Instructions for Your Colonscopy

Please read the following document in its entirety as it provides you with important information regarding your upcoming procedure. Please follow all instructions exactly as written.

Please arrive 30 minutes prior to your scheduled appointment time and bring a valid health card.

You MUST have someone with you upon discharge. You will not be allowed to take public transportation, drive yourself, take a taxi or an UBER, or walk unaccompanied from this appointment. If you do not have someone with you, there is a chance you will not receive sedation and the appointment will be rescheduled.

Please avoid taking COUMADIN (Warfarin) for 5 days prior to your procedure. Stop taking XARELTO, PRADAXA, ELIQUIS or LIXIANA for 2 days prior to your procedure. If you are taking ASPIRIN or PLAVIX, you can continue taking them without issue.

You may resume taking your medications after your test is done. This may be delayed if polyps are removed, or biopsies are taken. Your doctor will guide you accordingly.

Please stop taking your Ozempic 7 days prior to your procedure. Once the procedure is complete, you can resume taking it as directed.

This procedure requires your bowel to be cleaned out. The preparation is very important. The cleaner your bowel, the more accurate the test will be.

You will need to purchase the bowel preparation laxative solution - PICO SALAX from your local pharmacy.

Your preparation solution will consist of the following:

• Two boxes of PICO SALAX (Please disregard the instructions that come with the box of PICO SALAX and follow the instructions outlined below). Note: Each box will have 2 packets in it, this means you will have a total of 4 packets, but you will ONLY BE USING THREE packets.

DO NOT make any substitutions with generic brands. Generic brands are less tolerated and bowel prep is not as adequate as PICO SALAX.

If you purchased the Endoscopy Comfort Package from Medcan, you will have the correct number of packets needed to prepare for your colonoscopy. The package will be sent to you at least 5 days before the procedure.

Please avoid any seeds, quinoa, nuts, and popcorn 7 DAYS leading up to your procedure. Also, STOP taking Ozempic 7 days prior to your procedure.

DO NOT EAT ANY SOLID FOOD. You must follow a clear liquid diet only. A clear liquid is defined as anything you can see through. Examples of clear liquids are:

• Apple juice
• Jell-O (not red, or dark colour)
• Tea or coffee (without milk/cream)
• Ginger ale
• Gatorade
• White cranberry juice
• White grape juice
• Chicken broth (no noodles, no chicken, just the broth)

Avoid red liquids (red Jell-O, cranberry juice) and vegetable soup. A good quality bowel preparation is essential for a colonoscopy to be effective. Inadequate bowel preparation can result in incomplete procedures, missed lesions, higher complication rates, prolonged procedure time, and increased costs resulting from an aborted examination. If preparation has not been adequate, you may need to repeat your colonoscopy.

Splitting the dose of PICO SALAX, as outlined below, significantly improves detection rates of polyps and adenoma. It also improves the quality of the preparation and colonoscopy. Additionally, you may be able to better tolerate consuming the volume of fluids required if the dosage is split rather than taken all at once. This also decreases nausea, vomiting, and abdominal discomfort.

1. To prevent dehydration, drink 2 liters of clear liquids during preparation. The clearer the liquids are, the more effective the preparation will be.
2. Take the first packet of PICO SALAX at 6:00 PM. Mix the powder in the packet with 5 oz of cold water.
3. Take the second packet of PICO SALAX at 9:00 PM. Mix the powder in the packet with 5 oz of cold water.
4. Take the third packet 4 hours before your scheduled procedure time.
5. DISCARD the fourth packet as it is not necessary.
6. Continue drinking clear fluids up until 2 hours prior to your procedure to prevent dehydration.

Be sure to stay close to a restroom once you begin taking the laxatives. Please be aware that cramping, bloating, and vomiting may occur.

• Do NOT eat any food prior to your appointment.
• You may have a glass of water up to 2 hours prior to your appointment. For example: if your appointment is at 9:00 AM, you may drink water up until 7:00 AM.
• Take your regular medications the morning of your appointment until 2 hours prior to your appointment (except for diabetes medications and blood thinners as listed on Page 1).
• A bag will be provided for you to place any valuables in and will stay with you during the length of your stay.

The attending physician and/or specialist will consult with you prior to the procedure and determine the best method of sedation for your endoscopy examination. You may experience some discomfort during your colonoscopy as air is injected into your colon. This can cause a bloating/cramping sensation. In case your colonoscopy is accompanied by a gastroscopy, the latter is not painful. However, you may experience a gagging sensation during the insertion of the scope, which may cause slight discomfort. A numbing medication may be sprayed that will help diminish the gag reflex.

• Following the procedure, you will feel drowsy and will be required to stay in our recovery area for a minimum of 30 minutes.
• Once you have been discharged, you may resume your regular diet.
• You MUST have someone with you upon discharge. You will not be allowed to take public transportation, drive yourself, take a taxi or an UBER, or walk unaccompanied from this appointment. If you do not have someone with you, there is a chance you will not receive sedation and the appointment will be rescheduled.
• You should avoid alcohol and sedatives for 12 hours following this procedure. You are not allowed to drive for 12 hours following this procedure.

While a colonoscopy is considered an effective diagnostic procedure, there are always some risks associated with invasive tests. Please contact us or talk to your doctor if you have any questions or concerns.

If for any reason you may need to reschedule your appointment, please let us know 14 full calendar days prior so the appointment may be offered to someone else with adequate time to prepare.

A cancellation / no show fee of $395 will apply if less than 7 days’ notice of cancellation is provided.

It is necessary that you follow a clear liquid diet the day before your exam. Failure to do so will result in a cancellation of your appointment and a charge of $395.

We look forward to seeing you at Medcan. If you have any questions related to this appointment, please email us at LiveWellClientCareExternal@medcan.com