Having a Colonoscopy with Moviprep

A Colonoscopy is a test, which allows the Endoscopist to look directly at the whole of the large bowel (colon). In order to do this
a flexible tube the thickness of a finger, is carefully passed through the anus into the rectum and into the large bowel. This can be
uncomfortable as bends in the colon are negotiated and air is used to inflate the colon. The Colonoscope has a small camera attached
which is connected to a monitor system where images can be seen. In order for the test to be successful, it is important that you take the
Moviprep bowel preparation as directed. This will assist in cleaning your bowel, enabling us to make a correct diagnosis.

By examining your bowel the cause of your symptoms may be found. Images and biopsies (samples) may be taken and sometimes polyps
(small growths in the bowel) can be removed or other treatments performed.

 

A Colonoscopy is a safe examination but rarely, a complication such as bleeding or perforation may occur (1 in 1500, or if polyps removed
1 in 200). Other risks are discomfort, bloating and pain. Entonox (gas and air) may cause nausea, dizziness and euphoria. Sedation
may cause nausea and vomiting, and rarely you may become over sedated which can reduce your breathing rate.

There may be alternatives to this procedure but your physician has advised that this is the most appropriate procedure available to you.
If you would like to discuss alternatives further please speak to your referring physician.

• If you are unable to make your appointment or need to change your appointment time, please do telephone via the numbers on the back of this leaflet.
• Your appointment time takes into account the time required to admit you onto the unit. You should therefore not expect to immediately go through for the test when called. You will be in the department for upto 4 hours. Please note we usually have 6 different lists running consecutively, this may mean some people will have to wait longer than others, even with the same appointment time.
• Please note that the time of day that you will need to start taking the Moviprep solution differs between a morning and an afternoon appointment. Please follow the instructions carefully.
• Please be aware we are a Teaching Hospital and may have trainees in any areas of your pathway. They will always be supervised and they will always be working at an appropriate level for their training stage. If you would rather not have a trainee involved in your care please let the staff know your wishes. This will not affect your care.

• Before the procedure a nurse will take you into a room and explain the test and ask you some health questions.
• Please bring a list of all your medication with you on the day
• Please leave valuables and jewellery at home where possible as we unfortunately are unable to look after these
• You will be asked to sign a consent form and change your underwear to some procedural dignity shorts that we supply.
• When it is your turn you will be taken to another area where we will insert a cannula (a small plastic tube). From here you will be called into the procedure room for your test.

• If you are having Entonox (gas and air) instructions will be given on how to self administer this before your colonoscopy starts.
• Entonox is inhaled through a mouthpiece to relieve pain. A cannula (small plastic tube) will be inserted just in case any medication is needed during your colonoscopy.
• After the procedure you will be transferred to our recovery area for about half an hour where you will be given a drink and some biscuits.
• Recovery from the effects of Entonox is rapid and you will be able to drive after half an hour from stopping Entonox, providing you have had a straightforward Colonoscopy.
• You may feel bloated with wind-like discomfort. This is normal and usually settles quickly. If you have a biopsy taken or a polyp removed it is common to pass small spots of blood from your bottom for a day or two following the procedure.
• Details of your results and discharge advice will be given before leaving the unit. Biopsy results will be communicated by the referring clinician at a later date.
 

• In the endoscopy room a sedative and pain reliever is given through the cannula. This is not an anaesthetic. It will relax you but you will be aware of what is going on. The sedative may cause loss of memory and judgment for up to 24 hours following the test.
• After your procedure you will be transferred to our recovery for approximately 30 minutes whilst you recover. The nurse will prepare your results & discharge advice.
• If you have had a sedative you should not drive, drink alcohol, operate machinery or sign legal documents for 24 hours following your test. You will need someone to accompany you home and to be with you overnight following your procedure as the effects of the sedation may remain in your system for this time.
• As with Entonox, you may feel bloated with wind-like discomfort. This is normal and usually settles quickly. If you have a biopsy taken or a polyp removed it is common to pass small spots of blood from your bottom for a day or two following the procedure.
• Again, as with Entonox, details of your results and discharge advice will be given before leaving the unit. Biopsy results will be communicated by the referring clinician at a later date.
N.B. Please leave all valuables and jewellery at home where possible as we are unable to look after these for you.
 

