An effective bowel preparation allows the doctor to clearly view and examine the interior lining of the bowel. Studies have shown that inadequate bowel preparation may lead to abnormalities going undetected during your Colonoscopy. The success of your Colonoscopy examination depends on the bowel being as clean as possible. Without a clean bowel the specialist may be unable to examine you thoroughly and the Colonoscopy may need to be repeated. It is extremely important to take all the medicine and follow your instructions carefully.

Unfortunately there is no magic tablet for bowel preparation. Our bowel preparation range is based on years of experience and patient feedback. During your Nurse Consultation we will perform a throughout health assessment which will assist us in determining the best preparation for you.

Yes, it is very important that you have a responsible adult with you at all times during your bowel preparation. Although most people tolerate their preparation well, some patients do become unwell and require assistance. Often people become unwell during the night when they are also tired and at risk of dehydration, this may make it harder to gain assistance if needed.

Yes it is safe to have bowel preparation during breastfeeding. Due to the additional fluid requirements placed on your body whilst producing milk, it is especially important to remain hydrated during your bowel preparation.

The drugs used during your procedure are safe to have whilst breastfeeding, however the Anaesthetist will provide you will information about when to return to breastfeeding at the time of your procedure.

Your bowel cleansing actually commences 7 days prior to your Colonoscopy - Please do not consume any nuts and seeds 7 days prior to your procedure date.

Examples of nuts and seeds include;

Almonds, Brazil nuts, cashew nuts, hazelnuts, macadamias, pecans, pine nuts, pistachios, walnuts, peanuts, pumpkin seeds, flax seeds, sesame seeds, poppy seeds, sunflower seeds, chia seeds, and any fruit which contains edible seeds such as strawberries, grapes, blueberries, tomatoes and cucumbers.

During your bowel preparation you will be required to commence a liquid diet, usually 1-2 days before your Colonoscopy. A liquid diet includes any fluids which do not contain lumps or pieces of food. Your bowel preparation process includes consuming a Free Fluid diet initially, followed by a Clear Fluid diet until your Nil By Mouth time. Maintaining Hydration is extremely important during this time, planning ahead using the guides below as well as having some sports drinks to consume during this time can assist.

What is a Free Fluid diet?

A Free Fluid diet includes all liquids which do not contain solid pieces of food. Free fluids include some thicker pureed liquids, milky drinks, and frozen liquids such as ice cream and ice lollies. Below is a general guide to foods which can be consumed as part of the Free Fluid diet;

• Milk tea, coffee, hot chocolate

• Fruit juices, cordials, soft drink, and sports drinks

• Milk shakes and smoothies (avoid fruit smoothies that may contain seeds)

• Custards and Yoghurts (avoid fruit yoghurts that may contain seeds)

• Plain ice-cream, ice lollies and frozen yoghurt

• Pureed soups such as pumpkin and tomato

What is a Clear Fluid diet?

The day prior to your procedure (usually around lunch time) you will be required to commence a Clear Fluid diet. You should be able to see through a clear fluid when pored into a glass. A Clear Fluid diet does not include milk or milky products. We also ask that during your Clear Fluid diet you avoid liquids with red food colouring as this may stain your bowel altering the appearance during Colonoscopy. Below is a general guide to foods which can be consumed as par of the Clear Fluid diet;

• Black tea, black coffee, herbal & fruit teas

• Fruit juice without pulp, cordials, soft drink and sports drinks (avoid red food colouring)

• Jellies and ice-lollies (avoid red food colouring)

• Clear broths, consommés, and soups (e.g. stock cube or Bovril in hot water or flavoured instant noodles with noodles removed)

Do you have any tips for staying hydrated?

It is extremely important to follow your instructions to avoid dehydration during your bowel preparation. Although the large volumes of fluids indicated in your instructions may seem overwhelming, this is the minimum fluid intake requirement to ensure an effective bowel prep and to avoid becoming dehydrated. Some other tips which may help include;

• Be prepared, read through the above list of allowed liquids and ensure you have a plan for your bowel preparation diet

• Stock up on sports drinks such as Hydralyte, Poweraid and Gatorade (avoid the red coloured flavours)

• During the night have a glass of fluids each time you go to the toilet

• If you are struggling take a break, take sips, or use a straw

• If you become nauseated or vomit see our tips under "What if I can't finish my prep?"

