Flexible Sigmoidoscopy Prep

Flexible Sigmoidoscopy Prep Explained

This preparation is used before a flexible sigmoidoscopy to allow clear visualization of the rectum and lower colon. Proper preparation helps ensure the exam can be completed safely, accurately, and without delay.

Important Things to Know

Continue all aspirin and anti-inflammatory medications including ibuprofen, Motrin, Aleve, naproxen, Naprosyn, sulindac, piroxicam, Feldene, indomethacin, diclofenac, and Voltaren. Tylenol (acetaminophen) is also safe to continue.
If you take a prescribed blood thinner you will need holding instructions from our office.
Arrange to have a driver take you home after the procedure. You will not be allowed to drive after receiving sedation.
If you have diabetes or are taking medications for weight loss, use the following instructions:
- Fasting (going without food) is required for this procedure, monitor your blood sugar and follow these directions
  - GLP-1 - STOP 7 days prior to your procedure. (ex: Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity, Semaglutide, Tirzepatide)
  - SGLT2 - Stop 3 days prior to procedure. (ex: Jardiance, Farxiga, Invokana, Steglatro, Brenzavvy, Glyxambi, Synjardy, Xigduo, Qtern)
  - Other oral diabetic medication: do not take the morning of your procedure.
  - Insulin Pump: Leave on, if you have questions refer to your endocrinologist.
  - Long-acting Insulin: half dose the evening before procedure. Do not take the morning of your procedure.
  - Short-acting insulin: dose as necessary with blood sugar monitoring.
  - If you are concerned about your blood sugar dropping, consider purchasing glucose tablets.

Timing & Schedule

Preparation follows a short, structured timeline leading up to the day of your exam. You’ll make diet adjustments in advance, follow a clear-liquid diet beforehand, and complete the required prep on the day of the procedure. Detailed instructions and exact timing are provided below.

Instructions:

Step 1.

7 Days Before Your Procedure

If applicable,

STOP ALL GLP-1 medications 7 days prior to procedure.

Step 2.

5 Days Before Your Procedure

No nuts or seeds.
Stop all fiber supplements including Metamucil, Citrucel, Benefiber, FiberChoice and flax seeds. If you are taking these to treat constipation, take 17g of MiraLAX daily starting five days prior to your procedure in place of the fiber. (This will require you to purchase MiraLAX in addition to bowel preparation stated above).
Stop all oil-based vitamins and supplements to include Vitamin A, D, E, Fish Oil, Etc.

Step 3.

3 Days Before Your Procedure

If applicable,

STOP SGLT2 medications 3 days prior to procedure.

Step 4.

Day of Your Procedure

8 hours prior to the procedure, BEGIN A CLEAR LIQUID DIET. Do not eat any solid foods. You may consume clear fluids including juice (apple, grape, strained orange, strained lemonade), tea, coffee (no milk or creamer), soft drinks, sports drinks (Gatorade, Powerade), clear broth or bouillon, Jell-O, and popsicles.
4 hours prior to your procedure, STOP ALL LIQUIDS. This also means NO water other than to take your medications – this is very important. Drinking less than 4 hours before your procedure may result in delay or cancellation of your procedure.
To prepare the bowel for the procedure, take 2 enemas 1 to 1 ½ hours prior to leaving the house. Try to hold the enema for at least five minutes before releasing it. Wait 15 minutes between each enema. On occasion, the doctor may have you drink an oral laxative as well.
Please continue consuming clear liquids after prep completion to avoid dehydration up until 4 hours prior to your scheduled procedure.
Take your usual prescribed medications with small sips of water.
Please bring a list of your current medications and correct dosage to your appointment.

Step 5.

After Your Procedure

NO DRIVING – you cannot drive for the remainder of the day if you are sedated. You need to have a responsible driver to take you home after your procedure. If your driver wishes to discuss the results of your procedure with the doctor, have them accompany you to your procedure and remain on site.
We do not recommend Uber, Lyft, or taking a taxi – these are not acceptable forms of transportation post-sedation.
You will be sedated for your procedure. Please avoid alcohol and making legal decisions for the remainder of the day after your procedure.

Take Aways

Additional Details

Medication:

STOP GLP-1 medications 7 days prior to your procedure.
STOP SGLT2 medications 3 days prior to procedure.
Clear liquids only the day before your exam – that means no solid foods for breakfast, lunch, or dinner – liquids only.
PLEASE do not drink water or anything while driving to your appointment or waiting for your appointment.
If you are sedated, you may not remember your conversation with your doctor after your procedure – we STRONGLY recommend your driver stays IN our facility to speak with the doctor after your test.

Your procedure time will be approximately 90 minutes from the scheduled check-in time to discharge for procedures in the Endoscopy Centers. Please coordinate with your driver to alleviate delays in discharge. Patients’ stay times for hospital procedures may be longer.
We cannot be responsible for your valuables (watches or various jewelry items). Please leave them at home.
Bring all insurance cards and a photo ID with you. Please check with your insurance company regarding prior authorization. Fee for services is required at time of check-in. Please be prepared to make a payment.
IGA recognizes that your time is valuable, and so is ours. If you need to cancel or reschedule an appointment, please do so more than 48 business hours prior to your scheduled appointment arrival time at 208-343-6458. Late cancellations and no shows may be assessed a $200 fee.

This summary is based on Idaho Gastroenterology’s Flexible Sigmoidoscopy prep instructions and is for education only. Always follow the specific written instructions provided for your appointment, and call the office if anything is unclear.

Flexible Sigmoidoscopy Prep