You have been prescribed Citramag and Senna as laxatives to empty your bowel in preparation for your colonoscopy. It is important you make all the preparations to ensure the bowel is clean before the examination so the endoscopist can examine it thoroughly.
- 7 days before, stop taking iron tablets, such as Ferrous Sulphate or Ferrous Fumarate.
- 5 days before, stop taking stool bulking agents, such as Fybogel or Laxido.
- 5 days before stop eating nuts, seeds and seeded breads. These can clog the colonoscopy equipment and the procedure may not be completed successfully.
- 3 days before, stop taking constipating agents, such as Loperamide or Codeine Phosphate.
- If you take blood-thinning medications, please inform the pre-assessment nursing team for advice.
Please refer to the procedural information leaflet you have been given, or raise any medication queries to the endoscopy unit.
Dietary advice in the days leading to the procedure
YOU MUST START YOUR LOW-RESIDUE DIET 5 DAYS BEFORE YOUR FLEXIBLE SIGMOIDOSCOPY
Try to drink two litres of clear fluids (8-10 glasses) per day until the day of your test. If you are a vegan/vegetarian, please swap suggested items with suitable alternatives.
| FOOD TYPE | FOODS ALLOWED | FOODS TO AVOID |
| Bread, cereals and grains | Refined breakfast cereals such as: Rice Krispies®, Coco Pops®, Weetos®, Frosties®, Cornflakes®, Sugar puffs®, Ready Brek®. Products made from white flour, for example white bread, white pasta, crumpets, English muffins, wraps, pitta bread, bagels. Well-cooked white rice, rice noodles, egg noodles, white noodles. Plain naan bread, plain chapatti, poppadoms. Rice pudding, semolina, tapioca, plain couscous, polenta. | Wholemeal cereals. Cereals containing nuts, seeds or dried fruit. Muesli, Fruit and Fibre®, Shredded Wheat®, Bran Flakes®, Crunchy Nut Cornflakes® . Any bread products or biscuits containing coarse grains, seeds or nuts or dried fruit such as multigrain bread, seeded batch, rye crispbread, rough oatcakes, hobnobs, muesli bars, flapjacks, teacakes, scones, fruit loaves. Brown rice, brown pasta, quinoa, pearl barley. |
| Meat, poultry and fish | Soft, tender, minced or pureed meat or poultry without visible fat and with skin removed such as poultry, lamb, beef, pork, veal and ham. Plain tofu, textured vegetable protein, seitan, Quorn®. All types of eggs. Fish without bones such as cod, salmon. | Tough, gristly meat or skin including pork scratchings. Fish with bones like sardines or with edible bones like whitebait. |
| Dairy products, fats and oils | Limit all types of milk including nut and plant-based milks to no more than half a cup a day. As an alternative to dairy, try soybean milk or soybean ice cream, for example Tofutti®). | Cheese containing dried fruit, onions or nuts. Yoghurts or fromage frais containing fruit pieces, dried fruit, nuts, seeds or cereal. |
| Vegetables | Well-cooked or pureed root vegetables such as carrots, parsnips, turnips or swede. Tomatoes without skins or seeds such as tomato juice, canned deseeded tomatoes, passata, tomato puree. Well-pureed hummus, lentil soup sieved to remove skins. Vegetable juices or soups – sieved to get rid of any seeds/skins. Avocado Mashed potatoes or wellcooked potatoes without skin, for example jacket potato, boiled potato, gnocchi. | All vegetable stalks, skins, seeds and peel. Sweet corn, broad beans, runner beans, mange tout, sugar snap peas, sweetcorn, spinach. Raw vegetables such as peppers, radishes and celery, tomatoes, cabbage, leeks, onions, lettuce, spinach and salad leaves. Firm beans and pulses with thick skins like kidney beans, baked beans, haricot beans, borlotti beans, soybeans, puy lentils, mushy peas or chickpeas. Potato skin. All curries made with legumes or pulses, such as lentils or beans. |
| Fruits | Fruit juice or smoothies (no seeds, pips, skins or piths). Cooked or stewed fruit without skin. Melon, banana. Canned pears, peaches or apricots. Canned citrus fruit with no pith, skin or pips, such as mandarins or grapefruit. Pureed fruit or fruit coulis (sieved). | All dried fruit. Any fruit skins, pips or seeds. Strawberries, raspberries, blueberries, blackcurrants, gooseberries, passion fruit, pineapple, kiwi, mango, apricots. |
| Desserts | Custard, ice cream, milk puddings. Clear jelly. Plain cakes Vermicelli (seviyan / plain kulfi). | Coloured jelly, for example red jelly. Ice cream containing fruit and nuts. Cakes, puddings and pies containing any of the following: wholemeal flour, dried fruit, nuts, dried coconut and any fruits you have been advised to avoid. |
| Drinks | Fruit and vegetables juices with no bits. Smoothies that have been sieved or have no seeds in. Water, soft drinks, weak tea and coffee, herbal te | Fruit and vegetable juices or smoothies with pulp and seeds. |
| Others | Clear or strained soups. Sugar, honey, golden and maple syrup, seedless jam, marmalade. Dark, milk and white chocolate, boiled sweets, marshmallows, toffee. | Chocolate with fruit or nuts. Nuts, seeds, coconut and desiccated coconut. Marmalade with peel, jam with seeds. |
Acceptable fluids include:
- Water / flavoured water
- Tea and coffee (no milk)
- Clear soup, for example, Consommé that contains no solids
- Fruit juice without pulp, for example, orange or lemon squash that is diluted (not red or purple in colour)
- Clear fizzy drinks, for example, lemonade, Lucozade, tonic water, cream soda, soda water
- Bovril/ Oxo
- Lime cordial
- Herbal teas (no milk)
- Clear apple juice or white grape juice
One day before your appointment
- You may eat and drink today but take only from the low-residue diet as described above.
- At 7pm, take 5 SENNA tablets with water (NB, you may not have a bowel movement straight away, so continue to drink plenty of fluids.)
On the morning of your afternoon appointment
- At 6 am – have a light breakfast. Please choose foods from the low-residue diet list above.
- After breakfast, DO NOT eat any further solid food until after your examination, but drink plenty of clear fluids (tea, coffee without milk, water, clear soups without bits).
- At 7:30 am– dissolve the contents of the 1 sachet of Citramag in 200 MLS (8 fluid ozs) of hot water in a large jug as the mixture may fizz over when water is added. Allow to cool for at least half an hour before pouring into a glass and drinking.
- REMEMBER TO DRINK AT LEAST AN ADDITIONAL 1 – 2 LITRES OF WATER AFTER TAKING CITRAMAG
Some people have frequent bowel actions and eventually diarrhoea starting within 1-2 hours of the first dose of bowel preparation. Some intestinal cramping is normal. Please use a barrier cream such as Zinc or Castor oil on your bottom to prevent soreness. It is advisable to stay within easy reach of a toilet after commencing the preparation.
Remember to drink plenty of clear fluids. These may be continued until you are at the unit. If you do not drink enough fluids, you may get dehydrated, feel dizzy, faint or experience a headache. You can drink water up to 2 hours before your procedure (no more water, sweets, or chewing gum after this).
Please continue to take all other prescribed medication as usual unless advised otherwise.
If at any stage you vomit the preparation mixtures, or you have any other concerns regarding side effects, please contact the Endoscopy Reception:
- Monday to Friday 8am – 6pm
- 0203 058 9083 / 0203 058 9068
- or NHS 111 after 6pm