How to Prepare for Your Colonoscopy or Flexible Sigmoidoscopy Using Klean-Prep

This leaflet tells you how to prepare for your colonoscopy or flexible sigmoidoscopy examination with Klean-Prep.

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 below or your examination may have to be cancelled or repeated.

Before taking Klean-Prep

Please read the back of the Klean-Prep packet and contact nursing staff in the Endoscopy Unit for further advice if you answer yes to any of the following questions:

• are you diabetic on insulin or tablets?
• 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 medication to thin your blood?
• are you pregnant or breast feeding?
• do you suffer from any kidney disease?

If you are taking aspirin, you can continue to take this.

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 Codeine Phosphate, but continue to take all other usual medications.

3 days before your appointment

You must drink at least 250ml to 300ml of fluid (an average size teacup full) of drink from the diet list every hour (throughout the day time) over the 3 day preparation period. If you do this your bowel will be empty, clean and ready for your endoscopy and colonoscopy examination.

2 days before your appointment

If you are taking Fybogel or any other fibre products stop taking them now.

1 day before your appointment

You are advised not to go to work on this day. You should expect frequent bowel actions starting within 3 hours of taking your bowel preparation. Some abdominal cramping is normal.

Stay within easy reach of the toilet. To complete the 4 sachets should take between 4 to 6 hours.

It is important that you are well hydrated (drink plenty of fluids) before your appointment.

You may drink black tea, coffee and soft drinks throughout the day. You can add sugar if you like but no milk in any form.

You must not drink any alcohol.

Prescribed tablets or medicine (if due) must be taken at least 2 hours before taking your Klean-Prep. If taken after this, it will be flushed out of your system before it has had time to work.

For a morning appointment

If you have a morning appointment please follow the instructions below.

Between 8.00am to 12.00 noon on the day before your appointment, you should have your breakfast. No more food or medication to be taken after this time until after your examination.

2.00pm:

Dissolve the first sachet of Klean-Prep in 1 litre (1¾ pints) of water. Stir until the solution is clear.

This can be prepared in advance, flavoured with fruit squash (not fruit juice) and stored in the fridge.

Drink 1 glass full (¼ litre or ½ pint) of Klean-Prep about every 15 minutes until you have drank it all. It should take about 1½ to 2 hours.

Some abdominal cramping is normal, stay within easy reach of a toilet.

Do not take more than 1 sachet at a time.

4.00pm:

Prepare the next 2 sachets in the same way. You can store the Klean-Prep solution in the fridge while you are drinking them. You should be starting to have watery bowel motions so stay near a toilet.

If you have not had a bowel movement after taking the 2nd sachet, wait until you do before taking the 3rd sachet.

If, after taking the 3rd sachet your bowel movements are watery (no solids), there is no need to take the 4th sachet. If you are not sure then you should take the 4th sachet.

If you have slept through the night and still have not had a bowel movement you should contact the Endoscopy Unit (see contact numbers).

For an afternoon appointment

If you have an afternoon appointment take 2 sachets on the evening before your appointment and the rest the next morning. Please follow the instructions below.

Between 12 noon to 2.00pm on the day before your appointment, you should have your lunch. No more food or medication to be taken after this time until after your examination.

4.00pm:

Dissolve the first sachet of Klean-Prep in 1 litre (1¾ pints) of water. Stir until the solution is clear. This can be prepared in advance, flavoured with fruit squash (not fruit juice) and stored in the fridge.

Drink 1 glass full (¼ litre or ½ pint) of Klean-Prep about every 15 minutes until you have drank it all. It should take about 1½ to 2 hours.

Some abdominal cramping is normal, stay within easy reach of a toilet.

On the morning of your appointment

7:00am:

If, after taking the 3rd sachet your bowel movements are watery (no solids), there is no need to take the 4th sachet. If you are not sure then you should take the 4th sachet.

If you have slept through the night and still have not had a bowel movement you should contact the Endoscopy Unit (see contact numbers).

Contact numbers

University Hospital of North Tees

Endoscopy Unit

Telephone: 01642 624387

Opening hours: 8:00am to 7:00pm (Monday to Friday)

Accident and Emergency Department

24 hours a day, 7 days a week.

Telephone: 01642 382899

University Hospital of Hartlepool

Rutherford Morison Unit

Endoscopy Unit – Hartlepool

Telephone: 01429 522356

Opening hours: 8:00am to 6:30pm (Monday to Friday)

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 is available from:

NHS Choices

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

Calls to this number are free from landlines and mobile phones or via the website.

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]