Gastroenterology

Colonoscopy

Thank you for choosing Tufts Medical Center's GI Motility Service. We have provided the below instructions to ensure that your time in our care is as pleasant and safe as possible. Please read all instructions carefully before your colonoscopy procedure as these directions are critical to your health and safety. Failure to follow these directions may lead to a cancelled colonoscopy.

The procedure and what to expect

A colonoscopy is an examination of the colon (large intestine) with a flexible instrument called a colonoscope. The colonoscope has a light at the end of the device with a camera to allow direct visualization of the colon lining.

A colonoscopy is performed to evaluate symptoms of diarrhea, constipation, rectal bleeding, lower abdominal pain, or to screen for colon cancer and colon polyps (growths in the colon). The colonoscopy is performed by a doctor (gastroenterologist) trained in endoscopy. The colonoscopy is performed after ingesting a laxative solution which will cleanse the colon. You will be given medication prior and during the procedure to make you comfortable.  Most patients fall asleep or nap, and you will most likely have little or no awareness of the procedure.

Planning for your appointment

The Tufts Medical Center GI Motility Unit is located on the third floor in the Proger building. To find information on directions, parking and our campus map, visit the hospital locations and directions page >

Plan to spend about three hours in our unit for your procedure. We will do everything possible to avoid a delay, but emergencies may interrupt the schedule. Please arrive 60 minutes (1 hour) prior to the scheduled procedure time.

What to bring to a colonoscopy

When preparing to come to the Medical Center for your appointment, please be sure to bring:

  • Photo ID
  • List of current medications and allergies and your completed medical questionnaire
  • Insurance referral, if required by your insurance company.
  • Name, address, phone, and fax number for the doctor(s) you wish to receive a copy of the report 
  • Name and phone number of a responsible adult who will bring you home

Please leave all valuables at home.

Please arrange for an adult escort, 18 years or older, to take you home after the procedure. You will be receiving sedation, and you should not drive until the next day. Your escort does not have to come with you when you check in but MUST meet you in the Endoscopy Unit on Proger 3 when you are ready to go home. You are still required to have an adult escort, 18 years or older, if you plan to take the T, taxi, ride sharing service, THE RIDE, or are walking home. If you do not have an escort on the day of your procedure, your procedure will be CANCELLED and RESCHEDULED.  

*If you are above 60 years of age and need an escort home, volunteer escorts may be available if scheduled 2 weeks in advance. 

Preparing for the procedure

NINE DAYS before your procedure

  • Buy clear liquids for your CLEAR LIQUID DIET. The clear liquid diet starts the day before your procedure.

Drinking only clear liquids will be a required part of your procedure’s preparation. A clear liquid is anything you can see through such as water, tea, black coffee, clear broth, apple juice, Gatorade, or Jell-O (not red!). DO NOT DRINK milk, cream, dairy products, alcohol (including white wine), or red/purple liquids during this diet.

  • Buy food for your LOW FIBER DIET.  The low fiber diet starts 5 days before your procedure

This diet is 4 days long and starts 5 days before your procedure. On this diet, you cannot eat corn, raw vegetables (for example: carrots, broccoli, lettuce, celery, cucumbers, etc.), SEEDS OR NUTS, or take fiber supplements (Metamucil).

  • Buy items to make prep easier, like baby wipes to help with irritation and Crystal Light (not red in color) or Ginger ale to make the prep taste better.
  • If you have constipation, take narcotic pain medications, or you previously had a colonoscopy and you were told that your colon was not well cleaned out, your preparation for the procedure will require that you take a “PRE PREP” for 3 days with MiraLax before starting the prescription preparation from your doctor. This is very important for your procedure to be successful. Please purchase a bottle of Miralax (available over the counter) now to have ready.

EIGHT DAYS before your procedure

  • If you take any BLOOD THINNING MEDICATIONS OTHER THAN ASPIRIN (for example: Coumadin (Warfarin), Eliquis, Pradaxa, Xarelto, Plavix, Brillinta, Lovenox), contact your primary care physician or heart doctor for instructions on if and when to stop these medications prior to your procedure. ASPIRIN should be continued prior to the procedure.
  • If you have diabetes and take medication to control your blood sugar, contact your primary care physician or diabetes doctor for instructions about how to take your diabetes medication while preparing for the procedure.
     

FIVE DAYS before your procedure

  • Plan to purchase the colon preparation at the pharmacy. We will submit the prescription electronically to the pharmacy we have on file in your medical record.
  • Please review and complete the medical questionnaire and medication list (see enclosed).

  • Stop taking iron or multivitamins with iron. Iron may darken your stools. 
  • Start a low fiber diet TODAY. On this diet, you cannot eat corn, raw vegetables (for example: carrots, broccoli, lettuce, celery, cucumbers, etc.), SEEDS OR NUTS, or take fiber supplements (Metamucil).
  • If you have constipation or take narcotic pain medications, your “PRE PREP” with MiraLax (available over the counter), 1 scoop (17 grams) in 8 ounces of water twice daily for 3 days STARTING TOMORROW MORNING.
  • If you take any BLOOD THINNING MEDICATIONS OTHER THAN ASPIRIN (for example: Coumadin (Warfarin), Eliquis, Pradaxa, Xarelto, Plavix, Brillinta, Lovenox), contact your primary care physician or heart doctor for instructions on if and when to stop these medications prior to your procedure.  ASPIRIN may be continued prior to the procedure.
  • If you have previously had a colonoscopy and you were told that your colon was not well cleaned out, your “PRE PREP” with MiraLax (available over the counter), 1 scoop (17 grams) in 8 ounces of water twice daily for 3 days STARTING TOMORROW MORNING.