In order to examine the whole of the bowel it must be clear of all waste materials. This is achieved by using a combination of
changing what you eat and taking laxative medicines.
Moviprep works by loosening your stools. This is unpleasant but necessary and may last up until the time of your appointment. Easy
access to your toilet will be required for most of the day.
You might like to use a barrier cream to prevent a ‘sore bottom’. A product such as petroleum jelly can be effective.
7 days before your Colonoscopy appointment please stop taking iron tablets.
2 days before your Colonoscopy appointment please stop taking medication that might constipate you for example codeine, cophenotrope
(Lomotil®), loperamide (Imodium®) or Kaolin and Morphine mixture.

If you are taking other medication, please take it at least one hour before or at least one hour after taking Moviprep, otherwise they may
be flushed through your digestive system and not work so well.
Do not take Moviprep if
• You are allergic to any of the ingredients
• You are pregnant
• You are on dialysis
• You are taking medication for an organ transplant
• You have not passed wind or opened your bowels in the last five days leading up to your bowel preparation time
Please contact us if any of these cautions apply to you via the phone numbers on the back of this leaflet.
 

Some possible side effects of Moviprep Abdominal pain, abdominal distension, sleep disturbances, dehydration, dizziness, tiredness, feeling generally unwell, soreness of the anus, nausea, vomiting, headache and indigestion. If you experience any of these symptoms try taking the Moviprep more slowly. Rarely are people allergic to Moviprep. They may experience a rash or itching, swelling of the face or ankles, palpitations or
shortness of breath. If any of the side effects become serious, stop taking Moviprep and seek medical advice.

If you are taking an oral contraceptive pill, diarrhoea can make it less effective. Continue taking the pill but use other precautions for the
rest of that cycle.
Important: No alcohol should be consumed on the day before and the day of the procedure.
 

Two days before your test please follow a low residue diet, which consists of the following:
• Fats (use sparingly) – Butter or margarine
• Rice – Plain boiled white rice
• Eggs – Boiled or poached
• Meat / Fish – Well cooked meat, beef, lamb, ham, veal, pork, poultry, fish, shellfish
• Cheese – Cream, cottage or cheese sauce
• Bread – White bread or toast
• Cereals – Crisped rice cereal, cornflakes (no bran)
• Pasta – Plain macaroni, spaghetti, noodles
• Potatoes – Boiled, creamed, mashed or baked (no skins)
• Dessert – Clear jelly (not red jelly)
Foods to avoid:
Red/rare meat, sausage, pies, any fruit or salads, most vegetables, potato skins, chips, wholemeal or brown bread, nuts, pulses, baked
beans, wholemeal pasta, brown rice, puddings containing fruit and nuts, cakes, biscuits and yoghurts.

The day before your examination
Eat your breakfast before 9am. Do not eat anything after 9am.
Do not eat food again until after your examination even if you feel hungry. Your bowel must be completely empty for the examination to
be successful.
You may drink clear soup, Oxo, Bovril, soft drinks (not red coloured), black tea or coffee (no milk). You may add sugar if you like. You may
drink as much as you like of these fluids.
5pm
Open one sealed plastic bag of Moviprep. Each of the two sealed plastic bags contain two sachets. One sachet marked A and the
other sachet marked B.
Empty the contents of sachet A and sachet B into a jug. Add water (not chilled) to make up to one litre and stir until the powder has
completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 to 30 mins until you have taken the full litre. This may take 1 to 2 hours.
Take your time, there is no need to rush.
You should also drink at least an additional 500mls of water or clear
fluids with each litre of the Moviprep that you take. This will prevent
you from becoming dehydrated.                                                                                                                                                                                       8 - 9pm
At about 8 - 9 pm make up the second litre of Moviprep as you did the first one.
• Again drink it over 1 - 2 hours. Again it important that you drink an additional 500mls at least of water or clear fluids along with
the Moviprep during the course of the evening. This will prevent you from becoming dehydrated.
When you start taking Moviprep solution it is important that you stay
close to a toilet. At some point you will start to experience watery
bowel movements. This is quite normal and indicates that the
Moviprep solution is working. The bowel movements will stop soon
after you have finished drinking.
Allow 2 hours for the second litre of Moviprep to work.
You can go to bed when you stop going to the toilet (for example 11pm).
If you follow these instructions your bowel should be clear and this will help you have a successful examination.
You may continue to drink water up to 2 hours before your procedure.

