A colonoscopy is a medical procedure that allows doctors to examine the inside of your colon (large intestine) for any abnormalities such as polyps, tumors, or inflammation. To ensure a successful and accurate colonoscopy, the colon must be completely clean, free of stool and debris.
For this, bowel preparation is necessary, and one of the most commonly used methods is the use of Fortrans (a prescription laxative solution).
This guide explains why it is essential to prepare for your colonoscopy with Fortrans and provides detailed instructions on how to do so.
Why Do You Need to Prepare for a Colonoscopy?
- Clear View of the Colon: The colonoscopy procedure involves inserting a long, flexible tube with a camera into the rectum and through the colon. If the colon is not properly cleaned, stool or waste residue may block the view, making it difficult for the doctor to detect any issues. Proper preparation ensures that the colon is thoroughly cleaned, allowing the doctor to have a clear view for accurate diagnosis.
- Accurate Results: If the bowel is not adequately prepared, the colonoscopy may need to be rescheduled, resulting in delayed diagnosis. Incomplete preparation can also lead to missed abnormalities, potentially delaying the detection of conditions like colorectal cancer, polyps, or inflammation.
- Safety: A clean colon reduces the likelihood of complications during the procedure and helps ensure that the doctor can proceed with the colonoscopy safely.
How to Prepare for Colonoscopy with Fortrans:
1. Understand the Fortrans Solution:
Fortrans is a prescription laxative solution that contains polyethylene glycol (PEG) and electrolytes. It works by drawing water into the colon to help soften the stool and increase the frequency of bowel movements. The goal is to completely empty the colon.
2. Follow Your Doctor’s Instructions:
Your healthcare provider will give you specific instructions on how and when to take Fortrans. Make sure to follow these instructions carefully for the best results. Depending on your procedure time, you may need to take the solution either the day before or on the morning of your colonoscopy.
- 4 up to packets of Fortrans will be prescribed
MORNING PROCEDURE ☀️
ONE DAY BEFORE PROCEDURE
- At 1pm one day before procedure: dissolve first packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (1 to 2 pm)
- At 3pm one day before procedure: dissolve second packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (3 to 4 pm)
- At 5pm one day before procedure: dissolve third packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (5 to 6 pm)
Tip: Drink 30-50 cc salty chicken or beer broth (which saturates the salt receptors on your tongue) then 250-300 cc of Fortrans solution goes down easy with no taste.
ON THE DAY OF PROCEDURE
- At 5am on the day of procedure if stools are not clear ++: dissolve fourth packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (5 to 6 am)
- No more water or fluids 2 hours before the procedure to avoid aspiration
AFTERNOON PROCEDURE 🌇
ONE DAY BEFORE PROCEDURE
- At 1pm one day before procedure: dissolve first packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (1 to 2 pm)
- At 3pm one day before procedure: dissolve second packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (3 to 4 pm)
- At 5pm one day before procedure: dissolve third packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (5 to 6 pm)
Tip: Drink 30-50 cc salty chicken or beer broth (which saturates the salt receptors on your tongue) then 250-300 cc of Fortrans solution goes down easy with no taste.
ON THE DAY OF PROCEDURE
- At 5-6 am if the procedure is in the afternoon: you may have a small meal which consists of either 1 slice of bread or 2 biscuits with a glass of water. No more food after 6 am please.
- At 6am on the day of procedure: dissolve fourth packet of fortrans powder in 1000ml of water. Drink this solution over 1 hour (6 to 7 am)
- No more water or fluids 2 hours before the procedure please to avoid aspiration
3. Mixing the Fortrans Solution:
- Mix the prescribed amount of Fortrans powder (usually one packet) with a large quantity of water (typically 1 liter or 1 quart).
- Stir the mixture until the powder is fully dissolved. The solution should not be thick or gritty.
- The solution may have a salty taste, which is normal. To make it more tolerable, you can chill it in the refrigerator or drink it with a straw.
4. Drinking the Solution:
- Drink the Fortrans solution in small sips over the course of 1 hour.
- For example, you might be instructed to drink one glass every 10–15 minutes until you finish the entire liter.
- Continue to drink water or clear liquids (like broth, tea, or clear juice) throughout the day to stay hydrated.
5. Monitor Bowel Movements:
- After consuming the solution, you will begin to experience frequent and urgent bowel movements.
- The stools should eventually become clear or light yellow in color. This indicates that your colon is adequately cleaned.
- If your stool remains brown or there is still visible waste after drinking all the solution, contact your doctor for further advice.
6. Clear Liquid Diet:
- In the 24 hours leading up to the colonoscopy, you will need to follow a clear liquid diet. Clear liquids include water, broth, clear juices, tea, coffee without milk or cream, and clear sports drinks.
- Avoid any liquids that are red, purple, or orange, as they may interfere with the examination.
7. Avoid Solid Foods:
- Solid foods should be avoided for at least 24 hours before the procedure. This includes foods like meats, vegetables, and fruits.
- Stick to the clear liquid diet as directed by your doctor.
8. Follow Special Instructions for Medications:
- If you take medications, particularly blood thinners, or medications for diabetes, ask your doctor for specific instructions about when and how to take them before the procedure. Some medications may need to be temporarily adjusted or stopped before the colonoscopy.
9. Transportation:
- After the colonoscopy, you will be sedated, and you will not be able to drive. Arrange for someone to take you home.
Common Side Effects and Tips for Comfort:
- Frequent Bowel Movements: As Fortrans works to cleanse the colon, you will experience frequent and urgent bowel movements. Be near a bathroom during the preparation period.
- Abdominal Bloating or Cramping: Some people experience bloating, cramping, or nausea while drinking the Fortrans solution. Drinking the solution slowly and chilling it may help reduce discomfort.
- Hydration: Be sure to drink plenty of water and clear liquids to prevent dehydration during the prep.
Conclusion
Proper bowel preparation with Fortrans is crucial for a successful and accurate colonoscopy. By following the instructions provided by your healthcare provider, you ensure that your colon is thoroughly cleaned, allowing your doctor to detect any issues during the procedure. While the preparation may seem challenging, it is an important step for your health and will provide the best conditions for an accurate diagnosis.
If you experience any difficulties during the preparation or have concerns, don’t hesitate to contact your healthcare provider for guidance.
