Diet and Bowel Preparation Information for patients using Plenvu

Morning and Afternoon Appointments

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• Days before the procedure
• The day before your procedure
• On the day of your procedure
• After the procedure

The aim of this information is to help you to prepare for your endoscopy procedure (colonoscopy, flexisigmoidoscopy or enteroscopy). Please read this thoroughly for advice on alterations needed to your diet and administration of bowel preparation medication to clean your bowel in the days leading up to your endoscopy test.

These instructions for taking your bowel preparation replace those enclosed in the packets containing Plenvu.. However, it is important you read the manufacturer’s leaflet inside the packet of preparation before you take the bowel preparation. The leaflet will tell you about the preparation itself, allergies, indications for taking or not taking the preparation, the possible side effects, the effect it can have on taking oral medications – in particular medications that may affect fluid balance, and when you should consult a doctor before taking the bowel preparation.

Any usual oral medication should be taken at least two hours before starting the Plenuv to minimise the risk of flushing the medication through the gut and not being fully absorbed.

The aim of the bowel preparation is to clean your bowel so that there are clear views of the lining of your bowel during your endoscopy procedure. If you are unable to take any of the bowel preparation for any reason or your bowel preparation does not work properly it is important you contact the endoscopy unit using the contact telephone number on your endoscopy appointment letter.

Poor bowel preparation may mean that your endoscopy procedure will be stopped or may not go ahead and you will need to repeat the preparations and endoscopy test on another day.

We understand we may be asking you to get up early on the day of your test to take your second sachets of bowel preparation.

Research shows that to achieve good views during your colonoscopy procedure and reduce the risk of missing lesions or polyps it is best to take the second part of your bowel preparation 5 hours before the time of your appointment for your endoscopy test. If you feel it is impossible to get up this early to take your bowel preparation please contact endoscopy.

Important information about some of the ingredients of Plenvu
Plenvu contains aspartame, which is a source of phenylalanine which may be harmful for people with phenylketonuria (a genetic disorder affecting metabolism). It also contains ascorbate which may be harmful for people with glucose-6-phosphate dehydrogenase deficiency. Do not take Plenvu if you have phenylketonuria or glucose-6-phosphate dehydrogenase deficiency, please contact endoscopy.

The remainder of this information advises you on how to prepare in the days leading up to your endoscopy procedure. Please follow the actions below starting 7 days before the day of your appointment if you take iron medications or day 4 before for all other patients.

Schedule for preparing for your endoscopy procedure (colonoscopy, flexisigmoidoscopy, enteroscopy)

Please follow the instructions below, starting seven days before your procedure.Make sure you finish all the Plenvu even if your motions are already liquid and clear.

Seven days before the procedure

If you are taking iron tablets please stop taking them, but continue all other medications including laxatives.

Four days before the procedure

If you are taking any constipating agents (e.g. loperimide, codeine phosphate etc.) stop taking them. Continue with all other medications until your appointment.

Three days before the procedure

Start low fibre diet and continue until you start taking your bowel prep medication. For the best results in cleansing the bowel a low fibre diet is advised. Eating other foods may affect how well the bowel preparation works to ensure good views of your bowel during your procedure.

Low Fibre Foods Allowed	High Fibre Foods NOT allowed
White meat, including skinless chicken, grilled or poached fish	Red meats, bacon, sausages or pies, black pudding
White bread, toast, pasta, rice, noodles or boiled or mashed potatoes (no skins)	Breakfast cereals
Cheese, Eggs boiled or poached, Tofu	Wholemeal or seeded bread, wholemeal pasta or brown rice
Ice Cream, custard, clear jelly (NO red or blackcurrant), boiled sweets	Fruit, Vegetables or salad
Butter/margarine	Deep fried or roasted potatoes, potato skins or chips
Shredless marmalade or clear jam (no bits)	Nuts, pulses, lentils, beans
Clear soups	Chocolate, Cakes, Yoghurts, Cream
Rich tea Biscuits or similar plain biscuit	No other Biscuits than specified in foods allowed
Water, Tonic water, black tea or coffee sugar or sweetener	Milk
Soft drinks (non fizzy) including quash (no red or blackcurrant) Clear fruit juices without pulp/bits examples clear apple or white grape	Fresh orange or juices with pulp Alcohol
Bovril	Crisps

The day before your procedure

Take your regular morning medicines unless you have been instructed otherwise.

Breakfast as usual (using foods from fibre diet)

Lunch no later than 1pm (using foods from low fibre diet)

Following lunch even if you are hungry, do not eat any solid food after 1pm because this may affect how the bowel prep works, your bowel must be completely empty to ensure we have clear views during your endoscopy procedure.

You should not eat any further solid food until after your procedure. However, you may drink clear fluids throughout the day. This should preferably be water, but you can also have tonic water, tea or coffee without milk, soft drinks (non fizzy) including squash (no red or blackcurrant) clear fruit juices without pulp/bits for example clear apple juice, Bovril.

Plenvu is a two-dose preparation.

Dose 1 is a single mango-flavoured sachet.

Dose 2 is two sachets (A and B) and fruit-punch flavour.

All sachets must be taken with the right amount of water following the schedule below.

7pm

Make up your first dose of Plenvu

Open the carton and remove Dose 1 (one sachet)
Pour the contents into a jug or container that can hold 500mls of fluid.
Add 500mls of water and stir until all the powder has dissolved, this may take up to 8 minutes.

Drink the 500mls of Plenvu, try to drink a glass full every 10 to 15 minutes over 30minutes till complete.

You should continue to drink plenty of clear fluids (at least 500mls or 1 pint) over the next couple of hours.

You should expect frequent bowel motions and eventually watery diarrhoea. Some stomach discomfort is normal. Please use a barrier cream if your bottom becomes sore and stay within easy reach of the toilet.