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Hello I’m booked for survillience as I’m a frequent pouchoscopy patient with the 1-2 cm rectal cuff

what time do I give the first enema to myself and when should I do the second one?

I have a new gastroenterologist who is interventional unlike the prior of 22 years

the new instructions are no miralax and liquid diet of clears on day before the pouchoscopy

i have an afternoon scope and I’ve always had morning scopes prior but did overkill prep of miralax w the former gastroenteroligist

has anyone did an enema the evening before  the day of the afternoon scope then by 10 am the 2nd enema insuring for a full clean out for a 1 pm? (The 2nd enema at 10am day of scope for a 1 pm arrival for a 2pm)

I have fap how do you afternoon pouchoscopy folks survive the length and duration of not eating so long?

thx

len

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A morning scope is certainly easier. I don’t think an enema the evening before is likely to have any value at all. If I were doing it I might do the enemas something like 30-60 minutes apart, with the second one just before I left the house. A J-pouch is tiny compared with a colon, so there’s no value to the bulk evening cleansing that’s needed for a colonoscopy. The enema cleans out a pouch pretty well, and then new stuff will enter from the small bowel not long afterwards. That small amount can be rinsed off using the scope, but over time the amount increases and can get in the way.

Miralax is overkill in my opinion. I've had regular & interventional pouchoscopies. Was instructed to have a clear diet the day before and to use a tap water enema before leaving for my appointments, some of which were in the afternoon. You'll never be able to get the pouch perfectly clean, as it starts accumulating waste/mucus immediately. My doctors always said my prep was fine.

hi jaypea

thanks for your response. i will consider following your advice and use it as a guideline. i can do my 1st enema at 11am, my pick up/transportation to deliver me to hospital on pouchoscopy day is 12;15pm.  i'll administer the 1st one slightly earlier so i dont feel the urge to expell while riding 15 minutes in the car to the hospital

ive never dealt with or had experience with afternoon scopes in my 22 years of j-pouching

a but nervous. former gi had me do miralax everytime. i recently mastered administering myself the warm tap water enemas

miralax is a bit overkill but i want to make sure my  cuff and higher upstream is clear of stool. i have a 2-3 cm rectal cuff as i was stapeled and not hand sewn. ive had times the morning of pouchoscopy residual effluent expelling in the toilet so i want to be sure because the dr will be resecting alot and he doesnt have time to waste by rinsing effluent while using either emr, esd or ablation/burning technique to deal with my polyps.

im waiting on gi docs nurse to get back to me because the idea of a 2nd part of day scope worries me. im used to eating and snacking and hear i wobt be eating till 5pm the day of the scopes which is my dinner time. its a 2-3 hour gig for me each time the pouchoscopy so for a 2pm start time 1pm arrival tp hospital i can espect to be there till 4 o clock -430.

i need to get this over with. im a frequent flyer/get scopes frequently but i need to cause fap is not uc.

i will take your advice into consideration, thank you!

len

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