Preparation for a colonoscopy with Pico-Salax
Download a copy of the patient guide Preparation for a Colonoscopy with Pico-Salax (PDF).
Download a copy of the Checklist – preparation with Pico-Salax (PDF)
What is a colonoscopy?
A colonoscopy is an examination that allows the doctor to see the inner lining of your intestines, including the rectum (anus) and the colon (large intestine). The doctor uses a flexible tube called a colonoscope to do this test.
A colonoscopy allows the doctor to diagnose a health problem and determine an appropriate treatment. If necessary, a small sample of tissue may be taken for laboratory analysis. This is called a biopsy.
The examination helps to find the causes and treat problems related to:
- Bleeding
- Anemia
- Diarrhea or constipation
- Stomach pain
- Intestinal cancer or polyps
- Crohn’s disease or ulcerative colitis
- Narrowing of the colon
Why must you prepare for a colonoscopy?
Your bowels must be empty in order for your physician to clearly see the bowel lining during the exam. The quality of your preparation directly influences the quality of your exam.
- A good preparation will ensure more accurate results. The doctor may not be able to see polyps or cancer because of an incomplete preparation.
- Your exam may be cancelled or you may have to retake it if your preparation is inadequate.
How to cancel or reschedule your appointment?
To cancel or reschedule your appointment, please call 613-632-1111 extension 72504 at least 5 business days in advance.
How to prepare for a colonoscopy with Pico-Salax?
You must follow all preparation instructions carefully. If you are taking any medications (prescription, over-the-counter or herbal) or vitamins and supplements, ask the specialist who will be performing the colonoscopy if you should stop taking them for a period of time before the procedure or continue as usual.
At least 7 days before your exam
- Read carefully to understand all the instructions. You will need to change your diet, which may require some planning of your schedule.
- Call 613-632-1111 extension 72504 if you have any questions.
- Purchase the following products from a pharmacy (required):
- A box of Pico-Salax (or Purgodan) containing two packets
- 4 tablets of Bisacodyl
- Stock up on clear drinks that you like, such as:
- Energy drink like Gatorade or Powerade
- Clear fruit juice without pulp (apple juice, white grape juice, white cranberry juice or lemonade)
- Clear soup or clear broth
- Water, Kool-Aid, iced tea, fruit juice popsicle, Jell-O, ginger ale, 7-Up, Sprite
- Tea or coffee without dairy products or milk substitutes
- Do not buy any products that are red or contain red dye (drinks, popsicles, Jell-O). Red stains the bowels and looks like blood during the examination.
- Get zinc oxide ointment and wet baby wipes. These products are optional, but they will help reduce irritation of the skin around the anus.
- Plan your return home.
- You will not be able to drive for 24 hours after the exam because of the sedatives used for the procedure. A sedative is a medication that causes drowsiness.
- A responsible adult must accompany you back home. We cannot let you leave by yourself in a cab.
- If you do not have a ride home, your exam will be cancelled or done without sedation.
About Pico-Salax and laxatives
A laxative is a medicine that makes you eliminate stools, often in the form of diarrhea.
- Pico-Salax is a powerful laxative – it is also called Purgodan. Strictly follow the instructions on this page. Do not follow the instructions on the Pico-Salax package.
- Bisacodyl is also a laxative. The first dose of Bisacodyl often causes a bowel movement, but does not necessarily cause continuous diarrhea.
- Everyone reacts differently to laxatives. You may feel the effects within an hour or a few hours after taking the laxative.
- Allergic reactions to any of these products are very rare. However, if you have severe stomach pain, persistent vomiting, weakness or fainting, call 9-1-1.
Tips for preparing and drinking the Pico-Salax mix
- Use only water to dissolve Pico-Salax powder and never other types of liquids. The water can be cold or at room temperature.
- Drink the mixture with a straw placed at the back of your mouth, in order to taste it as little as possible.
