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Hello all,

Despite having a bit of a rocky start, I have thankfully been doing fairly well and without functional problems! I am coming up on my first pouchoscopy, and I was wondering if it were possible to prep for the procedure without the bowel prep?

I still tend to get dehydrated really quickly, and it would be so much more comfortable for me if I could perhaps just drink liquids 24 hours before the procedure versus using actual prep. I also have a long commute to my doctor, and so it would be really helpful if I could avoid the bathroom continuously.

I'd really appreciate any tips! I do have to get a good reading on this, since I may have some minor problems that we need to look out for (potential tears/bleeding).

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Those laxative preps follow "one size fits all." Before and after my colectomy, I've vomited the preparatory laxative solution several times. The volume of liquid required is usually waaay too large for my stomach.

I understand now that I'm a tall guy with a small stomach. Hard lesson.

At a certain point in experience you inevitably make calls on your own.

Hello, Teddy92.

I am scheduled for endoscopy appointments every six months. My prep for pouch scopes and previously for colonoscopy procedures:  Soft foods three or four days in advance, such as fish, egg, tofu. Foods that are easily digested and pass through cleanly. No red meat, or seeds or grains, no corn or peas, no insoluable food.  Twenty four hours before the procedure I have only clear liquids and clear broth. No cranberry juice or anything with colour. I bring a thermos of warm broth so I can have something to drink right after the procedure when I am usually loopy and tired (I always ask to be sedated for endoscopy or any procedures happening back there!) I try to ease back into solid food afterward. Good luck. I hope your results are clear.

Thank you all so much for the kindness and helpful info! I'll try and do just fluids 24 hours prior to the procedure and will bring an enema bottle to the hospital in case I think it'll help to clear things further before the procedure.

Winterberry, is there a reason you try to ease back into food? I was hoping to eat a normal full meal to help my empty stomach after the procedure!

Hi, Teddy92,

i ease back into solid food after the endoscopy because I've spent a few days slowly emptying my stomach and pouch, and 24 hours pre-scope have only liquids, so I want to help my empty stomach and pouch accept the food without cramps or diarrhea. I start with sips of warm broth when I'm fully awake (I always ask for sedation) then I go home and have rice, pasta or chicken for lunch, although as soon as I'm awake the nurses offer juice and a cookie. Every patient is offered that whether they were sedated or not because of the recent fasting or enema to bring blood sugar back up. I've had three scopes since colon removal a year ago (including the pouchoscopy in preparation for takedown) and 25 years of sedated colonoscopies so I developed this routine that is easy on my stomach, and pouch. Once, I was hungry and we had a big lunch. I was sorry a few hours later with cramps and loose output that I could have avoided. Whatever you decide is best for you, remember to have fluids afterward to replace whatever you lost through enema or food slowdown. 

I haven't had a scope done since my post op scope in 2008. so I'm seeing a different doc. he has me on liquids for 2 days. laxatives the nite before. plus a fleet enema the morning of. and instead of air, uses water during the scope. Is this common?  I tend to have low blood pressure and dehydrate easily.  and my bowels are normally watery. I'm worried about all this. my score is in 2 days. please reply

Deb, this is more prep than most of us go through for pouchoscopy. Clear liquids the day before and a couple of tap water enemas (until clear) on the morning of the procedure is usually sufficient for most purposes. Did you get these instructions directly from the doctor or from some other staff member? They often don't have pouchoscopy-specific instructions prepared, so the staff will say all kinds of things. 

I fast for two days prior to the pouchoscopy just having clear fluids, broths, jello, ect.  Apple juice acts on me like a like a Strong laxative.  The night before I drink some apple juice and after many trips to the bathroom I am then ready for the test.  I never drink apple juice unless I am prepping for a scope.....lol

Be careful of "one size fits all" scope directions, as most GI offices draft  stock instructions for colonoscopies . 2 bottles of magnesium citrate is a colonoscopy prep. My doctor does like laxatives for a pouch prep- usually half a 10 ounce bottle of Mag Citrate is enough. But I also do a Fleet enema. You can probably get away with doing no laxatives if you drink clear liquids for a long enough time.

