Cleaning the bowels with antibiotics and bowel preparation prior to surgery has been shown to significantly reduce the chances for infection in some colorectal operations.
ITEMS YOU WILL NEED:
- We will obtain the medications needed from St Georges Hospital Pharmacy before your procedure. These medications are made up in the pharmacy and our pharmacist needs a few days to prepare.
- Antibiotics start 4 days prior to the procedure
- Bowel preparation the night before the procedure
- You will need to buy apple juice or white grape juice to drink on the morning of the procedure
- Get a straw, toilet paper and baby wipes for the bowel preparation
4 DAYS BEFORE:
Gentamycin and Vancomycin has been prepared for you in the pharmacy. You have to use these antibiotics 4 times per day.
- If your procedure is on a Thursday, you start these medications on the Monday before
- If your procedure is on a Monday, you start these medications on the Friday before
Preparation and administration
Vancomycin: (250mg=5ml). Use a 5ml syringe to withdraw 5ml and dispense into a cup. Add 5-10ml sterile water for injection and take orally.
Gentamycin: (80mg=2ml). Use a 2ml syringe to withdraw 2ml and dispense into a cup. Add 5-10ml sterile water for injection and take orally.
Storage
The vancomycin and gentamycin solutions should be stored in the fridge for no more than seven (7) days. The contents should not be frozen but maintained at 2-8 Degrees Celsius.
BOWEL PREPARATION THE NIGHT BEFORE:
Similar to the preparation for the colonoscopy, you will have to take medication to clean the bowels prior to surgery. MOVIPREP was prescribed and included in the package received from the Hospital Pharmacy.
On the evening before surgery
- You are allowed to have a light supper before 6pm
- From 6pm start taking the MOVIPREP.
- Mix sachet A & B in 1-liter water and drink
- As soon as possible thereafter, mix the second sachet A and B in 1-liter and drink.
- You can drink clear liquids (fluid that you can see through) after finishing the MOVIPREP. To avoid dehydration, it is important to drink clear fluids after taking the MOVIPREP.
- From 6pm until your procedure, you are not allowed to eat anymore.
The morning of your surgery
- You can have clear liquids up to 2 hours before the surgery
- Dr Coetzee gave you a document with the time of admission and the planned time of the procedure (please note that this time may change due to unforeseen circumstances). Drink a glass of apple or grape juice just before you leave home (2 hours before the procedure). From then onwards, don’t dink or eat anything for the last 2 hours before the procedure.
CHRONIC MEDICATION:
Dr Coetzee discussed the chronic medication that you should and should not take on the morning of your procedure. If you are unsure, please confirm with the rooms which of your chronic medications should be used on the day of the procedure.
Please bring the original boxes of all chronic medications (or a document with the names and dosages of your medications) with you to hospital.
BOWEL PREPARATION TIPS:
- Stay near a toilet. You will have diarrhoea. It is common even to have a little accident!
- Drink the MOVIPREP 1 glass every 10 to 15 minutes. It may help to chill it in the fridge or with ice. Some people find it easier to drink it with a straw.
- Rarely some people experience nausea and may even vomit. If this happen, give yourself a break. Rest 30 minutes to 1 hour, brush your teeth and start again slowly.
- It is common to experience some abdominal discomfort after taking the medication. It may last several hours.