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Preparing your bowel for diagnostic examination
You are due to undergo a diagnostic examination of the bowel, for which you must prepare with an
It is extremely important to achieve a high level of cleanliness of the bowel for the forthcoming
enteroscopy (coloscopy). For this there is a gentle, modern and palatable agent – G
Good preparation of the bowel will enable the diagnostic procedures to show all details, thus reducing the
examination time. Only good preparation of the bowel will ensure that you do not have to repeat the
The measures you have to undertake, particularly the evacuation of the bowel and the restriction of your
food intake are viewed by many patients to be more unpleasant than the examination itself. A sedative
and analgesic drug is often prescribed for the examination, to prevent unpleasant sensations.
The aim of this brochure is to tell you how intestinal cleansing with our G
avage product should be
performed to ensure success and comfort. In doing so we will attempt to answer any questions you may
have on intestinal cleansing and allay any fears or problems with explanation.
WUVO GmbH wants to help you to easily and successfully prepare your bowel for your examination using
the extremely effective, and pleasant-tasting, G
avage product. Please read the following instructions carefully, as they contain important information about what
you should be aware of when using the bowel preparation! Please consult your doctor if you have
I. Taking medication:
Please discuss with your doctor how you should take your normal medication before and during the
intestinal lavage. Medication may be flushed out of the bowel during the intestinal lavage and therefore be
ineffective. It is particularly important that you consult your doctor if you are taking any of the following
: Aspirin or. ASS (Thrombo-ASS etc.), or ticlopidin/clopidogrel (=Plavix or Iscover)
should normally be stopped 1 week prior to the enteroscopy. Therapeutic heparinization should be
suspended 6 hours before the coloscopy.
2. Oral antidiabetics and insulin
: Oral diabetics should be stopped or adjusted, with monitoring of blood
Insulin patients can inject themselves as normal in the morning before the examination. It is essential that
you discuss the details with your GP or diabetologist.
3. Iron preparations
: Despite good preparation, these can significantly impede visibility during the
enteroscopy and it is therefore imperative that they are stopped 3 to 5 days before the examination.
4. Contraceptive pill
: The evacuation of your bowel may reduce effectiveness, resulting in insufficient
protection. You can nevertheless continue to take the pill as normal, but additional forms of contraception
should be used! These are general recommendations only and you should discuss your exact course of action with
We also recommend the use of an anal cream (e.g. Bepanthen) when preparing for the coloscopy, to
avoid irritation of the skin as the bowel is evacuated. II. Nutritional advice:
In the 5 days leading up to the enteroscopy
, please observe the following:
Please do not
eat any fruit or vegetables with small pips
(e.g. grapes, strawberries, kiwi fruits,
tomatoes, cucumbers) or bulking and thickening agents
(wheat bran, Agicur, Metamucil etc.).
Please also avoid all high-fiber foods
of any kind (wholemeal bread, asparagus or muesli), as these are
hard to digest and can impede the intestinal cleansing. 2 days before and after the examination
, please eat a light, low-waste and flatulent diet
includes, for example, lean beef, poultry, veal, rice and pasta.
Please avoid fruit and vegetables, pulses, dairy products, sugar, black (rye) bread, cabbage, pumpkin,
onion, garlic, sausages, roast and fatty meat and egg-based foods. On the day before the examination:
Have tea and zwieback for breakfast, and a broth with rice or pasta for lunch. Only drink clear fluids
Clear fluids can include clear soup, clear broth (small quantities), fruit juice without fruit pulp, black tea,
black coffee or still lemonade.
III. Preparing and taking the intestinal lavage solution:
You have received a pack with 8 sachets
avage powder to prepare 4 liters
For a complete intestinal cleansing please drink the entire 4 liters prior to your scheduled bowel
(If deemed appropriate by your doctor, you may alternatively have received fewer sachets.)
Dissolve the content of 1 sachet in half a liter
of lukewarm water. The solution is pleasanter to drink
After leaving to cool (in the fridge), drink one glass (250 ml) every 10 - 15 minutes; the first 2 liters should
have been consumed within 2 hours.
The next liter or next 2 liters are then drunk in the morning before your enteroscopy. You can therefore divide the quantity to be drunk as follows:
2 or 3 liters on the day before the enteroscopy and 2 or 1 liter(s) respectively on the morning of the
The last liter should be taken at least 1 hour before the start of the examination, to allow complete
evacuation of the bowel. IV. Taking the intestinal lavage solution:
No solid food should be eaten for at least 2 hours before taking the intestinal lavage solution until after the
examination. On the day before the examination,
have a light breakfast and lunch. A total of 2 or 3 liters
solution must be drunk at the necessary intervals throughout the afternoon by 10.00 p.m.
(2 or 3 l)
Plus clear fluids or water
Day of the coloscopy
(1 or 2 l) On the morning
(before the intestinal examination) please drink 1 or 2 liter(s)
of the intestinal lavage
solution as applicable from about 6:00 a.m. onwards
The aim of cleansing the bowel with our product G
avage is to achieve a clear watery bowel
movement. As soon as this is the case, you can stop drinking. If your enteroscopy is scheduled for the afternoon,
the drink solution you have created with G
avage should be drunk as follows:
Start drinking the intestinal lavage solution from 6:00 a.m. onwards on the morning
of the day of the
examination. The entire quantity (4 liters
) of the solution should be drunk in glassfuls at 10-minute
intervals within 2-3 hours
. After that, if you feel thirsty during the evacuation, you can drink some clear
fluid (still water).
Please follow the instructions above with respect to food intake. Please do not eat any more food once
you have started taking the bowel preparation.
V. Please note:
Remain near to a toilet for the whole duration of the intestinal cleansing.
In the case of unpleasant symptoms such as stomach cramps or nausea (due to the extremely
high volume which has to be drunk for the intestinal lavage), it is often enough to simply
slow down consumption slightly! Also be aware of the possible side effects listed on the leaflet
Please note that you should not drink anything up to 1 hour before the examination!
If you drink considerably less than the recommended quantity, your bowel may not be
thoroughly cleansed and the examination cannot take place as planned. Please therefore
Do not add any other solutions or additives (particularly sugar or aromatics) to the intestinal
lavage solution, as these will alter the osmolality or electrolytic composition and may cause gas
compounds to develop in the bowel when the added substances are broken down by intestinal
If you suspend or prematurely stop taking the solution, your bowel may again not be thoroughly
cleansed and the examination cannot be performed as planned.
VI. What else should be borne in mind?
If you are given a sedative for the examination, your ability to drive
may be impaired. In this case, do not
drive yourself to the examination. You are welcome bring a companion along to the examination who can
take you home afterwards, or arrange for someone to collect you.
If you wear contact lenses
, we would ask you to wear your glasses on the day of your examination. Thank you very much for your cooperation and good luck with preparing for your examination!
Status: May 2005
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from the Neandertal type specimen. Proc. Natl Acad. Sci. USA 35. Cavalli-Sforza, L. L., Menozzi, P. & Piazza, A. The History and But a few exceptions do exist. Some reces- 96, 5581–5585 (1999). Geography of Human Genes (Princeton Univ. Press, Princeton,sive mutations (mutations that influence a25. Krings, M. et al. A view of Neandertal genetic diversity. Nature person only if
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