Last edited by CTBarrister

I am currently prepping as well 2 days prior. Pouchoscopy is on Tuesday and I started clear liquids today, Sunday (soup, powerade zero, Popsicles, apple juice and grape juice). I agree with what some are saying our pouches sometimes get left out in the prep work we are sent and i don't want to wreak havoc on my pouch so I think by doing the few days of liquid will help ensure I am cleared and cleaned by the time I go in without laxative.

Last edited by FabSab

I am prepping for my endoscopic balloon dilation tomorrow and just downed a 10 ounces bottle of Magnesium Citrate.  It always amazes me that I am able to get the entire bottle down without vomiting.  I always do it but I always have a sickening aftertaste in my mouth that doesn't go away for a long while.  But I never puked from it.  Any of you guys ever puke from Mag Citrate?

I will post in the EBD thread after the procedure and results are back.

Last edited by CTBarrister

Just had the procedure yesterday with . Dr Bo Shen's at Columbia.  

prep was clear liquids day prior and 1 bottle of Miralaxpowder (Polyethylene Glycol : 238 gmsor 8.5 oz.) mixed with 64 oz. bottle of Gatorade.  Drink 8 oz every 10-15 starting 6pm the night before, and plenty of clear liquids during prep. Then nothing by mouth 6 hrs before procedure.

This was also a component of the bowel prep prior to surgery with Dr. Kiran.

As someone who has suffered greatly with various prep methods in the past, I found it remarkably easy, especially for the pouchoscopy  

but as others have noted:  prep should be agreed upon by the endoscopist beforehand  


@AMB posted:

Just had the procedure yesterday with . Dr Bo Shen's at Columbia.  

prep was clear liquids day prior and 1 bottle of Miralaxpowder (Polyethylene Glycol : 238 gmsor 8.5 oz.) mixed with 64 oz. bottle of Gatorade.  Drink 8 oz every 10-15 starting 6pm the night before, and plenty of clear liquids during prep. Then nothing by mouth 6 hrs before procedure.

This was also a component of the bowel prep prior to surgery with Dr. Kiran.

As someone who has suffered greatly with various prep methods in the past, I found it remarkably easy, especially for the pouchoscopy  

but as others have noted:  prep should be agreed upon by the endoscopist beforehand  

Hey AMB,

How did it go with Shen? Did you have the banding?

Regarding the prep, I had the same with Shen which was way more than my local surgeon. I think it depends on what they plan to do during the scope. If they’re going to band and/or treat a sinus tract with needle knife than they probably want things a bit cleaner. Hence the laxative.

@Pouch2021,

Procedure went well, Pouch in great shape except for a prolapse. The banding will happen after additional tests: barium defecogram and manometry.  Apparently this is to help evaluate the mechanics issue and identify where to band and also rule out significant functional problems for which they typically order biofeedback. I will skip any biofeedback because I think I have the straining under control and it is not practical for me because of distance.

In addition to the prep,  they put me out with propofol for the scope. He takes a biopsy during the procedure and tests for prolapse using air to emulate straining. Perhaps the prep and sedation are to allow for that evaluation. I'm curious about it, and will ask when I'm there next.

@AMB posted:

@Pouch2021,

Procedure went well, Pouch in great shape except for a prolapse. The banding will happen after additional tests: barium defecogram and manometry.  Apparently this is to help evaluate the mechanics issue and identify where to band and also rule out significant functional problems for which they typically order biofeedback. I will skip any biofeedback because I think I have the straining under control and it is not practical for me because of distance.

In addition to the prep,  they put me out with propofol for the scope. He takes a biopsy during the procedure and tests for prolapse using air to emulate straining. Perhaps the prep and sedation are to allow for that evaluation. I'm curious about it, and will ask when I'm there next.

https://www.j-pouch.org/topic/...ntly-asked-questions

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