The term nil by mouth; often shortened to NBM, is used to tell you when to stop drinking any fluids prior to your procedure. This is usually 3 hours before your Colonoscopy. It is very important to ensure that you do not have anything to drink after this time.

How does bowel preparation work?

Bowel preparation works different on each person, however the desired outcome is always the same. Bowel preparation causes evacuation of the contents of your bowel through the passing of frequent bowel motions. In addition to emptying your bowel, the large volumes of fluid flush and clean the bowel lining.

A common question that our Pre-Assessment nurses hear is "When will I start passing bowel motions, and how many times will I need to go?". Although this varies from person to person it is advisable to plan to be at home or where-ever you are are going to complete your bowel prep when you begin to drink the provided solution. If you have been given tablets to take before your solution this may have some effect, however is less likely to cause frequent loose motions.

You can expect to take around 20 trips to the bathroom during the preparation period. These will usually begin as normal formed stools, progressing to watery diarrhoea, and finally a clear yellow liquid.

Most people tolerate bowel preparation very well with only minor discomfort, however others can find the process more challenging. Stomach cramps, nausea and vomiting are the most common issues that patients experience. Usually stomach cramps can be managed with a heat pack and over the counter pain medication. There are a number of techniques and strategies to avoid Nausea and vomiting, such as drinking through a straw, cooling the preparation solution and medication management. This information will be provided at your Nurse Consultation, or see the "What should I do if I'm struggling to finish my preparation?" section of this page.

The other reason people may feel unwell whilst taking their preparation is due to dehydration, causing headache and dizziness. It is extremely important to ensure that you follow your instructions, and to note that the volume of fluid on your instructions is the minimum required to ensure a clean bowel and to maintain hydration. If you experience a headache you can take over the counter pain relief that you would normally have to treat a headache. Please do not take any medication after your Nil By Mouth time. If you arrive for your appointment feeling dehydrated or have a headache, please let our Nurses know on admission as we can provide treatment for this.

If at any time you need further advise please call us;

On (07) 3801 2220 or (07) 3806 1689 - outside of office hours calling this number will provide you with the URGENT ON-CALL DOCTOR.

The main two reasons patients may struggle to finish their preparation are the amount of volume they need to drink and nausea and vomiting. Some tips that can be beneficial are listed below;

• Drink through a straw

• Cool the preparation in the fridge prior to drinking

• Take a break, or take regular sips instead of full glasses

• If you have been provided with anti-nausea medication take as directed

• Have a hot drink especially Ginger or Peppermint tea

If the tips above don't help and you need further advise, please call us;

(07) 3801 2220 or (07) 3806 1689 - outside of office hours calling this number will provide you with the URGENT ON-CALL DOCTOR.

If you have been unable to finish all your preparation you may be required to come in for your procedure earlier. If you are unwell we will be able to provide you with care needed to assist you in completing your bowel preparation. It is important that you call us as soon as possible so that we are able to ensure you are ready for you procedure.

Please call us as soon as possible;

(07) 3801 2220 9AM-3:30PM

(07) 3806 1689 URGENT AFTER HOURS ENQUIRES WITH THE ON-CALL DOCTOR

As you progress through your bowel preparation you should find that your bowel motions become more watery and clear. A good result is when your bowel motions are free from solid particles and appear a clear mid to dark yellow colour (similar to urine). See the below chart;

If you have finished your preparation and are concerned that you may not be clean enough please call us for advise as soon as possible as we may be able to admit you earlier for further preparation before your procedure.

Please call (07) 3801 2220 or (07) 3806 1689 - outside of office hours calling this number will provide you with the URGENT ON-CALL DOCTOR.

Most people are able to return to a normal diet immediately following their procedure. You will be given something to eat and drink during your recovery period at the facility. If for any reason you are unable to return to eating normally following your procedure, you Doctor will speak to you about this.