Union Health 

Patient Information Sheet 



Phone appointment with Pre-Anesthesia Testing nurse:    
Please be sure to answer this call. If you miss the call, please call the PAT clinic at 812-238-7474. All of your medications will be discussed and instructions will be given by the pre-anesthesia testing nurse during this phone appointment. 

Procedure Date:  


Place of Service:  

Please make transportation arrangements, you will not be able to drive yourself home. 

Procedure Time: The PAT clinic will call you the day prior to your procedure to give your arrival time.   
You will need to pick up the following at the pharmacy:  

Golytely Bowel Prep Kit – Prescription necessary

Important things to note:  

- Do not take any anti-inflammatories (Ibuprofen, Advil, Aleve, Motrin, Nuprin, Medipren or fish oil) for 5 days prior to your procedure. You may take Tylenol. 

Do not eat popcorn or chia seeds 5 days prior to your procedure 

- If you are currently taking any prescribed blood thinners:   
Plavix, EffientBrilinta, Warfarin/Coumadin - needs to be stopped 5 days prior to your procedure. 
Pradaxa, Eliquis – needs to be stopped 2 days prior to your procedure 
Xarelto – needs to be stopped 1 day prior to your procedure 
Aspirin – 81 mg once a day does not need to be stopped, you may take as normal.  


      GI office will contact your prescribing physician to request clearance for you to stop these prior to the procedure. Plan on stopping them the number of days listed unless you are contacted and told otherwise. If your doctor does not grant clearance you will be contacted and advised to continue taking your medications as normal. If you have any concerns about this you may contact your prescribing physician. 


Stop all fiber supplements ( Benefibre) and medications containing iron, including multivitamins.

Cocoa, coffee, tea, carbonated beverages, synthetic fruit-flavored beverages (no red food coloring), cooked refined cereals (cream of wheat or oats), gelatin, sherbet, ice cream, ices, puddings, custard, cream, butter, margarine in cereal or soup, meats pureed in milk or very thin cream soup or broth, baby food, strained cream soups, broth or bouillon, vegetables pureed in milk or very thin cream soups or broth, salt, honey, sugar, plain syrups, hard candy, marshmallows, flavorings except anything with red, purple or orange food coloring; soft chocolate, plain cream candies, eggs chopped finely.


  • Morning: Mix Golytely/Nulytely with water as directed and refrigerate.
  • Remember to drink plenty of clear liquids throughout the day to ensure hydration.
  • Beveroges: Coffee, tea, carbonated beverages, apple juice, cranberry juice or grape juice if all natural with no food coloring, Pedialyte
  • Desserts: Plain gelatin (no fruits or vegetables) - No red food coloring
  • Soups: Bouillon, or strained broth (NO vegetables or meat)
  • Sweets: Sugar, hard candy, popsicles (NO red food coloring), shaved ice
  • Miscellaneous: no alcoholic beverages
  • 3PM Drink Golytely/Nulytely one (1) glass every 10 - 15 minutes until completely gone. Nothing by Mouth after MidnightMorning of the Procedure
  • Take blood pressure, heart, thyroid, seizure and breathing medication with sips of water.
    Note: You will not be allowed to drive yourself home following the procedure due to the sedation used for the exam.

How do I know if my prep is enough?

The stool should be watery in consistency and should be a clear, yellow-tinged fluid without stool particles. Digestive stomach secretions will continue to “tint” the stool yellow. If you are concerned that there are still stool particles present, you can give yourself one or two saline enema laxatives (these are available in pharmacies without prescription as 4.5 fluid ounce enemas) prior to leaving home for the procedure. If your prep is inadequate, the physician may not be able to visualize the entire colon adequately.


If you have any questions please feel free to contact your doctors office. 

Reference: Union Health.