Colonoscopy Prep

[doubletwenty]

Why do doctors order 4 L colonoscopy prep for some patients and then 8 L of colonoscopy prep for other patients? I was curious if there is a reasoning behind that.

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[RXDOC1986]

Why do doctors order 4 L colonoscopy prep for some patients and then 8 L of colonoscopy prep for other patients? I was curious if there is a reasoning behind that.

Maybe some patients need a bit more evacuation? There is no exact science or mg/kg dosing to go by. Nobody is going to overdose on GoLytely!
The one-gallon Golytely is about 3.8Liters, take 1/2 at midnight and 1/2 at 4-5am. Then there is Moviprep 16oz X2. Or 5-10 GM of Miralax. There is even a capsule you can take with a lot of water. It depends on the MD's training and background. You can't really go wrong with dosing.

The trick for outpatient use (since I have been through 3) is getting off solid foods 72-48hrs prior, getting down to soups and shakes. Makes the prep the night before real easy. Just some senior citizen, pharmacist advice! Also ignore the "come back in 10yrs" advice. Make your insurance pay for every 3-5 yrs AND now starting @45 yrs. Colorectal cancer can go from zero to death in 5 years. Trust me, seen it happen.

 

[doubletwenty]

Ah okay. Thanks for your input. I was just curious if there was a science behind that. I agree there would be no issues in overdosing. Only problem I would see if the patient has kidney problems but who would know that on the retail side.

 

[Chrish]

I have never seen anyone on 8 L prep.

 

[Dred Pirate]

oh yay- this reminds me I get to do this sometime this year :-(

 

[VA Hopeful Dr]

oh yay- this reminds me I get to do this sometime this year :-(

Cologuard!

 

[Dred Pirate]

Cologuard!

how accurate are those thou? I have heard stories where it is positive, then you need to go in for a confirmatory colonscopy- but that isn't covered by insurance because they cover it or the cologuard - so you have to wait a year (which obviously you do not want to do if CA). I think I would rather just suck it up and do it (and get a propofol nap) - but then again I had a HS classmate die of colon cancer about 5 years ago, so I don't have the "it won't happen to me" mindset.

 

[VA Hopeful Dr]

how accurate are those thou? I have heard stories where it is positive, then you need to go in for a confirmatory colonscopy- but that isn't covered by insurance because they cover it or the cologuard - so you have to wait a year (which obviously you do not want to do if CA). I think I would rather just suck it up and do it (and get a propofol nap) - but then again I had a HS classmate die of colon cancer about 5 years ago, so I don't have the "it won't happen to me" mindset.

There's a new screening code for "screening colonoscopy after positive stool test" that is being covered as a screening test so 0 copay.

They are within 1% as accurate as a colonoscopy and prevent death by colon cancer at the same rate.

 

[Dred Pirate]

There's a new screening code for "screening colonoscopy after positive stool test" that is being covered as a screening test so 0 copay.

They are within 1% as accurate as a colonoscopy and prevent death by colon cancer at the same rate.

Thanks !