overwhelming majority of polyps are harmless, polyps are always sent to the lab afterwards for analysis. After the procedure is complete you may experience some flatus, or gas that we will encourage you to expel. The gas or air in your intestine is air we used to gently inflate the colon to ensure thorough viewing and has no odor.

What happens afterwards?
The sedation wears off quickly, once you are awake and alert you will be offered a snack and your discharge instructions will be reviewed. Even though you will feel fine, the lingering, subtle effects of the sedation will make it dangerous for you to drive, so a responsible adult must accompany you home. You should be able to resume normal activity the next day.

How to Prepare

Thorough cleansing of the entire bowel is essential for a thorough evaluation. Instructions for doing this will be given by your physician (see Bowel Prep).

If you take Coumadin (Warfarin), Plavix, Aggrenox, Ticlid, Lovenox or any other prescription blood thinner you MUST contact your primary care physician or the physician that prescribed the medication to you for instructions on IF and WHEN to stop the medication.
If you take insulin or oral diabetes medication, you must contact your prescribing physician for advice on adjusting your medication dosing.
You may continue your routine medication before the procedure unless listed above.
You may resume your diet as usual after the procedure.

To avoid dehydration, patients should drink clear, fat-free bouillon or broth, gelatin, strained fruit juice (no grape juice or any liquid with red color), water, plain and unsweetened coffee or tea, or soda. Unless otherwise instructed, continue taking any regularly-prescribed medication. Your physician may also ask you to stop taking iron preparations a few weeks before the test if you are on them. Finally, you need to arrange for someone to drive you home afterward because lingering, subtle effects of the sedation will make it unsafe for you to drive until the next day.

Your doctor will also want to know if you have heart disease, lung disease, or any medical condition that may need special attention.

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Bowel Prep
Nulytely Colonoscopy Bowel Preparation for Constipation

Colonoscopy Information

Insurance Coverage
Please know your insurance guidelines and check your insurance benefits. If your insurance requires a PCP authorization (insurance referral), please be sure our office has received this prior to your procedure to prevent any unnecessary out-of-pocket expenses for you. Also, not all insurance policies cover screening colonoscopies. For instance, if you are under 50 years old and/or have PPO insurance, this procedure may not be covered. Every insurance is different; please contact customer service for your insurance plan to check your benefit coverage.

Nulytely Colonoscopy Bowel Preparation for Constipation
Purchasing bowel preparation:
Get your prescription for Nulytely filled at your local pharmacy. You may use the flavor packets that come with it, or you may purchase Crystal Light powder for flavoring (no red, blue or purple colors). Allowable colors include yellow, orange or green.

Purchase 6 Dulcolax tablets (NOT suppository or stool softener). You will need 6 TABLETS for the prep. These are available over the counter and do not need a prescription. Generic is OK.

7 days prior to colonoscopy:
Stop Iron supplements and/or multivitamins that contain Iron.

Stop fiber supplements such as Metamucil, Benefiber or Citrucel.

You may continue taking all of your usual laxative/bowel medications per your routine.

If you are diabetic, call your prescribing doctor to determine how your diabetes medicine (pills or insulin) should be taken the day of the procedure.

If you are on prescription blood thinning medications, you must call the prescribing doctor and have a plan for these medications (Coumadin, Warfarin, Plavix, Xarelto, Pradaxa, Effient, or equivalent).

2 days prior to colonoscopy:
Drink as much clear fluids as you can to keep yourself well hydrated.

REVIEW bowel prep instructions.

Arrange and confirm your transportation to and from your appointment. You CANNOT drive the day of your procedure because of the sedating medications.

Begin low residue/ low fiber diet

AVOID: fresh and dried fruit, all vegetables, raisins, nuts, seeds, cloves, popcorn, beans and any other meat besides what is listed below

ALLOWED: soup, fish, chicken, eggs, white rice, white bread, crackers, plain yogurt, pasta, potato with no skin, gelatin, broth, bouillon, all liquids

In addition to your own treatment for constipation…
At 5PM take 2 Dulcolax tablets with a full glass of water. This should cause you to have a bowel movement within 6 hours. Due to your chronic constipation, the additional laxatives will help you get a better result from your bowel preparation which is very important for a high quality exam.

