Microsoft word - colono_gavilyte_ instruction, en 09-2012.doc

Preparing for Your Colonoscopy (Lower GI Endoscopy)
You have been scheduled for a COLONOSCOPY on _______________ at _______ am pm

ATTENTION: If you need to reschedule or cancel your procedure, you must call by 9:00AM three
business days before your procedure is scheduled. If you do not call before that deadline, you will be charged a $200 late cancellation fee. Please allow 3-4 hours for your procedure, including recovery time. It will be done at: ( ) Hoag Hospital Irvine, 1F GI Lab/Special Procedure Room
( ) St. Vincent Medical Center, 1F Short Stay Unit
2131 W. Third Street, Los Angeles, CA 90057 ATTENTION: Because you will be under anesthesia during your Colonoscopy, you cannot
drive afterwards. You must have someone who will drive you home. A staff member will escort
you from the facility to your driver’s car.

The better you prepare, the procedure findings will be more complete and it is less likely you will need
to reschedule or repeat the procedure. The following instruction should be followed for optimal

If you drink ALCOHOL, please stop 3 days before your procedure.
If you are taking anything listed below, please stop taking them 7 days before your procedure.
Blood Thinner medication such as COUMADIN, HEPARIN, WARFARIN, etc. IRON pills, Multi-Vitamin that includes IRON Any painkiller that includes IBUPROFIN (Advil, Excedrin, Motrin, Nuprin), NAPROXEN NOTE: you may take Acetaminophen (Tylenol).
1. Gavilyte
1 large plastic jug [4 liters]
2. Bisacodyl Tablet
2 tablets
Simethicone Gas Relief Drops, 1 oz (30ml)
small box containing 1 bottle
Clear Liquids (for you to drink the day before the procedure)
ATTENTION: Avoid RED or PURPLE colored drinks
- water, Kool-Aid (ex: lemonade or orange flavored) - carbonated drink (ex: orange soda, ginger ale, cola, sprite, seven-up, etc) - fruit juice that is clear and without pulp (ex: apple, white grape, white cranberry, orange, lemonade) - green tea, black tea, coffee (no milk or sugar) - low sodium chicken or beef bouillon soup - hard candy - Jell-O (lemon, lime, orange flavored) - ice candy, Italian ice (gelato) (**do not eat ice cream or fruit sherbet) DAY BEFORE YOUR PROCEDURE
You may drink Clear Liquids at any time & as much as you want
clear soup, boiled egg, chicken or turkey without skin, fish, white bread without butter, noodle, soft rice, tofu, Ensure 8oz (not Ensure Plus). Bisacodyl Tablet (2 tablets) with as much Clear Liquids as you want.
Add water to the Gavilyte plastic jug up to the line. Add the flavor packet. Add the entire
30ml bottle of Simethicone Gas Relief Drops. Shake well until the white powder
Drink 1/3 of the Gavilyte plastic jug between 6pm~ 7pm. You must finish in 1 hour.
DO NOT EAT OR DRINK except Gavilyte.
Drink 1/3 of the Gavilyte plastic jug. You must finish in 1 hour.

The time to drink the Gavilyte depends on your scheduled procedure time.
[Special for 2:30pm: you may drink water or clear apple juice only until 10AM]
There will be 1/3 left in the Gavilyte plastic jug. Please bring it with you to your procedure.
You can take your usual medications as long as they are not stopped before the procedure (see front page). Please take them with only a mouthful of water. Please take only 1/2 of normal
dosage for your diabetes medication.
You may also bring your medications and take them after
your procedure.
Please do not bring any valuables (jewelry, watches, etc). Please do not use any lotion or cream on your neck, chest, or stomach area. Please bring a list of your usual medications and the Gavilyte plastic jug.
Please bring your driver with you when you check-in for your procedure. You will not be You cannot work after your procedure.

If you have any questions or need to reschedule/cancel your procedure, please call ASAP.
Dr. Jun-Ichi Ohara

TEL: Irvine Office (949) 654-8963 & Little Tokyo (213) 617-7712



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