Every doctor's office varies on the extent of the prep so you should ask your office. Per my GI doctor I have nothing but clear liquids after 12 noon the day before the procedure, one 10 ounce bottle magnesium citrate (clear) before bedtime and one Fleet enema early am day of the procedure at least 2 hours before leaving for procedure. Always request conscious sedation in lieu of propofol which is a scam run by many hospitals/doctors offices at the expense of patients, because it's 20 times more expensive and enables the office/hospital to move patients in and out quicker and do more procedures. Most patients with insurance give in to this scam, but the unseen cost to them is the extent their insurance payout goes up thereby increasing the health insurance premiums. Most people in my office are (before firm contribution) over $1,000 a month on the premiums, and if you want to see it go up even more due to an unnecessary payment on propofol, then by all means go for it.

Of course the cheapest alternative is no sedation at all, but I always select conscious sedation which is the cheaper of the sedation methods.

I don’t do Magnesium Citrate, but clear liquids the day before and one or two tap water enemas before leaving the house have always worked well enough for me. You didn’t ask about sedation, but I strongly prefer skipping it.

One reason for excessive preps is that the exam isn’t really a flex sig (flexible sigmoidoscopy), since we no longer have sigmoid colons. It’s a pouchoscopy, often performed with a flexible sigmoidoscope. Often the doctor doesn’t have separate instructions for pouchoscopy and they use the flex sig instructions instead.

i get flex sigs. i did not have a total colectomy as a patient who has familial polyposis syndrome.

my prep is  a small bottle of miralax 236 or 238 grams mixed in 64 oz of water (i dont drink electrolyte drinks of any kind, and im a diabetic type 2, so i dont do anything drink wise that will increase my blood sugar/glucose)

i have 6 to 8 inches of sigmoid in me and my jpouch is up top the anastomosis site not what is seen normally with a jpouch patient who has gone full an dtotal colectomy.

i have clear liquids from wake up through out the afternoon until about 430 pm the evening/day/pm prior to the early morning - next day flex sigmoidoscopy.

this works for me every time and ive never failed at my prep regimine, im always 100% cleaned out.

my scopes arent pouchoscopies since there is a simoid section of colon in me.  on october 7th my gi  in addition to my scheduled flex sig that morning completed an ileo-oscopy procedure on me as well.

i agree with ct and scott the gi doctors relay/dish out standard protocol instructions to patients that arent specific to the uncoloned/bowel resected and  so the prep instructions given are often over kill instructions

good luck with your clean out/scope!

len

Definitely a lot of offices give "one size fits all" directions for scopes without distinguishing between colonoscopies, sigmoidoscopiies and pouchoscopies and you have to speak to your doctor to sift through the boilerplate stuff. My prep may be more than what is needed, but you can do more than what is needed, you can't do less than what is needed. I one year got put in the Yale scope recovery room to wait for my procedure and I heard many docs lecturing their patients that their scopes were crap (literally) because they hadn't prepped properly. My own assistant a year or two ago was made to redo her colonoscopy due to a poor prep. She claimed she did everything she was told, but who knows, maybe she has motility issues or is resistant to laxatives. The point is you don't want to do 2 procedures and with a pouch it's really hard to screw things up unless you have the attitude that you can coast on the prep and fast forward to the day of the procedure. You would really be rolling the dice and pushing the envelope on a possible re-do.

I personally do not like enemas because I am scared of damaging something inside of me, just a personal preference. I would do a liquid diet all day and drink 2 bottles of Magnesium Citrate

My favorite liquids are gatorade and lemonade yummmmy!

I had my first pouchoscopy awake (no sedation at all)  in July, it went great! Its definitely tolerable doing it awake if you do not have a ride I drove there and back home

My last pouch check called for a prep of magnesium citrate. Always before my doctor recommended Miralax mixed with Gatorade (not red). They followed that with laxatives taken with gas x.  Before the prep, I was on a liquid diet. Both seemed to work fine, the magnesium citrate better, but personally, the taste leaves much to be desired

Every GI is different. I'd ask your doctor what he/she recommends. We definitely don't have to take the prep full colon people do. From what I hear, drinking that poison is worse

None of these preps are pleasant, but if they give the doctor a clear picture of the pouch they're worth it.  There is nothing like peace of mind knowing what is going on inside.

