Understanding Bowel IMPROVING DIGESTIVE HEALTH THROUGH Preparation Before Colonoscopy EXCELLENCE IN ENDOSCOPY What are the types of
bowel prep?
Understanding Bowel Preparation Before Colonoscopy
Several types of bowel prep medications It is extremely important that your colon be thoroughly cleaned before your are available and are listed to the right. colonoscopy. This will let the doctor see any abnormalities, such as colon Your physician may recommend one of polyps, during the procedure. Polyps are small growths in the colon that these or another available prep. You will could later turn into cancer.
need to carefully follow your doctor's Cleansing the colon before a colonoscopy is called bowel preparation, or instructions about the exact dose and "prep." It involves taking medication that causes diarrhea, which empties timing of your prep. Some bowel preps the colon. The medication is taken by mouth, and comes in liquid, powder are covered by your medical insurance. to be mixed with water or tablet form.
You should consider asking your insurance company if any available preps would require you to pay out-of- In order for the
pocket costs.
procedure to
What determines the type of
be accurate and
prep I get?
complete, the colon
must be completely
Your medical history and current clean. Your doctor
condition are the most important factors will tell you to change
in deciding which type of bowel prep is your diet at least
best for you. Tell your doctor if you have one day before your
any medication allergies or have ever had difficulty with taking a bowel prep in the past. Let the doctor also know if you are pregnant or breast feeding What bowel (colon)
before your colonoscopy. Your doctor or have ever had high blood pressure, preparation steps are
will decide which prep is best for you. heart, kidney or liver disease, or a involved before a
previous bowel obstruction. Your doctor • It is important to avoid dehydration might also consider your individual during bowel prep. Drink more fluids preferences (taste and amount of Your doctor will prescribe the type of than you usually do. medication) and out-of pocket costs bowel prep that is best for you. You will when choosing your prep.
receive specific instructions on how to Can I continue to take my
take your prep. Carefully follow all the current medications?
steps your doctor prescribes. In general, Tell your doctor what medications you can expect to do the following: you're taking, especially aspirin • Limit your diet to clear liquids for at products, arthritis medications, blood least one day before your colonoscopy. thinners (such as warfarin, clopidogrel Clear liquids include broth, tea or and dabigatran, which are available coffee (no milk or creamer), gelatin under the brand names of Coumadin®, desserts, soda, sorbet, popsicles, and Plavix® and Pradaxa®), blood pressure clear fruit juices (without pulp) such as medications, insulin or iron products. apple juice. Avoid gelatin desserts or Most medications can be continued liquids that are red or purple in color. while you take your prep, but some can interfere with either the prep or the • Your doctor will tell you exactly when colonoscopy. Your doctor will decide to stop eating and drinking before your which medications to continue or stop.
Polyps are benign growths
within the lining of the colon.
Most colon cancers develop
• Some preps are split dose. This means Why is bowel prep important?
from colon polyps over a period
that you would take some of the prep Your bowel must be clean so that your of several years. Removing
the day before your colonoscopy and doctor can thoroughly examine your colon polyps reduces the risk
the rest of the prep on the day of your colon. It is important that you try your for colon cancer.
colonoscopy. Or, your doctor may ask best to fully complete the prep.
you to take the entire prep the day What if I forget to take the
medication when I should or
remember too late to finish
the prep?
Bowel Prep Medications
Call your doctor if you are unable to Polyethylene glycol (PEG) electrolytes lavage solution comes as a
complete the bowel prep. You should powder to be mixed with water before use. PEG-based products are
also call the doctor if you experience often preferred for patients with kidney, heart and liver conditions
vomiting, severe abdominal pain or because they do not cause mineral or fluid changes that can lead to
if there is visible brown stool after dehydration. PEG products are available as full volume (4 liters) or low
completing the bowel prep volume (2 liters) preps.
as instructed.
Phosphate-based preps come in liquid or tablet form. Sodium
phosphate can cause mineral or fluid changes in the body. Because
What are the common side
of these changes, it is not recommended in the elderly, patients with
effects of bowel prep?
kidney disease, high blood pressure or heart failure, or in patients
taking certain blood pressure or arthritis medications. In rare cases,
The type and severity of side effects sodium phosphate can cause kidney injury.
differ among patients and with the prep used. Some patients have nausea, Sulfate-based prep is an osmotic laxative indicated for cleansing of the
vomiting, bloating (swelling in the colon as a preparation for colonoscopy. It is available in liquid form.
abdomen) or abdominal pain. In rare It is important that you consult your doctor about your specific
cases, certain preps can cause kidney injury, worsen heart failure or cause seizures. Your doctor will explain the possible side effects of the prep selected Cleaning your colon thoroughly before your colonoscopy
allows the doctor to see abnormalities, such as colon polyps,
during the procedure. Cleansing the colon involves taking
medication that causes diarrhea, emptying the colon.
Some people have found these tips helpful
for taking the prep:
• refrigerate the prep prior to drinking it
• drink it with a straw
• suck on a lemon wedge before drinking it

• plan ahead—think about the time it
will take to travel to your appointment
when deciding when to start and finish
your prep
Important Reminder: This
information is intended only to
provide general guidance. It does
not provide definitive medical
advice. It is very important that
you consult your doctor about your
Since its founding in 1941, ASGE has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. This information is the opinion of and provided by the American Society for Gastrointestinal Endoscopy.
Gastrointestinal endoscopy helps patients through screening, diagnosis and treatment of digestive diseases. Visit to learn how you can support GI endoscopic research, education and public outreach through a donation to the ASGE Foundation.
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Copyright 2014 American Society for Gastrointestinal Endoscopy



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Isolation of the highly pathogenic and zoonotic agent burkholderia pseudomallei from a pet green iguana in prague, czech republic

Elschner et al. BMC Veterinary Research 2014, 10:283 Isolation of the highly pathogenic and zoonoticagent Burkholderia pseudomallei from a pet greenIguana in Prague, Czech Republic Mandy C Elschner1*, Jan Hnizdo2, Ivonne Stamm3, Hosny El-Adawy1, Katja Mertens1 and Falk Melzer1 Background: Melioidosis caused by Burkholderia (B.) pseudomallei is an endemic zoonotic disease mainly reportedfrom northern Australia and Southeast Asia. In Europe, cases of human melioidosis have been reported only frompatients travelling to endemic regions. Besides humans, B. pseudomallei has a very broad host range in domesticand wild animals. There are some reports about importation of B. pseudomallei-infected animals from endemicareas into Europe. The present report describes the first case of B. pseudomallei infection of a pet iguana in Europe.