Before colonoscopy

Preparing for a colonoscopy requires professional preparation, which also takes time. A specialist consultation precedes the mirror examination, where the preparation of the examination is discussed after the patient's condition has been assessed and complaints have been identified. If the examination is performed under anaesthesia, a further face-to-face meeting with the anaesthetist is necessary to decide whether the anaesthesia is suitable.

The day before the test, a thorough bowel movement is required. This can be done by the traditional method, using a combination of bitter salt and ion replacement; at Endomedix centres we use the much gentler Endogol prep. In all cases, the use of the preparation is determined by the doctor or assistant, based on the exact date of the colonoscopy.

The doctor should be informed about the use of blood thinners prior to the colonoscopy, as some medicines (e.g. Aspirin protect, Astrix) should be discontinued 7-10 days before the test. These drugs may increase the risk of post-operative bleeding during the therapeutic procedure (polypectomy).

If you are taking Syncumar or Marfarin, and if you are anticipating a biopsy or bleeding procedure, it is advisable to switch to a therapeutic dose of a low molecular weight heparin preparation (e.g. Clexane, Fraxiparin, Fragmin, etc.) 4-5 days after the switch. After the switch, the blood thinning injection should no longer be given on the morning of the study. However, it is essential that you seek the advice of your doctor.

In a high-risk group of patients (patients who have undergone coronary catheterisation and dilated or stent implantation, coronary artery bypass grafting), discontinuation of Plavix (sometimes combined Plavix/Aspirin) may be associated with a higher risk of a new coronary occlusion. In such patients, consultation of a cardiologist and a gastroenterologist before colonoscopy is strongly advised. If there are cardiological contraindications to the omission of medication, colonoscopy with haemostasis should only be performed in hospital.

Diabetics should also inform their doctor about their condition! In preparation, it may be necessary to reduce the dose of diabetes medication or insulin. If possible, diabetics should drink sugary tea during the preparation to prevent a drop in blood sugar levels.

To prevent hypoglycaemic nausea on the morning of the test, you should not take or administer any diabetes medication (e.g. metformin, glyclazid, etc.) or insulin. In such cases, they should always be taken after the test. It is recommended that the usual insulin doses are delayed on the day of the test.

It is advisable to perform a blood glucose profile test on the day of the test.

In patients with congenital heart valve insufficiency requiring endocarditis prophylaxis, antibiotics should be taken the evening before the test or the morning of the test, after diarrhoea has resolved. It is essential to inform your investigating physician of the need for endocarditis prophylaxis. The choice of the antibiotic to be used as a prophylactic is a medical one.

It is also essential to determine blood coagulation parameters (INR-prothrombin, aPTI, bleeding and clotting time) before colonoscopy. These will be recommended by your gastroenterologist.

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