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Scott M. Browning, MD, FACS, FA SCRS Megan M. Kavanaugh, MD, FACS, FASCRSJeffrey V. Manchu, MD, FACS, FA SCRS Colon and Rectal SurgeonsINPATIENT SURGERY INSTRUCTIONS LOCATION:DATE: CHECK IN TIME:SURGERY:

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How to fill out pre-colonoscopy clear liquid diet

01

Follow your doctor's instructions on when to start the clear liquid diet. Typically, you will need to start the day before your colonoscopy.

02

Avoid red, purple, or orange colored liquids, as they can be mistaken for blood during the procedure.

03

Only consume clear liquids such as broth, clear juices, water, tea, clear sodas, and gelatin.

04

Avoid dairy, solid foods, and anything with pulp or residue.

05

Stay hydrate by drinking plenty of fluids, but do not consume anything that is not on the approved clear liquid list.

Who needs pre-colonoscopy clear liquid diet?

01

Individuals who are scheduled to undergo a colonoscopy procedure typically need to follow a pre-colonoscopy clear liquid diet.

02

This diet helps to clear the colon of any remaining stool so that doctors can get a clear view of the colon during the procedure.

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What is pre-colonoscopy clear liquid diet?

Pre-colonoscopy clear liquid diet is a diet consisting of only clear fluids such as water, broth, and clear juices before a colonoscopy procedure.

Who is required to file pre-colonoscopy clear liquid diet?

Patients scheduled to undergo a colonoscopy procedure are required to follow and adhere to a pre-colonoscopy clear liquid diet prescribed by their healthcare provider.

How to fill out pre-colonoscopy clear liquid diet?

To fill out a pre-colonoscopy clear liquid diet, patients should carefully follow the instructions provided by their healthcare provider, ensuring to only consume clear fluids and avoiding any solid foods or colored beverages.

What is the purpose of pre-colonoscopy clear liquid diet?

The purpose of a pre-colonoscopy clear liquid diet is to cleanse the colon and ensure optimal visibility during the colonoscopy procedure.

What information must be reported on pre-colonoscopy clear liquid diet?

Information such as the types of clear fluids consumed, the timing of the last intake, and any symptoms or concerns experienced during the diet period must be reported on the pre-colonoscopy clear liquid diet form.

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