Scott d. levenson, m.d.


Digestive Care Medical Center
1000A Laurel Street, San Carlos, CA (650) 596-8118
Date and Time of Procedure:

Arrival Time:
Purpose of Procedure:
To evaluate the colon with a flexible instrument.
 Obtain the prescribed 4 liter bottle of PEG-3350 laxative (e.g. Trilyte, Golytely) with flavor packets or Crystal Light and four 5mg Dulcolax tablets from a pharmacy. Also obtain Tucks medicated
wipes if you wish to minimize irritation from wiping.
Five Days Before: Stop taking any iron, aspirin, Coumadin, Lovenox, Plavix, or NSAIDs (e.g.
ibuprofen, Motrin, Advil, Nuprin, Aleve, Naprosyn etc.). Tylenol, Celebrex, and Mobic are O.K. to take as directed. Also stop taking any Olestra containing products (e.g. Frito-Lay’s WOW chips, Pringle fat-free chips).  Two Days Before: Add one flavor packet or Crystal Light to the bottle, fill with lukewarm
water to the line, and mix well. Refrigerate.
One Day Before:
1. Drink only clear liquids the entire day (black coffee, tea, soda, water, apple juice, cranberry
juice, grape juice, Gatorade, clear broth, popsicles, and jello. No red jello. No alcohol. No solid food). 2. At noon take 2 Dulcolax tablets by mouth. At 3 pm remove the laxative bottle from the refrigerator and at 4 pm begin to drink it. Drink at least one 8-ounce glass every 15 minutes. Finish 3L (or 3/4 of the container) by 7 pm. Once completed take 2 more Dulcolax tablets by mouth and refrigerate the last 1 liter of PEG solution overnight. (Note that responses to laxatives vary; it may take anywhere from 30 minutes to 4 hours to cause diarrhea)  Day of Procedure:
1. Starting 4 hours before procedure drink remaining 1L of PEG solution (one 8oz. glass every 15min). 2. Nothing to drink for 2 hours prior to the exam. You may take any necessary medications with Please note:
 If you are diabetic or take blood thinners check with your doctor about specific instructions.  Arrange for someone to drive you home (not taxi or bus) and be prepared to be at the endoscopy center for 90 minutes. You will not be able to drive for the remainder of the day of your
 Please call the Center at (650) 596-8118 or the Office at (650) 596-8800 for any questions about the preparation or procedure. Please call 596-8800 at least one week prior to exam if you must
cancel. There is a $300 charge for procedures cancelled within 5 business days of scheduled date.
 The above procedure may result in a bill from our office, the Digestive Care Medical Center, and from a pathologist. All three of these providers may not be in your insurance company network.


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