Microsoft word - colytegolytelynulytelyprep2-132013

Tanya Davis, MD and Ashita Shah, P.A.-C
Patient’s Name________________________________ Date__________ Time__________ Location____________
*There is a $150 fee for procedures cancelled with less than 72 hours notice.
Colyte, Golytely or Nulytely and Reglan prescriptions need to be filled at your pharmacy. Dulcolax laxative tablets are an
over-the-counter item. Call our office for questions or problems with the prep at 703 780-7010.
Four days before the procedure:
STOP TAKING iron, anti-inflammatory medication [Ibuprofen, Advil, Motrin…], aspirin, Plavix, Coumadin,
Ginkgo biloba or other blood thinners 4 days before the procedure. You may continue taking your other medications, such as blood pressure meds. ● STOP EATING corn, peas, lettuce, celery, green leafy vegetables, broccoli, raw tomatoes or seeds 4 days before
Two days before the procedure:
● Take ______ Dulcolax Laxative tablets [THIS IS AN “OVER-THE- COUNTER ITEM”] in the evening.
One day before the procedure:
1 In the morning begin a clear liquid diet. This includes coffee/tea (no milk or non dairy creamer), any soda/seltzer
water, apple juice, white grape juice, white cranberry juice without pulp, chicken broth/bouillon soup, yellow Jell-O without fruit, yellow popsicles, Italian ice, clear or lemon Gatorade, Power Ade. No solid food, dairy or anything red or purple in color.
2 In the evening or late afternoon the day before your procedure, take a Reglan [metoclopramide] tablet.
3 A half hour after taking the Reglan, start drinking the Colyte, Golytely or Nultytely. Drink one 8oz glass every
10 to 15 minutes until the entire gallon has been consumed. If you feel nauseous or bloated take a 30 minutes break and then continue. It is very important that you finish all the prep liquid so that your stools start looking like beer or lemonade.
You can expect to start having bowel movements either while taking the prep or within one hour after you have finished the
prep. Remember to stay close to toilet facilities, as the Laxative will work quite suddenly.
Nothing to eat or drink after midnight, except if your procedure is after 1:00pm you may have 2 glasses of clear liquid
before 9:00 am on the day of the procedure. (This includes coffee/tea without cream.)

If you take DIABETIC MEDICATION, DO NOT TAKE them the NIGHT before the procedure or the MORNING of the
If you take BLOOD PRESSURE MEDICATIONS DO TAKE them with a small sip of water the MORNING of your
Please bring all your medications, including inhalers to the procedures. If you use a BiPap or CPAP machine at home, please
bring those as well. Please, do not use any lotion on your skin the day of the procedure.
You must have someone drive you home from the procedure. You cannot take Taxi home.
● If you have a procedure done at INOVA Healthplex: report directly to the 2nd floor Surgical Suite 45 minutes
If you have a procedure done at Mount Vernon Hospital: report directly to Same Day Surgery Suite (Yellow
parking entrance) on the first floor 60 minutes before your scheduled procedure time.
● If you have a procedure done at Digestive Healthcare Endoscopy Suite: report to suite 307 at 2616 Sherwood
Hall Drive in the Sherwood Hall Medical Center 30 minutes before your scheduled procedure time. You may bring
a robe and slippers for your comfort (Digestive Healthcare Endoscopy suite patients only)

Please call the office in 10 days for results if a biopsy was taken, if you do not receive a letter from us.
*This procedure is safe but carries the risk of, but not limited to reactions to medications, tear in the intestines, bleeding and the possible
need for surgery or blood transfusion.


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