Associate Professor John Lubel
BDS, FDS RCS (Eng), MBBS, MRCP (UK), FRACP, PhD, FGESA
Consultant Gastroenterologist and Hepatologist
Bowel Preparation with PLENVU
BOWEL PREPARATION WITH PLENVU
For a successful colonoscopy the bowel must be clear of any stool (faeces). Inadequate preparation increases the duration and risk of the procedure, limits the views of the bowel lining and hence increases the chance of missing abnormalities. This may result in the colonoscopy (and bowel preparation) being repeated.
Bowel preparation is not pleasant as it results in diarrhoea and is generally inconvenient. Please adhere to the following instruction as best you can. These instructions are more detailed than those provided with the PLENVU packet, and we strongly advise that you adhere to these instructions, as they have been designed to optimise the bowel preparation for colonoscopy.
PLENVU offers a low volume bowel preparation (1 litre total) compared to standard preps such as MOVIPREP (2 litres).
The timing of the bowel preparation depends on when the procedure is to be performed. Please take note whether your colonoscopy is in the morning or afternoon.
STEP 1 - TWO DAYS BEFORE COLONOSCOPY - LOW FIBRE DIET
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Stop eating high fibre foods. A list of foods that are allowed and foods that should be avoided can be found at the end of this document (appendix).
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Stop eating foods with seeds grains, peel or skin
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STEP 2 - ONE DAY BEFORE COLONOSCOPY - WHITE DIET
Commence the White diet:
• Milk (regular, low fat, skim), water, lemonade, soda or mineral water, clear (not coloured) Gatorade or other sports drinks
• Regular white bread/toast, rice bubbles, white rice, regular pasta, potatoes (peeled), rice noodles, plain rice crackers, white flour, sugar
• Eggs, chicken breast (no skin), white fish fillet (no skin)
• Plain cream cheese, cheddar cheese, ricotta, fetta, cottage, parmesan or mozzarella cheese, white sauce
• White coloured yoghurt (no added fruit or inulin), mayonnaise, cream, sour cream, butter and margarine, oil for cooking
• White chocolate, vanilla ice cream, lemonade icy-pole, clear jelly, custard, “milk bottles”(confectionery)
AVOID HIGH FIBRE WHITE FOODS: e.g. cauliflower, onion, parsnips, pears, couscous, high fibre white bread, popcorn, banana, porridge, and coconut
STEP 3 - THE AFTERNOON BEFORE COLONOSCOPY
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PLENVU comes as a powder for reconstitution to form two doses of bowel preparation solution. Dose 1 is made up from 1 sachet that makes a mango-flavoured solution and Dose 2 comprises 2 sachets that make up a fruit punch flavoured solution.
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You need both doses for adequate bowel preparation
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Prepare the 1st Dose of PLENVU solution by mixing sachet 1 with 500ml of water. The solution may be kept in the fridge (out of reach of children) for up to 12 hours.
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We use a “SPLIT” preparation for morning and afternoon procedures whereby the two doses are consumed on separate days. This has proven efficacy, increased detection of abnormalities and improved tolerability. The exact timing for taking PLENVU will depend on when the procedure is scheduled (see below).
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The bowel preparation is not a substitute for normal fluid intake. Dehydration can occur and it is very important that other clear fluids are also taken during the period of bowel preparation. At least a further 500ml (2 cups) of these clear fluids must be consumed for each 500ml of reconstituted PLENVU solution.
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STEP 4 - TAKING THE BOWEL PREPARATION SOLUTION
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Please look at the following chart to determine the timing of bowel preparation
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The timing of taking the preparation depends on when your procedure is scheduled.
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STEP 5 - AFTER THE BOWEL PREPARATION
• Please note the times above for the onset of FASTING. This is important, as your stomach must be empty at the time of colonoscopy. In addition, have NOTHING TO DRINK FOR AT LEAST 3 hours before the procedure. Occasionally, if you are suspected of having slow gastric emptying the period of NIL BY MOUTH may be extended to 6 hours before the procedure.
• For further information regarding colonoscopy please see the additional patient information sheet.
PLENVU CMI
PLENVU GUIDE