The day before your colonoscopy:
ONLY CLEAR LIQUIDS ALL DAY – NO FOOD. Anything other than clear liquids will impair the quality of the prep and the quality and safety of the colonoscopy. You may have clear liquids up until 3 hours prior to your procedure time.

Drink at least 8 glasses of water or clear liquids. It is important to drink a lot of fluids the day before the procedure, as the preparation is very dehydrating. The more you drink, the better you will feel.

Allowed: Clear liquid is any liquid that you can see through. This includes water, clear broth or bouillon, black coffee or black tea (sugar is ok to add). Gatorade, Powerade or vitamin water that is clear, yellow, orange or green are all OK. Lemonade, carbonated soft drinks, apple juice, white grape juice, white cranberry juice are all OK. Jello, and popsicles are allowed if they are yellow, green or orange colored.

Avoid: All solid foods, milk and milk products, any item with red dye. RED, BLUE, and PURPLE colored items are NOT allowed. Limit coffee and tea as they dehydrate you. Avoid alcohol as it dehydrates you.

In the morning, add water up to the fill line of your Nulytely bottle. Add the flavor packets or Crystal Light. Stir/shake until the entire contents are completely dissolved. Chill the mixture if desired. You will drink this later today.

At 1pm take 2 Dulcolax tablets with a large 8 oz. glass of water.

At 3pm take 2 more Dulcolax tablets with a large 8 oz. glass of water.

At 5pm Begin drinking the Nulytely solution. You should drink half of the solution tonight within a 2-3 hour time period. Drink one glass every 15 minutes. Drink each glass quickly, rather than drinking small amounts continuously. Refrigerate the remaining half of this solution. You will finish drinking this tomorrow morning.

Individual responses to laxatives vary. You may feel bloated, nauseated, or have abdominal cramping while drinking the solution; this is temporary and will improve once you start having bowel movements. If you feel ill, stop drinking for 30 minutes and then resume drinking at a slower rate. Walking around between drinking each glass can help with bloating. Bowel movements usually start within 2 hours of ingestion, but may take longer.

The day of your colonoscopy:
No Broth 8 hours prior to your arrival time or your procedure may be cancelled.

5 hours prior to your procedure time, shake up the remaining half of the Nulytely solution. Begin to drink and finish the rest of the jug within 2 hours.

3 hours prior to your procedure time, you may take only these medications with a small sip of water:

Daily narcotic

Anti-anxiety

Blood pressure/cardiac medication

Seizure medication

Asthma inhalers

After taking your medications, nothing by mouth, EVEN WATER, 3 hours before your procedure time or else your procedure WILL be cancelled!!

If you continue to pass thick, brown liquid or solid bowel movements, please call our office early in the day to discuss if you are adequately prepared. The best results should include passing only clear yellow liquid.

Important Information
You will receive intravenous sedation during this procedure. You will be monitored throughout the entire case. The medications used during the procedure although relatively short acting, have subtle, prolonged effects on your reaction/judgment time, thought processes, and wakefulness. You must, therefore, adhere to the following guidelines:

You must not drive at all the entire day of your procedure. It is required that a responsible adult must be present at the time of discharge to drive you home.

Please wear glasses; do not wear contacts.

Leave all jewelry at home, including body piercings.

It is okay to brush your teeth and wear dentures.

Please bring a complete list of medications you are currently taking to the facility with you.

Please allow for 2 hours at the facility.

No taxi's or public transportation unless accompanied by a responsible adult.

You may NOT walk home.

If you have small children, arrangements should be made for their care for the entire day

Do NOT make any important decisions for the entire day of your procedure.

Please have a responsible adult stay with you after your procedure. You should not be left unattended.

We fully expect you will be able to return to your normal activities the day after your procedure, i.e., return to work and drive.

