Gynaecology Leaflet: Pre-Operative Bowel Preparation for Gynaecological Laparoscopic Surgery

Leaflet Details

Patient Information

Introduction

Prior to your admission for laparoscopic surgery, we would like to ensure that your bowel is completely empty as this makes surgery easier to perform and reduces the risk of bowel injury to you. In the unlikely event of this occurring, it makes the management much easier as there is much less risk of contamination. It does, however, mean that you will have to go on a special diet for four days prior to your surgery and take strong laxatives. The laxatives will be given to you at your Preadmission assessment appointment together with instructions.

Bowel preparation is not suitable for all individuals if you have other medical problems for example diabetes or kidney problems. If you feel there is any reason why you may not be suitable for bowel prep then please discuss this with your doctor or nurse.

GUIDELINES FOR PATIENTS HAVING FULL BOWEL PREPARATION FOR SURGERY

Four days before operation, avoid foods that are high in fibre i.e. brown rice, cereals, and vegetables. Choose low fibre alternatives instead.

Three days before operation (fluids only): Omit all solid food and take your meals in liquid form.

NB: See further details on diet and free fluids

Two days before operation (clear fluids and nutritional supplement drinks only).

• Aim to drink 2-3 glasses of clear liquid every 2 hours during the day; e.g. water based drinks, squash, no milk, no fruit juice.
   
• Please take one sachet of bowel prep at 08.00 hours. This needs to be dissolved in one cup of water, stirred for 2-3 minutes and then drunk (please take care as the cup may get hot).

NB: This medication will clear your bowels so you will need to be close to a toilet.

• At 14.00 hours please take the second sachet of bowel prep as instructed.
   
• Please drink 2 Fortisips 200ml cartons (1 in the afternoon and 1 in the evening).

NB: Please note that whilst Fortisips are not a clear fluid, the benefits of taking them outweigh the need to have a totally clear fluid diet before surgery.

One day before operation:

• Continue to drink plenty of clear fluids all day.
   
• Please drink 4 cartons of the Fortisips throughout the day (total 800ml).
   
• On the evening before your operation drink 2 dissolved 50g sachets of your Preload.
   
• If you are admitted to hospital the day before your operation, please bring the Fortisips with you.

Day of operation:

• Drink 1 dissolved 50g sachet of Preload 2-3 hours before the scheduled operation time.
   
• If your operation is scheduled for the afternoon, drink 2 sachets of Preload during the morning.

NB: You are allowed water up to 4 hours before the operation. (Approx. 1 glass water per hour). It is important you do not become dehydrated.

The bowel prep acts as a powerful laxative. This will give you diarrhea and clear your bowel. The time the laxatives will act may vary, but stay close to a toilet after taking the preparation. A little Vaseline round the back passage will prevent soreness.

DIET INFORMATION

Low fibre diet

Bread, other cereals and potatoes

• White bread, white chapatti, white pitta and white flour
• White pasta, White rice
• Refined cereals e.g. Rice Krispies, Cornflakes
• Cream crackers, rice cakes
• Boiled, mashed or roast potatoes (no skin), yams, sweet potato (no skin)

Fruit and vegetables

• Fresh, tinned or stewed fruit but remove any skin, pith or pips
• Vegetables but remove any skins, stalks or seeds

No pulses and nuts

Meat, fish and eggs

• Meat, poultry
• Fish

Milk and dairy products

• Milk, cream
• Plain or fruit yoghurts
• Cheese, butter

Fats

• Margarine, oils

Others

• Plain biscuits e.g. Rich Tea, Morning Coffee
• Cakes, puddings made with white flour and that are nut and fruit free
• Jelly ice-cream, milk puddings, custard, sorbet
• Honey, sugar, syrup, ‘jelly’ type jams
• Tomato ketchup, brown sauce, mayonnaise
• Salt, pepper, herbs, spices
• Boiled sweets, chocolate, toffee and fudge without nuts or fruit
• Tea, coffee, fruit squash, smooth fruit juice (orange, apple or grape) fizzy drinks, hot chocolate or malted milk drinks, Bovril, Marmite

Free fluids / meals in liquid form

• Thick soups without solid bits (clear soups, Consommé, Bovril, Marmite),
• Milk based puddings, custard, ice cream, jelly, yoghurt.
• Boiled sweets, pastilles & peppermints are allowed.
• Drinks, tea & coffee (milk & sugar allowed), smooth fruit juices, squash and milky drinks (Horlicks, Ovaltine, drinking chocolate).

Clear fluids

• Water / plain or flavoured
• Clear soups, Bovril, Oxo & Marmite (dissolved in hot water),
• Squashes without added fruit juice, black tea or coffee (no milk allowed)
• Boiled sweets and pastilles

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