The day before your examination
Do NOT eat anything after your 1pm lunch. Do not eat food again until after your examination even if you feel hungry. Your bowel must
be completely empty for the examination to be successful.
You may drink clear soup, Oxo, Bovril, Soft drinks (not red coloured), black tea or coffee (no milk). You may add sugar if you like. You may
drink as much as you like of these fluids.
7pm
Open one sealed plastic bag of Moviprep. Each of the two sealed plastic bags contain two sachets. One sachet marked A and the
other sachet marked B.
Empty the contents of sachet A and sachet B into a jug. Add water (not chilled) to make up to one litre and stir until the powder has
completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 to 30 mins until you have drunk the full litre. This may take 1 to 2 hours.
Take your time, there is no need to rush.
• You should also drink an additional 500mls at least of water or clear fluids with each litre of the Moviprep that you take. This will prevent you from becoming dehydrated.
After you have finished the first litre of Moviprep and your 500mls of additional fluids, allow 2 hours for Moviprep to work. You can go to
bed when you have finished going to the toilet (for example 10pm).

6AM Remember, do not eat anything.
Mix the sachets as before: Empty the contents of sachet A and sachet B into a jug. Add water (not chilled) to make up to one litre
and stir until the powder has completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 to 30 mins until you have drunk the full litre. This may take 1 to 2 hours.
Take your time, there is no need to rush.
• You should also drink an additional 500mls at least of water or clear fluids during the course of the morning. This will prevent
you from becoming dehydrated.
Once again you will experience watery bowel movements which should subside after 1 - 2 hours. This will allow you to leave home in
good time for your hospital appointment.
When you start taking Moviprep solution it is important that you stay close to a toilet. At some point you will start to experience watery bowel movements. This is quite normal and indicates that the
Moviprep solution is working.
The bowel movements will stop soon after you have finished drinking. If you follow these instructions your bowel should be clear and this will help you have a successful examination.
You may continue to drink water up to 2 hours before your procedure.

If you have diabetes, please read the ‘extra’ leaflet sent alongside this leaflet.
This leaflet is specific to controlling your diabetes through the various procedures available within our unit and you will have been sent the
one that corresponds with your specific procedure it will be one of the below leaflets:
• Guidance for Managing Diabetes for Sigmoidoscopy /Colonoscopy
• Guidance for Managing Diabetes for Gastroscopy & Sigmoidoscopy or Gastroscopy & Colonoscopy (known as Dual Procedure)
This will give you clear instructions on what to do with your medication (including insulin) during the preparation for your test. If you have not received a copy of this leaflet, could you please contact us and request a copy.
 

How long does the procedure take?
A colonoscopy usually takes between 10 and 45 minutes. You will be in the department for upto 4 hours.
Does it hurt?
Sometimes patients find the test painful, gas and air (Entonox) or sedation is available to use as pain relief if needed.
Do I have to have the test?
No the choice is yours, see page 3 for alternatives and the reason why this test is appropriate.
Can I take my tablets as normal?
Yes unless instructed otherwise. Please take the tablets at least one hour before or at least one hour after taking Moviprep Diabetic patients please read page 13 for diabetic medication instructions.
Will I be asleep for this procedure?
No. Gas and air (Entonox) or sedation is available (if your circumstances permit), you will be awake throughout the procedure.
How can I make the Moviprep more palatable?
To reduce nausea it is important to sip the Moviprep and not gulp it down. A straw is sometimes helpful to drink the Moviprep with and you can add cordial (not blackcurrant) to taste if you prefer.
What shall I wear to attend the procedure?
Please wear loose comfortable clothing, you will be asked to wear dignity shorts under your own clothing before the procedure. You will
then remove your lower clothing (keeping your dignity shorts on and your own top clothing) in the endoscopy room prior to the procedure.
If you need advice before or after your procedure please contact The Gastroenterology & Endoscopy Unit between
7.45am - 6.00pm weekdays via the phone numbers on the back of this leaflet.

Access from the main hospital multistorey car park
We are located in Area 6 - Gastroenterology & Endoscopy Unit, highlighted in orange on the main hospital map. Follow the signs for the
Main Hospital up the escalator/lift towards Area 6, second corridor on the left. Follow the signs down the link corridor, exit to the right via the side
door (external) which is signposted for Patient Entrance to Reception.
Access for drop off/collection only & disability parking
Enter via East Park Drive and follow the road up the hill, take the second left signposted for Gastroenterology & Endoscopy Unit Drop
Off Only, follow the road round to the right.