Thinking of you!

SS, the Mag Citrate is a small 10 ounce bottle and the key is C and C- Chill and Chug! I take down one bottle in like 4-5 power swallows. Clear lemon favor, never red cherry.

I agree CT, "Chug it down" was a motto my mother passed on long ago.  I'm a big girl and know that "Chug it" is sometimes the only way to get on with it.  Still doesn't mean I have to love the taste....and I don't even remember what flavor I purchased.

@CTBarrister posted:

SS, the Mag Citrate is a small 10 ounce bottle and the key is C and C- Chill and Chug! I take down one bottle in like 4-5 power swallows. Clear lemon favor, never red cherry.

I love that!! C and C lol! I like to mix it with Gatorade sometimes, but doing it your way is much quicker!

@Still Standing posted:

I don't even remember what flavor I purchased.

I believe the only two flavors are lemon, which is clear, and cherry which is red, and you should receive a specific instruction NOT to consume anything that is red or has red dyes in it, as it will mess up your scope and cause a redo of it.

The C and C method works well for me as it a very small quantity of liquid (10 ounces) to get down. But I agree with you on the awful taste of Mag Citrate and what I do after the C&C is follow it with a strong flavored herbal tea "chaser" to wash down the aftertaste of the Mag Citrate.  It is essential that there be a "chaser" to blast the aftertaste of the Mag Citrate out of your mouth, and I tend to favor the Celestial Seasonings Bengal Spice Tea, which has a strong cinnamon flavor to overwhelm and wash away the Mag Citrate aftertaste.

@CTBarrister posted:

I believe the only two flavors are lemon, which is clear, and cherry which is red, and you should receive a specific instruction NOT to consume anything that is red or has red dyes in it, as it will mess up your scope and cause a redo of it.

The C and C method works well for me as it a very small quantity of liquid (10 ounces) to get down. But I agree with you on the awful taste of Mag Citrate and what I do after the C&C is follow it with a strong flavored herbal tea "chaser" to wash down the aftertaste of the Mag Citrate.  It is essential that there be a "chaser" to blast the aftertaste of the Mag Citrate out of your mouth, and I tend to favor the Celestial Seasonings Bengal Spice Tea, which has a strong cinnamon flavor to overwhelm and wash away the Mag Citrate aftertaste.

I 100% agree!!!! A long time ago I saw "grape flavor", I do not see it anymore but that would be a bad idea too to drink before a pouchoscopy, purple looks similar to red.

I had my annual pouchoscopy last week. My surgeon doesn't instruct me to do any prep except to skip breakfast on the day of the scope. But still, two days before my appointment I'll eat light meals. Soups, tuna salad, egg salad. No leafy vegetables. No beets or raspberries -- produces red residue which can be alarming.

I always ask for sedation. Sometimes I wake up in the middle of the procedure. I don't feel anything, and can watch the screen. The procedure takes an hour or so from sedation to waking up in recovery. Everyone is given cookies and juice to get moving.

@Winterberry posted:

I had my annual pouchoscopy last week. My surgeon doesn't instruct me to do any prep except to skip breakfast on the day of the scope. But still, two days before my appointment I'll eat light meals. Soups, tuna salad, egg salad. No leafy vegetables. No beets or raspberries -- produces red residue which can be alarming.

I always ask for sedation. Sometimes I wake up in the middle of the procedure. I don't feel anything, and can watch the screen. The procedure takes an hour or so from sedation to waking up in recovery. Everyone is given cookies and juice to get moving.

Thank goodness you get to skip magnesium citrate! I wish I could lol. And OOOO I wish they would give me cookies and juice lol