How to Prepare for your Colonoscopy or Flexible Sigmoidoscopy – PLENVU®

This leaflet tells you how to prepare ‘PLENVU®’ the laxative you take before colonoscopy or flexible sigmoidoscopy examination.

To have a successful examination of your bowel and to avoid you having to come back again, your bowel MUST be empty and clean. You MUST follow the instructions set out in this leaflet and take the PLENVU® preparation correctly.

If these instructions are not followed, your examination may have to be cancelled or repeated.

Before taking PLENVU®…

Please read the back of the PLENVU® packet and contact the nursing staff in the Endoscopy Unit for further advice if you answer YES to any of the following questions:

• Are you allergic to any of the ingredients listed on the packet?
• Are you taking Clopidogrel?
• Are you taking Rivaroxaban?
• Are you taking Apixaban?
• Are you taking Dabigatran?
• Are you taking any other blood thinning medications?
• Are you pregnant or breast feeding?
• Are you a diabetic on insulin or tablets?

Note: You can continue to take Aspirin.

7 days before your appointment

STOP taking any iron tablets. Iron makes everything inside your bowel black, making it difficult for your endoscopist (a doctor or nurse trained to do endoscopies) to see anything.

4 days before your appointment

STOP taking any drugs that may cause you to become constipated. For example, Lomotil, Loperamide or Codeiene Phosphate, but continue to take all other usual medications.

If you are taking Fybogel or any other fibre products, STOP taking them now. The fibre content of these products will work against the special diet you are about to take.

The day before your appointment

Dietary advice for a morning appointment

For your breakfast, you may eat and drink the following:

Eggs, white bread, toast, butter or margarine, croissants, shredless marmalade or jam.

For fluids, drink any of the following: black tea or coffee, water, fizzy drinks, fruit squash (but not blackcurrant as this stain the bowels).

Have your breakfast at 9:00am then do not eat anything else. You may drink only clear fluids until after your procedure.

At 5:00 p.m., make up your first dose of PLENVU® and sip slowly over 60 minutes. Allow at least two hours for the PLENVU® to start to work.

Between 8:00 p.m. and 9:00 p.m., make up the second dose of PLENVU® and sip very slowly over 60 minutes, again allow 2 hours for the PLENVU® to work.

Dietary advice for an afternoon appointment

For your lunch at 1:00 p.m., on the day before your appointment, you may eat and drink from the following:

Eggs, white bread, toast, butter or margarine, croissants, shredless marmalade or jam.

For fluids, drink any of the following: black tea or coffee, water, fizzy drinks, fruit squash (but not blackcurrant, as this stain the bowels).

Have your lunch at 1:00 p.m. then DO NOT EAT again until after your appointment. You may drink only clear fluids until after your procedure.

At 7:00 p.m., make up the first dose of PLENVU®. Sip very slowly over 60 minutes and allow at least two hours for the PLENVU® to start to work.

At 6:00 a.m. on the morning of your appointment, make up the second dose of PLENVU® and sip this very slowly for over 60 minutes.

How to prepare the PLENVU® mixture

Each box of PLENVU® contains three sachets. Dose 1 is sachet 1 and Dose 2 has 2 sachets, A and B. Dose 2 are sachets A and B mixed together to make the 2nd dose.

• Pour sachet 1 into a 500ml or 1 pint jug and water (not chilled) to meet the 500ml mark, stir until fully dissolved.

• Once PLENVU® has been made, it can be chilled.

• PLENVU® should be taken as directed above depending on your appointment time.

• Drink PLENVU® slowly over 60 minutes. Additionally, please drink a minimum of 500ml of clear fluids with each PLENVU® dose, which may include water, clear soup, tea or coffee without milk, fruit juices without pulp or soft drinks. Alternating between the reconstituted PLENVU® solution and clear fluid is acceptable. Continue to drink clear fluids to keep yourself hydrated until 2 hours before your procedure then stop drinking.

• PLENVU® may be easier to drink through a straw. It can be chilled once it has been made and tastes more pleasant by adding fruit squash but not blackcurrant.

Make sure you are within easy to reach of the toilet once you have taken PLENVU®. Be prepared to have your bowels opened several times during the late afternoon and early evening. It will be like having diarrhoea (very loose watery bowel motions – watery/loose poo).

Common effects of PLENVU® are:

• Nausea (feeling sick)
• Vomiting (being sick)
• Bloating
• Abdominal pain
• Anal irritation (itchy opening to your back package)
• Disturbed sleep

It is normal to suffer from any of the symptoms above. However, if any of these symptoms become severe you should telephone the unit where you are to have your examination or you should contact the GP Out of Hours Services (see contact numbers at the back of this leaflet).

Diarrhoea and severe vomiting may cause your body to become dehydrated.

Symptoms of dehydration are:

• Dizziness
• Headaches
• Confusion

If you develop any of these symptoms, YOU MUST contact your GP or the Accident and Emergency Department (see contact numbers at the back of this leaflet).

Prescribed tablets or medicine (if due) MUST NOT be taken within 1 hour of taking PLENVU®. If taken before this, your medication may be flushed out of your body by the effect of PLENVU®.

If you develop a rash, your body becomes itchy, you have any redness, or swelling in any parts of your body, YOU MUST attend the Accident and Emergency Department (see contact numbers at the back of this leaflet) as you may be allergic to PLENVU®.

Before your examination you must:

• Not smoke
• Tie back long hair for comfort
• Remove any nail varnish
• Remove any makeup
• Remove all jewellery except your wedding ring
• Wear loose fitting clothing

Please do not bring any valuables with you.

If you are not sure about how to prepare for your colonoscopy or flexible sigmoidoscopy, please contact your Endoscopy Unit for advice.

Contact numbers

If you need further advice or have any problems, please contact the unit where you are to have your examinations.

University Hospital of North Tees

Endoscopy Unit

Telephone: 01642 624387

Monday to Friday from 8:00 a.m. to 7:00 p.m.

Accident and Emergency Department

Telephone: 01642 383299

24 hours a day, 7 days a week

University Hospital of Hartlepool

Rutherford Morison Unit

Telephone: 01429 522356

Monday to Friday from 8:00 a.m. to 6:30 p.m.

If you have any worries or concerns, you should contact your GP during normal surgery hours. Outside surgery hours, you should contact your GP’s surgery for the Out of Hours Service number.

Further information available from:

NHS Direct

Telephone: 111 (when it is less urgent than 999)

Calls to this number are free from landlines and mobile phones or via the website at www.nhsdirect.nhs.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]