Hi 1993! After my recent experience, an enema beforehand is probably correct. One may not be enough?  I had a sygmoid scope and they told me to use MIROLAX to pre clean.  It did nothing.  I told them I have no peristalsis and can't force movement. They didn't listen. I told them I had a J-pouch and they didn't get it. They brought me back to my room after the failure and gave me 3 enemas to prep me and seemed aggrevated that I didn't clear out and I lengthened their day! I was so humiliated!  I KNOW I can't clear on demand especially after no food or liquid for 24 hours!  I told them if they had let me have a couple OREOS before the test, I would have been completely cleared!!  Good luck with your procedure!! What is an S-pouch?? Please let me know how your procedure goes?

The answer is yes Fleet enemas can be used to cleanse a J Pouch pre-scope, and I did use them in past years. They do the job, but they can be mildly irritating. More recently I have been emptying the Fleet bottle and substituting bottle or distilled water, with my GI doctor's knowledge and approval.

My standard prep is bottle of Mag Citrate the night before and Enema 2 hours before procedure. This is the highly standard prep.

Thank you for responding.

I'm sorry to hear that you had to do that. I'm sure in the world of the G.I. unit they've come across much much worse situations than getting a bit off schedule. Think of all the things they've seen!

I went back to and looked at previous posts about it and it looks like normally an enema is NOT given. I've got pretty much just water coming out of me at this point, so a fleet enema would be like taking a sledgehammer to solve a thumb-tack-sized issue. The nurse spoke to me again and said I didn't have to prep.

*shrug*

An S-pouch is just a different shape because I didn't have a long enough blood supply for the j-pouch.

@CTBarrister posted:

The answer is yes Fleet enemas can be used to cleanse a J Pouch pre-scope, and I did use them in past years. They do the job, but they can be mildly irritating. More recently I have been emptying the Fleet bottle and substituting bottle or distilled water, with my GI doctor's knowledge and approval.

My standard prep is bottle of Mag Citrate the night before and Enema 2 hours before procedure. This is the highly standard prep.

Okay, that makes sense to me - I will ask to do the same. I don't need any medication encouraging a bowel movement! I simply need to clear it out..

Thank you!

Thanks Jen, I'm learning.  Did you use Mirolax or anything to clear before that procedure?  I hope this works for you.  I needed 3 enemas. Good Luck.

CTBarrister, you provided great info for me! What does the Magnesium Citrate do?  I know that was a part of clearing my obstruction, x-ray Contrast media and IV Magnesium Citrate. I will share that with my provider the next time.  Thank you.

Oral magnesium citrate is a very different beast than IV mag citrate. OTOH my GI doesn’t make me bother with it. I just do a clear liquid diet the day before and a couple of tap water enemas (using the Fleet bottle) the morning of the procedure. The entire pouch is within a few inches of the anus, so clearing out the whole intestine aggressively is often considered unnecessary.

Thank you! I will share info with my provider.

@Drbev603 posted:

CTBarrister, you provided great info for me! What does the Magnesium Citrate do?

It's a 10 ounce bottle that is consumed orally, a high powered laxative that produces explosive, watery bowel movements usually within an hour of consumption.  It is designed to clear out the entire intestinal tract of fecal matter.  The Fleet just clears out the Pouch.  It's a standard prep I have been doing for 30 years.  It maybe is not for you, but a lot of people cheat on the prep or cut out steps or do not fast, and then have to be told they have to have a do-over.  I overheard some of those conversations in the Yale recovery room while waiting for my then GI and they were not happy conversations.  I heard one guy being told he had numerous polyps in his colon but they could not be visualized well because his prep had been poor.  He was told he had to have a do-over.  He was groggy when this news was received but did not sound happy.

My legal assistant went for a colonscopy a few years ago and did not take all of her prescribed laxative because she said it made her feel like puking.  She was told she had to have a do over because she was not clean.

The bottom line is cheating a prescribed prep = possible do over.  And do overs are NOT free.  With a J Pouch scope the prep is not as extensive as for a colonoscopy, but they do peek into the ileum and the doctor does want to see a cleansed bowel.

So I just try and do it right and not have to have multiple scopes, which I am actually having now anyway due to the dilation of my stricture, but that is a separate topic.

All of the above being said, there have been a number of threads on this board on this topic.  The vast majority were started by posters spooked or intimidated by the prep. They generally received supportive answers cajoling them into doing little to no prep.  I am not going to comment on that except to say, do no prep at your own risk of paying for a second procedure.

I don’t recall anyone here advising no prep at all. Inadequate preps are common with colonoscopies, but I’d be surprised if they were at all common with pouchoscopies. It would take a pretty lazy endoscopist to refuse to rinse off the wall of a J-pouch using the scope.

Thank you for the information. (Do-overs are free in Canada. It's all free...I could f' this up 75 times and it wouldn't cost me anything.) However, I'll do the water enema of the pouch beforehand because I don't want them to waste time up in there giving me a rinse.

I think a distilled water enema should be sufficient so long as you are on a liquid diet starting after lunch the day before the test. In my case they look well up the ileum because I have inflammation there. So my doc orders a laxative to make sure I am clean for the above pouch scoping.

It is cool that you get medical for free in Canada. Does that extend to dental? I have dental insurance but only covers cleanings and x rays. I fractured a molar last week and am having it extracted and an implant put in. It's over $1400 for the extraction and bone graft and over $2600 for the implant, a $4000 gut punch that I will need to take right in the solar plexus. No insurance coverage on it. When I catch my wind from that punch, there will be another $2000 gut punch for a crown 6 months after the implant. A $6000 double whammy of punches. This debacle all because one tooth fractured.

@CTBarrister posted:

I think a distilled water enema should be sufficient so long as you are on a liquid diet starting after lunch the day before the test. In my case they look well up the ileum because I have inflammation there. So my doc orders a laxative to make sure I am clean for the above pouch scoping.

It is cool that you get medical for free in Canada. Does that extend to dental? I have dental insurance but only covers cleanings and x rays. I fractured a molar last week and am having it extracted and an implant put in. It's over $1400 for the extraction and bone graft and over $2600 for the implant, a $4000 gut punch that I will need to take right in the solar plexus. No insurance coverage on it. When I catch my wind from that punch, there will be another $2000 gut punch for a crown 6 months after the implant. A $6000 double whammy of punches. This debacle all because one tooth fractured.

It doesn't extend to cosmetic dental. Depending on your income you can get free basic dental care (which means that if you need a root canal, you'd get it pulled for free). So we still have a lot of toothless folks. However, implants are about $5,000! I need one - ugh.

WOW! Thanks for the info!!