Lower EUS Prep Instructions

IMPORTANT MEDICATION INFORMATION

The following medications should be held as instructed prior to procedure:

Phentermine: Adipex-P, Qsymia, and Lomaira (Daily) – These medications will need to be stopped seven (7) days prior to your procedure.

GLP-1 Medications

All GLP-1 medications, including those listed below, will need to be stopped seven (7) days prior to your procedure if you are on a weekly dose or the day of your procedure if you are on a daily dose.

Dulaglutide: Trulicity (Weekly)
Exenatide: Bydureon (Weekly) and Byetta (Daily)
Liraglutide: Victoza (Weekly) and Saxenda (Daily)
Lixisenatide: Adlyxin (Daily) and Soliqua (Daily)
Semaglutide: Ozempic (Weekly), Wegovy (Weekly) and Rybelsus (Daily)
Tirzepatide: Mounjaro (Weekly) and Zepbound (Weekly)

General Prep Important Instructions

Bring an Adult Driver

Bring an adult driver. Your driver must be 18 years of age or over and they must stay in the Endoscopy Center. You will be given a sedative for your test, and you are not to drive until the next day. Therefore, one person must stay and drive you home. Your procedure will be rescheduled if your driver cannot stay in the Center.

Rescheduling

If you need to reschedule your procedure, please call your physician’s office at least 3-4 days in advance so that we may schedule another patient in your appointment time.

Notify Us in Advance

If you are taking a blood thinner prescribed by a physician (such as Coumadin, Plavix, Effient, Eliquis or Ticlid). Your gastroenterologist will need to determine if these medication dosages require adjustment prior to the procedure. Failure to properly adjust these medications may result in cancellation of your procedure. You may continue to take Aspirin as usual.
If you are having chest pain, undergoing cardiac testing, or have pending cardiac tests. (IMPORTANT: Please notify us before you begin to prep for your procedure.)
If you have had any recent hospitalizations.
If you have ever had excessive bleeding after an operation or problems with anesthesia.
If there is a possibility you are pregnant.

DO NOT

DO NOT take iron, diet pills (Phentermine, Adipex or Qsymia), GLP weekly injections, or herbal medications for seven (7) days prior to having your procedure. You may take vitamins.
DO NOT drink alcohol for 24 hours before or after your procedure.
DO NOT use items such as gum, hard candy, breath mints, smokeless tobacco, or illicit drugs such as marijuana on the day of your procedure.
DO NOT drink liquids that are not clear such as milk or creamer.
DO NOT drink liquids that are red or purple in color.
DO NOT smoke tobacco, marijuana, vape, or chew tobacco on the day of your procedure.
DO NOT eat solid food on the day of your procedure.

Other Important Details

If you have dentures, you may be required to remove them for the procedure.
Leave your valuables at home. If you have body piercings, you will be asked to remove them prior to the procedure for your safety.
If you are a diabetic, do not take your diabetic medication the day of your procedure. Bring your medication with you so you can take it after your procedure.
If you have asthma, please bring your inhaler with you.
Take your usual prescribed medications with no more than two (2) tablespoons / one (1) ounce of water up to three (3) hours prior to your appointment time.

1 Day Before Procedure

If you are having only a lower endoscopy follow these instructions.

The day before your procedure you may have your usual food until 10:00 pm. After 10:00 pm you may have clear liquids only until 3 hours before your scheduled appointment arrival time.

You may take your prescribed medications (except those listed in the booklet) with water up to 3 hours before your appointment arrival time on the day of your procedure.
Do not use items such as gum, hard candy, breath mints or smokeless tobacco on the day of your procedure.

Clear Liquids

Clear liquids include: water, coffee, tea, clear broth or bouillon, Gatorade, PowerAde, carbonated and non‐carbonated soft drinks, Kool-Aid or other flavored drinks, clear fruit juices such as apple or white grape juice, Jello or popsicles.

NO RED OR PURPLE COLORS – NO MILK PRODUCTS – NO ALCOHOL

If You Have Diabetes, Please Read

Diabetic Prep Information

Medications

If you take oral medications for your diabetes, do NOT take your diabetes pills on the day prior to your procedure (prep day) or on the day of your procedure (until your procedure is complete and you resume a normal diet).
If you take non-insulin injectable medications (Byetta, Bydureon, Victoza, Trulicity, Tanzeum, Symlin), do not take the medication if your injection day is the day prior to your procedure (prep day). You can resume it after the procedure is complete.
If you take insulin, reduce your dose by 50% (half) of your normal dose on the day prior to your procedure and the day of your procedure. You can resume your normal dose after the procedure when you resume normal diet.
If you use an insulin pump, contact your diabetes doctor for instruction. Generally, most patients will need to reduce their basal rate to 80% of the normal rate.

Diet

You should aim for 45-60 grams of carbs with each meal. Although you may ordinarily avoid sugars, they are ok to take when you are prepping for your colonoscopy as these will be the main source of calories when you are on a clear liquid diet.
For snacks, try to include other fluids that contain electrolytes such as broth.
Examples of clear liquids with carb amounts are listed below. Note, if you experience low blood sugar (<60) during the 2 hours before your procedure, you can take 3 teaspoons of soda or clear juice to raise your sugar. Do NOT take solid foods or non-clear liquids, as your procedure will be cancelled.

FLUID	AMOUNT	CARBS
Juice	1/2 cup	15 g
Jello	1/2 cup	15 g
Soda	1 can	40 g
Popsicle	1 double stick	15 g
Gatorade/Powerade	1/2 cup	15 g
Broth (veg/chicken/beef)	any	0 g
Clear Protein Drinks	any	0 g

Please call us at 901-747-3630 if you have any questions or if you are having difficulty with the preparation. We are available 24 hours a day, 7 days a week.

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