- After drinking it, you can:
- Rinse your mouth with water or mouthwash
- Take small sips of flavoured liquids such as Gatorade or Powerade (but not red liquids)
- Suck on a hard candy or lollipop
- If you have nausea, you can drink ginger ale to relieve it. You can also take Gravol (anti-nausea medication). Take 25 or 50 mg every 4 to 6 hours as needed. You can buy Gravol at the pharmacy without a prescription.
- You may chew gum during the preparation period before the test, but do not swallow it! However, do not chew gum while you are on the way to your appointment.
What to eat and not to eat before the exam
4 days before your test
You must pay close attention to what you eat. Follow the list of foods presented below until the exam.
- Stop taking any fibre supplements 4 days before the exam.
- If you are not sure if a food is allowed or not, don’t eat it as a precaution.
Permitted foods
- Fresh or toasted white bread
- White rice
- White pasta
- Dairy products (yogurt, milk, cheese)
- Eggs
- Chicken, beef, pork, fish
- Cooked vegetables
- Canned fruit
Foods to avoid
- Whole-grain breads, cereals and pasta
- Brown rice or wild rice
- Oats
- Fresh fruit
- Raw vegetables
- Nuts or seeds
- Foods containing nuts or seeds
- Popcorn
About seeds: Seeds and dietary fibre are part of a healthy diet. However, you should not eat them for 4 days before the exam because they block the colonoscope (the flexible tube used to perform the exam). If the tube becomes blocked, we may have to stop the exam and do it again later.
Instructions according to the time of your exam
Important: Preparation begins 3 days in advance. Please follow the preparation instructions based on the scheduled time of your exam, either before 10:00 a.m., or after 10:00 a.m.
Preparation for an exam before 10:00 a.m.
3 days before your exam
Example: If your exam is on Thursday, you must start your preparation on Monday.
- Eat foods that are low in fibre (see list of permitted foods above).
- At 8:00 p.m.: Take 2 tablets of Bisacodyl.
2 days before your exam
- Continue to eat foods that are low in fibre (see list of permitted foods).
- At 8:00 p.m.: Take 2 tablets of Bisacodyl.
The day before your exam
- Have a light breakfast (toast, tea, coffee, juice).
- Drink only clear liquids after breakfast. Solid foods, milk and dairy products are not allowed until after the exam.
- Throughout your preparation, drink enough clear liquids to prevent dehydration. Liquids such as Gatorade and Powerade are recommended.
- Dehydration can cause weakness or dizziness. It is best to have a responsible adult with you during your preparation.
- 5:00 p.m.: First dose of Pico-Salax
- Follow these instructions instead of the ones on the Pico-Salax package.
- Empty the contents of a packet of Pico-Salax into 250 mL (1 cup) of water.
- Mix for 2 to 3 minutes until the powder is completely dissolved.
- Drink the mixture, all at once. Then drink 6 to 8 250 ml (1 cup) glasses of clear liquid over the next 3 hours.
- Do not take any medication within 2 hours of drinking the Pico-Salax mixture.
- You will have cramps and very soft or liquid stools and will go to the bathroom often.
5 to 6 hours before the exam
- Second dose of Pico-Salax
- Example: If your exam is scheduled for 8:30 a.m., you should do this step around 3:00 a.m. We understand that this schedule is not suitable for everyone. If you can’t do it during the night, take the second dose at 10 p.m., or as late as possible in the evening.
- Prepare the second packet of Pico-Salax following the same instructions as last night.
- Drink the Pico-Salax mixture.
3 hours before the exam
- Stop drinking any liquids.
- Do not take anything by mouth, including candy and gum.
Preparation for an exam at 10:00 a.m. or later
3 days before your exam
Example: If your exam is on Thursday morning, you must start your preparation on Monday morning.
- Eat foods that are low in fibre (see list of permitted foods above).
- At 8:00 p.m.: Take 2 tablets of Bisacodyl.
2 days before your exam
- Continue to eat foods that are low in fibre (see list of permitted foods above).
- At 8:00 p.m.: Take 2 tablets of Bisacodyl.
The day before your exam
- Have a light breakfast (toast, tea, coffee, juice).
