“SUTAB” Colonoscopy Instructions
Laura K. Bianchi, MD
Rebecca W. Tsang, MD MPH
Endoscopy Center of the North Shore, LLC
www.ginorthshore.com
PHONE: 847-256-1855 FAX: 866-375-3001
| SUTAB can cause gastritis and is not recommended for patients having an upper endoscopy (EGD) along with colonoscopy! It also may not cleanse as well as liquid preps, so is not the first choice for an extended prep. |
| Things you need: Read everything! Download the app Clear liquids Sutab prescription Simethicone (infant gas drops) OTC Magnesium citrate 10 oz OTC A ride home! |
“SUTAB” Prep Kit Instructions
We are offering you a free app to guide you through the prep process and answer any questions you might have. Why? The prep is not easy, and we don’t want you to have to repeat the process. This was developed by Dr. Mehta and this practice. It takes less than a minute to register, is tailored to your exact prep type and time, and is available 24-7! Scan the QR or go to the website.
Summary:
Preparation for colonoscopy involves a restricted diet, drinking the prep with the goal of clearing the colon, fasting prior to the procedure, and some further instructions regarding an empty stomach on arrival, blood thinners, GLP-1 medications, metformin, phentermine, and having a ride. Please see the details listed below in Special Instructions.
THE WEEK BEFORE YOUR PROCEDURE – Discontinue all non-medical aspirin products, vitamin E, fish oil or any inflammatory agents for 7 days prior to the procedure. If your colonoscopy is less than 7 days away, stop taking any of these medications starting now. Stop all iron supplements. A multivitamin with iron is OK. No popcorn, seeds, or nuts for 1 week prior to your procedure.
You will need to go to the pharmacy and pick up one Sutab kit (available only by prescription). Also pick up a 10 oz bottle of magnesium citrate, and one 1 oz bottle of simethicone “Infant Gas Formula”. These are over the counter. Don’t wait till the last minute.
2-5 DAYS BEFORE YOUR PROCEDURE – Discontinue any blood thinners (Plavix, Effient, Pradaxa, Brillinta, Coumadin, Xarelto, Eliquis etc.). Aspirin for your heart is OK. The exact number of days to stop the medication is specific to exactly what you are taking and why. Prior to stopping medications, please contact your PCP or cardiologist for directions. If you have to stay on your blood thinner, let us know.
Day prior to procedure – NO SOLID FOOD AFTER BREAKFAST
- Breakfast with no fiber (eggs and black coffee, for example) is OK
- Clear diet the rest of the day till midnight (soft drinks, tea, apple juice or Gatorade)
- Jell-O and Popsicles
- No red, orange, or purple colors
- No milk or dairy Products
** It is very important to drink plenty of fluids throughout the day to stay hydrated**
At 7 PM the day before your procedure:
2ND dose – begin 5 hours prior to your procedure
Also take the second half of the “Infant Gas Formula”. You can add water to the bottle as it is very thick.
| You must start 5 hours earlier than your appointment to allow time for the prep to work. At the 4 hour mark you must assess your stools for the need for extra magnesium citrate. You must be fully fasting (not even a sip) >2 hours. |
Nothing by mouth after midnight except your prep, essential medications, and (if needed) magnesium citrate.
Are you clean enough?
| If needed! |
THE MORNING OF YOUR PROCEDURE – If your stools are not clear, drink the bottle of magnesium citrate at the four-hour mark before your procedure. If you are having anesthesia, they will not do your case if you have had anything by mouth within a critical time window so plan ahead.
Report to the G.I. lab 30 minutes (or as directed) before your scheduled appointment time. Please arrange for someone else to drive you home and be with you for 12-24 hours. If they can be flexible with the timing, we might call you in early, and we will make every effort to update them if we are behind. No taxi’s or Ubers are allowed. A limo service is available at your expense if needed, but this has to be arranged ahead of time.
A note about anesthesia – If you have special anesthesia needs, please make an office appointment first. All procedures done at the office involve the use of propofol and an anesthesiologist or CRNA. You will not be able to drive home because of this. Anesthesia at the hospital is usually conscious sedation unless by special arrangement, but even then they make no guarantees.
A note about billing – You may see charges for consultation or physical exam as well as the procedure. You may likely see separate bills from the hospital, anesthesia provider, and pathologist.
Afterwards – The doctor will speak to you before you leave and will share a copy of your procedure note via our patient portal. You must sign up for the patient portal if you want to be able to see and save your records, discuss results remotely, have prescriptions sent, etc. We do not print paper copies of reports.
Special Instructions:
- If you are on a blood thinner talk to your physician whether it can be discontinued and when. Do not discontinue unless OK’d by primary doctor, cardiologist, or another prescribing doctor.
- If you are on a GLP-1 agonist (Ozempic, Wegovy, Mounjaro, Zepbound, newer pill forms, and other brands) DO NOT take your usual dose for at least one week (a full 7 days) prior to the exam.
- If you are on phentermine, DO NOT take your usual dose for at least one week (a full 7 days) prior to the exam.
- Do NOT take elective pain medication such as naproxen or ibuprofen for 7 days before your procedure. Tylenol is OK. Aspirin for your heart is OK.
- Diabetics should NOT take diabetes medicines the day of the procedure, but you should bring these medicines with you. If you take metformin or a metformin-containing diabetes medication, do NOT take it for 24 hours prior to the procedure. If you have brittle diabetes, talk to your primary doctor or endocrinologist regarding glucose management the day before and the day of the test.
- You should take all your other regular medications every day, including the day of the procedure. You must take any necessary medications at least 4 hours before the procedure. Otherwise, take them afterwards.
- Patients with pacemakers or automatic implantable cardiac defibrillators (AICD) must contact the GI lab once the procedure is scheduled. The hospital may require interrogation of your device before and after the test. The office will NOT perform procedures with AICD’s or pacemakers.
Should you cancel your procedure for any reason we ask that you notify the office at least 72 hours in advance or a fee will be charged. Please be respectful of the many other patients who are waiting for openings. We cannot simply call someone in for a colonoscopy if there is a last minute cancellation, so these spots are valuable to people.
If you have any questions, call the office well in advance. If you have any urgent issues the night before, you can page the physician through the office number. You can also check the website for FAQ’s. If you have any questions please call the office, (847) 256-1855.