You will receive a call from one of our nurses a few days before your procedure to review your health history and answer any questions you may have. This will also help stream line the admission process the day of your procedure.

If you develop a fever, rash, cough or flu-like symptoms in the days leading up to your procedure, please notify our office immediately.

Please call Elliot Gastroenterology at (603) 314-6900 with any questions!

Did you know??

There are two types of polyps: Hyperplastic – these polyps are benign and the most commonly found. Usually pose no cancer risk. Adenomatous – these polyps are also benign but have the potential to turn cancerous over time (i.e., are PRE CANCEROUS).

One patient every 4 minutes is diagnosed with colon cancer in the U.S.

For most people, colon cancer is preventable by having any and all polyps removed before they have a chance to become cancerous.

Most often there are no symptoms that someone has developed colon cancer.

All polyps are removed or biopsied via a snare then cauterized and retrieved through suction or using a grasping device.

Colon cancer is the 2nd leading cause of death from cancer in the U.S. today and it affects men and women equally of all races. Colon cancer is found in all segments of the colon.

A colonoscopy test is 96% accurate for the detection of polyps and colorectal cancer. The polyps that are missed are typically small and are expected to be caught on the subsequent screening exam. The recommended interval for your next exam will be sent to you in a letter in 1-2 weeks with the final results of your exam.

Frequently asked questions:

Why avoid red liquids? The red color can persist in the colon and potentially look like blood, obscuring visualization of polyps.

One of the medications I was instructed to take the morning of my procedure is red. Can I take it? The medications that are listed in your instructions should be taken the morning of your exam, regardless of the color.

I feel like vomiting and do not think I can drink any more. What should I do? It is important that you continue to drink the solution if possible. Without a clean bowel, the doctor will not be able to thoroughly see inside of your colon to complete the examination. You can stop drinking for 30 minutes, then resume. If you do vomit, wait 30-60 minutes then begin drinking the solution again. If not improved, call us and have a phone number of an open pharmacy in case we need to call in a prescription.

I drank a lot of the solution and have not gone to the bathroom yet. What should I do? Keep drinking and be patient. Move around a bit. Most people have a bowel movement after an hour; however, some patients may take several hours.

I am taking the prep and now having loose, watery stool. Do I still need the rest of the prep? Yes, you may have solid stool higher in the colon that needs to be eliminated.

I already have diarrhea before taking the prep, do I still need to take the laxative? Yes, you must take the entire prep. Your colon is approximately six feet long. The entire colon must be emptied for your physician to see the colon clearly.

I see yellow color in the toilet bowl and a few flecks. What do I do? If you drank the entire solution or if your last bowel movements were clear enough that you were able to see the bottom of the toilet, you should be fine. It is okay if you have some flecks of material. The yellow color is a result of bile that normally colors the feces. This should not interfere with the examination.

Can I drink alcoholic beverages? Alcoholic beverages can cause dehydration and some wines thin your blood, therefore, we strongly suggest that you do not drink any alcoholic beverages prior to your procedure.

Can I chew gum or suck on candy? Yes, only up until 4 hours prior to your procedure time and nothing with soft centers or red color.

What if I am still passing stool the morning of the test? You may use a Fleets enema. Follow the instructions on the packaging. If this does not work, please call the office.

Can I brush my teeth? Please do. You may brush your teeth and rinse your mouth without swallowing.

Can I wear my dentures? Yes, you may wear dentures to the endoscopy suite. However, if you are having an EGD as well as a colonoscopy, you may be asked to remove them prior to the procedure.

What can I take for headaches and pain relief the night before and morning of the procedure? You may take Tylenol (acetaminophen) as directed.

Can I have chicken soup? You can have broth up until 8 hours before your procedure; no noodles, chicken or vegetables are allowed.

Can I have the colonoscopy if I am on my period? Yes, the procedure can still be performed. We ask that you use a tampon if possible but it's not absolutely necessary.

