Golytelysplitdoseinst0928.09

San Diego Gastroenterology Medical Associates
A Medical Corporation
Robert Epsten, MD; Kevin Haynes, MD; Gary de la Pena, MD; Suja DuBois, MD Sally Stipho MD 4060 Fourth Avenue, Suite 240 San Diego, California 92103 Telephone (619) 291-6064 FAX (619) 291-3078 Golytely Prep Split Dose Colonoscopy Instructions
Your procedure has been scheduled for ____________________________ Check in time: _________________ Procedure time:________________ Please register at:
• Scripps Mercy Hospital 4077 5th Avenue Check in at Outpatient Radiology on the FIRST (Main) floor (619) 260-7026 • San Diego Endoscopy Center 4033 Third Avenue Ste. 106 (619) 497-2888 One Week Before the Procedure:
1. STOP using all iron and aspirin medications. If you are required to take an aspirin daily by
your physician (i.e. for heart disease, stroke prevention), this may be continued.
2. If you take Coumadin or Plavix, please contact the doctor immediately for instructions. You
may need to stop using these medications for 5-7 days before your procedure.
3. Please purchase a package of Dulcolax Tablets (you will need four 5 mg. tablets, a total of
20 mg.) and fill your prescription for Golytely at any pharmacy.
4. Arrange a ride home from the procedure. You will receive intravenous sedation and will not be able to drive for 18 hours following this procedure. PLEASE leave your valuables (except your insurance card) at home or with the person who accompanies you. You will need your The Day Before the Procedure:
1. Starting when you awake the day before your procedure, eat no solid foods
and drink clear fluids only. Clear fluids include: Clear fluids include any of the following: DO NOT drink anything red or purple or any milk or dairy products.
San Diego Gastroenterology Medical Associates: Golytely Prep SPLIT DOSE Colonoscopy Instructions San Diego Gastroenterology Medical Associates
A Medical Corporation
Robert Epsten, MD; Kevin Haynes, MD; Gary de la Pena, MD; Suja DuBois, MD Sally Stipho MD 4060 Fourth Avenue, Suite 240 San Diego, California 92103 Telephone (619) 291-6064 FAX (619) 291-3078 2. Starting at 5 PM, please drink an 8-ounce glass of Golytely every 15 minutes
until you have consumed the first half of the gallon of solution.
3. Take 4 Dulcolax tablets with an allowed liquid after the second dose of Golytely.
4. At 5 AM, the day of the procedure, drink the second half gallon of solution. You must complete the second half gallon of the Golytely solution even if your stools look watery. Stop all fluids
*Continue your clear liquid diet all afternoon and evening up until midnight.
The Day of the Procedure:
• Drink only clear fluids until 3 hours before the procedure. Then drink nothing.
IF YOU ARE DIABETIC READ THE FOLLOWING INSTRUCTIONS:
• IF YOU TAKE INSULIN, reduce the dose by 50%
• IF YOU TAKE PILLS: do not take diabetes medicine until the procedure is over.
• Take other medicines 3 hours before the procedure or after you get home.
• Bring a list of all your prescription and over-the-counter medications.
• Do not drive for 18 hours after the procedure.
• You can resume your normal diet unless discharge instructions indicated otherwise.
Important Reminders
• Please allow 2-21⁄2 hours for the procedure.
• No iron or aspirin products including Bufferin, Anacin and Excedrin for
7 days before the procedure, unless medically necessary.
• Motrin and Aleve are allowed up to 48 hours before the procedure.
• Tylenol is OK up until the day of the procedure.
• If you take insulin please take 1⁄2 of your usual dose the day before and 1⁄2
of your usual dose the day of the procedure. If you take diabetes pills,
please don't take any the day before the procedure.
• The Physician's fee is separate from the facility fee. There may also be a
pathology fee.
• Please verify with your insurance company that an authorization is not
required for this outpatient procedure.
• Please be aware that some insurance companies do not cover screening
procedures.
• Please call the office with any questions or concerns (619) 291-6064.
You must cancel 2 working days in advance to avoid any charges.
San Diego Gastroenterology Medical Associates: Golytely Prep SPLIT DOSE Colonoscopy Instructions

Source: http://sandiegogastro.com/wp-content/download/GoLytelySplitDoseInst0928.09.pdf