TWO DAYS before your procedure

  • Be sure you have the colon preparation from your pharmacy.

**Please read the following bowel prep instructions carefully. You need to take all of the prep medication and follow the instructions carefully so that your bowels are clear for the colonoscopy.  If your bowels are not clear, your colonoscopy procedure may need to be rescheduled to a later date and would require ANOTHER PREP.**

ONE DAY before your procedure

  • Follow the instructions given on this form. DO NOT follow instructions on prep bottles.
  • Begin a clear liquid diet for the entire day, no solid food. A clear liquid diet includes any liquids you can see through such as water, tea, black coffee, clear broth, apple juice, Gatorade, white grape juice, soda, Jell-O (not RED). Do not drink anything RED. Do not drink milk or dairy products.

 YOUR BOWEL PREPARATION WILL FOLLOW A “SPLIT DOSE” SCHEDULE

  1. Between 6pm-8pm the evening before procedure, drink the FIRST HALF of the prescription colon laxative preparation.
  2. On the morning of your procedure, drink the SECOND HALF of the prescription colon laxative preparation. THIS HALF OF THE PREPARATION MUST BE FINISHED 2-4 HOURS BEFORE SCHEDULED PROCEDURE TIME to avoid delay or cancellation of the procedure.

**IF YOU HAVE DIABETES OR CONSTIPATION PLEASE FOLLOW A 2 DAY PREP:

  • Two days before the procedure, begin a clear liquid diet, no solid food. A clear liquid diet includes any liquids you can see through such as water, tea, black coffee, clear broth, apple juice, Gatorade, white grape, soda, Jell-O (not RED). DO NOT eat or drink anything RED. Do not drink milk or other dairy products.
  • Split the colon preparation over two nights, drink one colon preparation two nights before and the other one night before. For both nights, begin drinking the colon preparation between 4:00 PM and 6:00 PM. You should try to drink the whole bottle before midnight.

***HELPFUL SUGGESTIONS FOR COLONOSCOPY PREPARATION:

  • After mixing the preparation, place it in the refrigerator. Some patients feel it is easier to drink when it is cold.

  • You can add Crystal Light (any color but red) or Ginger Ale to the preparation. Do not add anything else to the preparation.
  • Keep drinking even if you have not had a bowel movement. 
  • You can suck on lifesavers or hard candy (any color but red) between glasses of preparation. 
  • If you are not tolerating the prep well (nausea, vomiting), wait an hour then start again at a slower pace. If you still cannot tolerate the prep, please call. You may want to use a straw to sip the solution
  • Baby wipes can help irritation from repetitive defecation. 

Day of the procedure

  • Take all of your usual medication with a sip of water, unless otherwise instructed by your primary care physician
  • STOP CLEAR LIQUIDS 2-4 HOURS BEFORE YOUR PROCEDURE TIME. THEN, DO NOT EAT OR DRINK ANYTHING UNTIL AFTER YOUR PROCEDURE.
  • Your bowel MUST be empty to clearly view your colon and remove polyps.
  • Please arrive 1 hour prior to the scheduled time.
  • Wear loose fitting comfortable clothes.
  • Remember "What to Bring" list

After the procedure

  • You will be monitored in the Endoscopy Unit recovery area for approximately one hour.
  • You will receive diet and medication instruction after your procedure.
  • You may return to work the day after the procedure.

  • Your escort MUST meet you in the Endoscopy Unit on Proger 3 when you are ready to go home.

IF YOU ARE UNABLE TO KEEP YOUR APPOINTMENT, PLEASE CALL SCHEDULING AT (617) 636-0142 AT LEAST 48 HOURS AHEAD OF TIME TO RESCHEDULE.

In addition to your enclosed Pre-Procedure Instructions, we also wanted to make you aware of a couple additional things to expect and be prepared for prior to your procedure.  Again, please do not hesitate to contact us directly at 617-636-0142 if you have any questions or concerns about these items or any of your instructions enclosed.

  1. Please be aware that all female patients between the ages of 12 and 50 who are receiving an anesthetic agent during their procedure will be offered a pre-procedure pregnancy test unless they meet certain exclusion criteria.  Our nurse will discuss this with patients directly.  Should a patient wish to waive this test they will be asked to sign a waiver form.

  2. We encourage all patients to contact their insurance company in advance of any procedure to understand all potential financial obligations that might result from their visit. This includes understanding financial responsibility if the procedure is deemed “preventive” or “diagnostic.”  Please note the coding of a preventive or diagnostic procedure is generally not determined till after the procedure is completed and it is best to have a conversation with your insurance company in advance.
The entrance to the Marlene Neely Center for Digestive Health

The Marlene Neely Center for Digestive Health

The Marlene Neely Center for Digestive Health provides one home for GI procedures including clinical exams, screening colonoscopies and complex GI procedures.

Read more about the Center