- Drink only clear liquids after breakfast. Solid foods, milk and dairy products are not allowed until after the exam.
- 8:00 p.m.: First dose of Pico-Salax
- Follow these instructions instead of the ones on the Pico-Salax package.
- Empty the contents of a packet of Pico-Salax into 250 mL (1 cup) of water.
- Mix for 2 to 3 minutes until the powder is completely dissolved.
- Drink the mixture, all at once. Then drink 6 to 8 250 ml (1 cup) glasses of clear liquid over the next 3 hours.
- Do not take any medication within 2 hours of drinking the Pico-Salax mixture.
- You will have cramps and very soft or liquid stools and will go to the bathroom often.
The morning of the exam (5 to 6 hours before your exam time)
- Second dose of Pico-Salax
- Example: If your exam is scheduled for 11:30 a.m., you should do this step around 5:30 a.m.
- Prepare the second bag of Pico-Salax following the same instructions as last night.
- You must finish drinking your mixture at least 4 hours before your appointment.
- Take your regular medications with a sip of water, especially your blood pressure or heart medications.
- Drink only clear liquids. Do not eat any solid foods.
3 hours before the exam
- Stop drinking any liquids.
- Do not take anything by mouth, including candy and gum.
Arrival at the hospital
Hygiene and clothing
- Take a bath or shower before coming to the hospital.
- Wear loose-fitting clothing that you will be comfortable in after surgery.
- Please do not wear:
- Jewelry
- Metal items
- Hair clips
- Nail polish
- Make-up or perfume
- Contact lenses
What to bring
- Valid Health Card
- A list of all your medications, including prescription, over-the-counter, vitamins and supplements, and herbal medicines.
Arrival time and registration
- Please arrive at least 60 minutes before your scheduled appointment.
- Register at one of the self-serve kiosks located at the main entrance. Clerks are available to help with the registration process.
- Then go to the Perioperative Services located in Block C, Level 1.
In the Endoscopy Unit
When you arrive in the Endoscopy Unit, you will be asked to change into a hospital gown. You can put your personal belongings in a locker or give them to the person accompanying you. Do not bring valuables with you.
- The nurse will confirm your medications and allergies, and take your blood pressure and pulse while you lie on a stretcher.
- The nurse will ask you questions about your preparation for the exam. If your bowels are not completely empty, you may need an enema.
- The nurse will insert a needle into a vein in your hand or arm to administer the sedative.
- You will then go into the examination room and be able to ask questions to the physician.
The examination
- You will be given a sedative to help you relax and induce conscious sedation, meaning that you will be able to breathe without the aid of a machine. Some patients fall asleep during the exam, but wake up easily and can follow instructions. Some patients are awake enough to watch the exam on the screen.
- During the examination, you will be lying on your left side in the fetal position (your knees brought towards your abdomen).
- The doctor inserts the colonoscope through the anus to perform the examination. The colonoscope is a thin, flexible tube with a camera that transmits images onto a screen. Air is blown into the colon to get a better visualization, which may cause slight discomfort or cramps.
- During the examination, the doctor may detect polyps and remove them, which is called a polypectomy. A polyp is an abnormal mass of tissue that can range in size from a few millimetres to several centimetres. A polypectomy is not painful.
- The examination usually takes 20 to 30 minutes.
After the examination
- You will be kept under medical supervision in the endoscopy department for 30 to 60 minutes. You may leave the hospital when the medication wears off.
- The specialist will explain the results of the examination and tell you what to do next. The specialist’s report will be available in your electronic medical record. To open an account or learn how to access your medical record online, visit MyChart.
- You may feel bloated for a few hours because of the air blown in during the examination.
Returning home
- You may resume eating and drinking normally immediately after the exam unless your doctor or nurse tells you otherwise.
- When you get home, if you have a severe stomachache, fever or a lot of bleeding from your anus, call your doctor. If you can’t reach your doctor, go to the nearest emergency room if you are worried about your symptoms.
Important: You must not drive for 24 hours after this test because of the sedatives you received. You must have someone drive you home.
