Colonoscopy and Sigmoidoscopy

Please report for the examination 30 minutes prior to its scheduled time; do remember to bring the referral form with you.
Diabetes sufferers should provide information about the disease at the registration desk while scheduling the examination, since in those patients the procedure should be performed early in the morning.

Necessary additional examinations
• None required.

Preparation for the examination
If the preparations described below cannot be applied, an alternative manner of preparing for the procedure will be determined by the referring physician.

7 days before the examination
• Discontinue iron preparation use.
• Persons taking antiplatelet agents - e.g. Aspirin, Acard, Ticlid - should discontinue them upon prior consultation with the prescribing physician.
• Persons taking anticoagulants - e.g. Sintrom, Syncumar, Acenocoumarol, Warfarin - should contact their attending physician and change the drugs to low-molecular-weight heparin.

4 days before the examination
• Avoid eating raw fruit and vegetables, particularly those with fine seeds, e.g. grapes, raspberries, currants, strawberries, kiwi, figs, tomatoes, cucumbers, and preserves made from them.
• Avoid eating beetroot, wholegrain bread, poppy seed.

The day before the procedure
• Breakfast should be light and not contain carbonated drinks or milk.
• Small lunch is allowed in the early afternoon. This should consist of semi-liquid and easily absorbed produce (e.g. kissel, custard, gruel, yoghurt). Dinner should not be eaten.
• If colonoscopy is scheduled in the morning, the whole preparation should be conducted in the afternoon and evening of the preceding day. In particular:
- at approx. 2 p.m., the main preparations start, i.e. the taking of FORTRANS preparation (available on prescription; the prescription is issued by the referring physician; please read the patient information leaflet prior to using it);
- each Fortrans sachet (four in total) should be dissolved in 1 l of still water (4 l in total); this should be drunk within 5-6 hours;
- to improve the flavour, the solution may be chilled or lemon juice added;
- from the moment of starting taking the Fortrans preparation, do not eat anything; drinking of still water or tea is allowed.
• If colonoscopy is scheduled in the afternoon or evening, the necessary amount of the laxative should be divided in such a manner that the 3 Fortrans sachets dissolved in 3 l of still water should be drunk in the afternoon/evening of the preceding day, while the last Fortrans sachet dissolved in 1 l of still water should be drunk in the morning on the day of the procedure.
The body's response to taking the Fortrans solution will be frequent defecation - ultimately with liquid content.
In the event of difficulties in the preparation for the examination, particularly deterioration in the general feeling, contact with a physician is necessary.

On the day of the procedure
• If colonoscopy is scheduled for the afternoon/evening, drink 1 l of still water with 1 Fortrans sachet dissolved in it, in the morning of the day of the examination.
• If the procedure is to be performed under general anaesthesia - do not eat anything 8 hours before the examination. Do not drink anything either 6 h before the examination!

NOTE - the binding principles of disinfection and sterilisation of endoscopic instruments limit to the minimum the risk of infectious disease transfer (including hepatitis) during endoscopic procedures. In view of the above, current vaccination against infectious diseases (including hepatitis A and/or B) are not mandatory for the procedure.

Drugs
• On the day of examination, take all the routinely taken drugs. The only exception are those lowering the blood glucose level used by diabetics - the manner of taking such drugs should be defined by the referring physician.

Necessary information for the physician
• The patient should provide the documentation of previous endoscopic procedures and medical history reports from the hospital.
• Provide information on all taken drugs.

During the procedure
• Inform about sudden complaints.

After the procedure
If the examination is performed under general anaesthesia:
• the patient stays in the clinic for approx. 2 hours after the procedure,
• the patient should leave the facility under the care of an accompanying person,
• the patient should not drive vehicles for 12 hours after the procedure.