Preparing for Your Unsedated Flexible Sigmoidoscopy

Questions after reading this?

Call the GI Triage Line at 720-723-6166, option 2, Monday – Friday and leave a message. An RN will call you back within 48 hours, or on Monday if you call on the weekend. For questions at night or on weekends, call 303-399-8020, select “0” and ask for the GI doctor on call.

As soon as you schedule your flexible sigmoidoscopy

• Please plan to arrive 60 minutes before your appointment time.
• A sigmoidoscopy is usually done without sedation, and you may come alone and drive yourself home.

14 days before your flexible sigmoidoscopy

• The Anticoagulant Clinic should call you if you take a blood thinner such as Warfarin/Coumadin, Eliquis/Apixaban, Xarelto/Rivaroxaban or Pradaxa/Dabigatran. If they haven’t by fourteen days prior to the procedure, call 720-723-6756.
• If you are on Plavix/Clopidogrel, Brilinta/Ticagrelor, Pletal/Cilostazol, Aggrenox/Aspirin with Dipyridamole or Prasugrel/Effient, you should receive a call from the GI Department at least fourteen days prior to the procedure. If you don’t, please call 720-723-6166.

7 days before your flexible sigmoidoscopy

• STOP EATING corn, popcorn, frozen corn, seeds or nuts of any type. These foods are very difficult to clean from your colon.
• STOP taking any IRON supplements as they may discolor your colon.

3 days before your flexible sigmoidoscopy

• STOP taking any Vitamin E, fish oil, mineral oil, or flaxseed oil. These can cause bleeding.
• Buy two bottles of Fleets enemas at your pharmacy or grocery store.

The day of your flexible sigmoidoscopy

• Take any morning medications you need (but not any of the supplements listed above).
• You may have a very light breakfast such as juice, tea, coffee, toast.
• If your procedure is in the afternoon do not have lunch.
• Administer the two enemas at least ONE HOUR before you leave home to come here. If you will drive over an hour to get here, you may wait until you are here to do the enemas.
• Come to your appointment 60 minutes beforehand! The GI Lab is on the 3rd floor of building D, Mount Harvard. Take elevator number 1 to the 3rd floor, and our waiting room will be on the east side of the building.

Do you have diabetes? Or take any weight loss/diet medication?

Take special care while only drinking clear liquids!

• Monitor your blood sugar every 4 hours during your prep time before your colonoscopy.
• If you have an insulin pump: Maintain pump as usual and bring all pump equipment and supplies as well as continuous glucose monitor on the day of the procedure.

Oral diabetic medications: Please hold all oral diabetic agents the morning of the procedure.

Metformin: Hold the night before and the day of the procedure.

GSLT2i: (Canagliflozin,Dapagliflozin,Empagliflozin): hold 3 days prior to the procedure.

GLP1R: agonists (Ozempic, Wegovy): Hold oral dose the morning of surgery. Hold weekly injections 1 week(7 days) prior to the procedure.

Insulin: Hold all short acting insulin when on the liquid diet (1- or 2-day colon prep). Decrease the long-acting Insulin 50% the days you are doing the prep/liquid diet. Take 50% of the normal long-acting dose of insulin on the day of the procedure IF YOU TAKE A MORNING DOSE.

Do Not Take short acting insulin on the days of prepping/liquid diet or day of the procedure.

Taking any of the following GLP-1 medications for Diabetes, weight loss, or any other reason? If taking once daily, stop taking 2 days before procedure. If taking once weekly, stop at least 7 days before procedure: Dulaglutide, Exenatide, Liraglutide, Lixisenatide, Semaglutide, Tirzepatide. Stop taking Phentermine 7 days before procedure.

Please consult your PCP or Endocrinologist if you think your diabetic or weight loss adjustment may be an issue for you.