Clear Liquid Diet - Foods/Drinks Allowed



Clinical Gastrointestinal Associates

Darren Andrade, M.D. Pawan Sahu, M.D. Kristin Braun, M.D.

Office :215-891-9400 Endoscopy Center : 215-579-2004

PROCEDURE : Colonoscopy

DAY:_________________________________________ DATE: ____________________________________________

TIME: _______________________________________ REGISTRATION TIME: ______________________________

LOCATION : The Endoscopy Center of Bucks County

790 Newtown- Yardley Rd, Suite 415

Newtown, PA 18940

215-579-2004

Clear Liquid Diet - Foods/Drinks Allowed

|  |Allowed foods / beverages |Do not eat these foods / |

| | |beverages |

|Fruits/juices |Clear fruit juices without pulp such as apple juice, grape |Nectars, canned, fresh or|

| |juice, cranberry juice |frozen fruits |

|Soups |Broth, bouillon, fat free consommé |All others |

|Beverages |Coffee, tea (hot or cold), gatorade/ sports drinks, soda, water,|All others |

| |clear iced tea/ lemonade | |

|Sweets and deserts |Fruit ices (without chunks of fruit), plain gelatin, clear hard |All others |

| |candy, popsicle made from clear juices, clear water ice | |

|Vegetables |Not allowed |All |

|Milk and dairy products |Not allowed |All |

|Bread, cereals and grain products |Not allowed |All |

|Meat, chicken, fish, and meat |Not allowed |All |

|substitutes (nuts, tofu, etc.) | | |

|Oils, butter, margarine |Not allowed |All |

Sample Menu: Clear Liquid Diet (This diet contains approximately 1000 calories, 1 gram fat and 14 grams of protein)

Breakfast  :  Hot tea with lemon juice and 1 tsp sugar (no pulp); Apple juice (8 oz); Gelatin (1 cup)

Lunch  :  Hot tea with lemon (no pulp) and sugar; Grape juice (8 oz); Fruit Ice (1 cup); Consommé (8 oz.)

Snack   : Fruit juice (apple, cranberry or grape, 8 oz); Gelatin (1 cup)

Dinner  :  Hot tea with lemon (no pulp) and sugar; Apple juice (8 oz); Consommé (8 oz); Fruit Ice (1 cup)

Please Note the following:

You will be given sedation for the procedure by an independent anesthesia group, therefore you must have someone drive you home after the procedure. If you are not accompanied by a driver the procedure will not be done. After the procedure you should not do any of the following : operate any machinery, power tools, drink alcohol, drive a car, make any important decisions until the morning after the procedure.

Stop : any iron supplements, NSAIDS (aspirin or aspirin like products, ibuprofen, motrin, aleve), coumadin, plavix, pletal, effient, brilinta, pradaxa, xarelto 5 days prior to the procedure. If you have any questions, take insulin, have had heart valve surgery, or were told never to stop any of the medications above please talk with one of the doctors. It is okay to take blood pressure and heart medications with a small sip of water the day of the procedure. Bring a list of medications with you to the exam.

On the day of the procedure please wear a short sleeve shirt. If you have any questions or trouble with the bowel prep please call 215-891-9400. You must give at least 48 hours notice for cancellations.

Do not eat or drink anything the day of the procedure unless it is medication with a small sip of water or you are instructed to do so specifically with a split dose/ 2 day prep.

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