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Miralax Colonoscopy Bowel Preparation

Colonoscopy Information

Colonoscopy Bowel Preparation
You need to buy the following (no prescription necessary):

Miralax powder 238 grams (8.3 ounces) or generic- polyethylene glycol 3350

Miralax powder 119 grams (4.1 ounces) or generic- polyethylene glycol 3350

Dulcolax tablets (NOT suppository or stool softener, you will need 4 TABLETS for the prep).

One 64 oz. bottle and one 32 oz. bottle of Gatorade, Propel, Vitamin Water, Crystal Light or other noncarbonated clear liquid drink (no red, blue or purple colors). Allowable colors include: clear, yellow, orange or green. Gatorade is recommended as it has added electrolytes. Refrigerate your clear liquid if you prefer to drink it cold.

7 days prior to colonoscopy:
Stop Iron supplements and/or multivitamins that contain Iron.

Stop fiber supplements such as Metamucil, Benefiber or Citrucel.

If you are diabetic, call your prescribing doctor to determine how your diabetes medicine (pills or insulin) should be taken the day of the procedure.

If you are on prescription blood thinning medications, you must call the prescribing doctor and have a plan for these medications. (Coumadin, Warfarin, Plavix, Xarelto, Pradaxa, Effient, or equivalent)

2 days prior to colonoscopy:
REVIEW bowel prep instructions.

Arrange and confirm your transportation to and from your appointment. You CANNOT drive the day of your procedure because of the sedating medications.

Begin low residue/ low fiber diet

AVOID: fresh and dried fruit, all vegetables, raisins, nuts, seeds, cloves, popcorn, beans and any other meat besides what is listed below

ALLOWED: soup, fish, chicken, eggs, white rice, white bread, crackers, plain yogurt, pasta, potato with no skin, gelatin, broth, bouillon, all liquids

The day before your colonoscopy:
ONLY CLEAR LIQUIDS AFTER 8AM. Anything other than clear liquids will impair the quality of the prep and the quality and safety of the colonoscopy. You may have clear liquids up until 3 hours prior to your procedure time.

Breakfast is to be eaten before 8am – you may have up to 2 eggs any style and 2 pieces of white toast (butter okay) OR 1 cup plain or vanilla yogurt (no seeds, berries/fruit, nuts) and 1 banana. Coffee or tea with cream or milk is ok prior to 8am.

Starting at 8am drink ONLY clear liquids throughout the entire day-NO MORE FOOD! Drink at least 8 glasses of water or clear liquids. It is important to drink a lot of fluids the day before the procedure, as the preparation is very dehydrating. The more you drink, the better you will feel.

Allowed: Clear liquid is any liquid that you can see through. This includes water, clear broth or bouillon, black coffee or black tea (sugar is ok to add). Gatorade, Powerade or vitamin water that is clear, yellow, orange or green are all OK. Lemonade, carbonated soft drinks, apple juice, white grape juice, white cranberry juice are all OK. Jello, and popsicles are allowed if they are yellow, green or orange colored.

Avoid: All solid foods after 8am, milk and milk products, any item with red dye. RED, BLUE, and PURPLE colored items are NOT allowed. Limit coffee and tea as they dehydrate you. Avoid alcohol as it dehydrates you.

In the morning, in a pitcher mix the entire 8.3 oz. of Miralax with the 64 oz. of Gatorade. Stir/shake until the entire contents of Miralax are completely dissolved. Chill the mixture if desired. You will drink this later today.

At 1pm take 2 Dulcolax tablets with a large 8 oz. glass of water.

At 3pm take 2 more Dulcolax tablets with a large 8 oz. glass of water.

At 5pm Begin drinking the Miralax/Gatorade solution. You should drink the entire 64 ounces within a 2-3 hour time period. Drink one glass every 10-15 minutes.

Drink each glass quickly, rather than drinking small amounts continuously.

The day of your colonoscopy:
No Broth 8 hours prior to your arrival time or your procedure may be cancelled.

4 hours prior to your procedure time, mix the entire 4.1 oz. bottle of Miralax into a pitcher and add 32 ounce container of Gatorade. Shake or stir well. Drink and finish the 32 ounces within 1 hour.