Colonoscopy Preparation Guide
🩺
Colonoscopy Preparation
Step-by-step guide for Australian patients — diet, bowel prep, medications, and what to bring.
🇦🇺 AustraliaGESA guidelines
📋 Sources
Bowel-preparation and dietary guidance compiled from the
Gastroenterological Society of Australia (GESA) patient information;
Healthdirect Australia; and standard split-dose bowel-prep protocols used by Australian endoscopy units.
Your endoscopy unit’s own instructions always take precedence — bowel-prep brand and timing vary between providers.
⚠️ Always follow the specific preparation instructions given to you by your gastroenterologist or endoscopy unit. Bowel prep products and timing vary. This guide covers general principles only.
What happens when — at a glance
2–3 DAYS
BEFORE
Start low-fibre diet. Avoid seeds, nuts, wholegrains, fruit skins, raw vegetables.
5–7 DAYS
BEFORE
Stop iron tablets if prescribed.
DAY BEFORE
Clear fluids only. Take bowel prep laxative as directed (usually evening). Nothing red or purple.
MORNING
OF
Nothing by mouth for 4–6 hours before (your letter will state the exact time). Some preps require a morning dose.
⚡
What the procedure itself involves: you'll be sedated through an IV cannula, so you won't feel or remember it. A thin flexible camera is passed through the bowel to check for polyps or other issues — the colonoscopy itself takes 30–60 minutes, though allow 3–4 hours in total for check-in, prep and recovery. You'll need a responsible adult to drive you home, as you can't drive for 24 hours after sedation. Full day-by-day diet and bowel-prep steps below.
🥗 What to eat and avoid
2–3 days before: low-fibre diet
✅ Eat these
White bread, white rice, pasta
Eggs, fish, chicken (no skin)
Smooth peanut butter
Peeled potato (no skin)
Dairy products
Clear soups and broths
❌ Avoid these
Wholegrain bread, cereals, muesli
Seeds, nuts, popcorn
Raw vegetables, salads
Fruit with skin or seeds
Legumes (beans, lentils)
Red or purple food and drinks
Day before: clear fluids only
✅ Permitted
Water
Clear broth or stock
Black tea or black coffee
Clear apple juice (not cloudy)
Plain jelly (not red or purple)
Sports drinks (not red or purple)
❌ Not permitted
Milk, cream, smoothies
Cloudy juices
Soup with solids
Anything red or purple
(resembles blood during the procedure)
💧 Bowel preparation (the laxative)
Your endoscopy unit will have given you a specific bowel prep solution (e.g. MoviPrep, PicoPrep, Glycoprep, Plenvu, Suprep). Follow those instructions exactly — they override any general advice.
📌
Mix and drink as directed. Most preps involve drinking 2–4 litres over several hours — typically evening before, and sometimes morning of.
📌
Stay near a toilet for 2–4 hours after starting the prep. Bowel movements typically begin within 30–60 minutes.
📌
The prep is working when your stools become clear or pale yellow. A clean bowel is critical — a poor prep means the procedure may need to be repeated.
💡
Tip: chill the prep solution in the fridge beforehand — many patients find it easier to drink when cold. Drink steadily; if you feel nauseated, slow down briefly and then continue.
💊 Medications
⚠️ Blood thinners — discuss with your doctor
Warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), clopidogrel (Plavix), aspirin. These usually need to be held several days before — your doctor or the endoscopy unit will give specific instructions. Do not stop without advice.
⚠️ Iron tablets — usually stopped 5–7 days before
Iron residue coats the bowel wall and significantly impairs the view. Endoscopy units commonly ask people who take iron tablets to stop them 5–7 days before; follow your endoscopy unit’s written instructions.
⚠️ Diabetes medications — check with your GP
If you take insulin, sulfonylureas (glipizide, gliclazide), or metformin, discuss dose adjustment on fasting days with your GP before the procedure.
✅ Most other medications — take as normal
Take your regular medications with a small sip of water at your usual time unless specifically told otherwise.
📅 On the day
🚫
Nothing by mouth for 4–6 hours before your procedure time (your letter will state the exact cut-off).
🚗
Arrange a driver. You will receive sedation and cannot drive for 24 hours. You must be taken home by a responsible adult — not a taxi or rideshare alone.
🧳
Bring: Medicare card, referral, any prep instructions you received, a list of your medications, and loose comfortable clothing.
⏰
Allow 3–4 hours total for the full appointment (check-in, prep, procedure, recovery). The colonoscopy itself takes 30–60 minutes.