Gastroenterology Department - Royal Liverpool Hospital

 

Your clinician would like you to have enhanced bowel preparation for your small bowel capsule endoscopy. The instructions are given below and should be followed carefully.

What is Bowel Preparation and what are the benefits of taking before the test?

Bowel preparation is medicine used to clear the waste material from the bowel in order that there are good views of the lining of the small bowel. Plenvu is a type of bowel preparation that is commonly used to clear the bowel.

This will allow for clear pictures to be taken of your small bowel lumen.

 Are there any risks/side effects?

  •  Plenvu will clear out the bowel resulting in diarrhoea within approximately one to three hours of the first dose. It is advised that you stay within easy reach of a toilet once you start to take the medication. 
  • Some patients experience nausea, vomiting, or abdominal pain. This can be associated with dizziness. If any of these symptoms occur, please lie down until they pass.
  • You might like to use a barrier cream to prevent a sore bottom. A product such as petroleum jelly can also be effective. 
  • Some stomach cramping is normal. 
  • If you vomit up the bowel preparation at any time or have any other concerns regarding side effects, please contact us directly – see end of leaflet for contact   details. 

Other medication 

  • Female patients: If you are taking an oral contraceptive pill, diarrhoea can make it less effective. Please use additional forms of contraception such as condoms. 
  • Any other oral medication can be continued as normal unless otherwise instructed.
  • Do not take any medication two hours either side of drinking Plenvu.
  • Please bring a list of your medications that we may review this on the day.

Laxative Treatment

Three sachets of Plenvu are included in this pack. They work together to empty your bowel. 

Three days before your tests, you must follow a low residue diet. Instructions explaining what you can eat and what you should avoid are listed further down on this leaflet.

You must also take one sachet of Plenvu the day before you test and an additional two sachets of Plenvu the morning of your test. 

How do I take the Plenvu sachets?

Dose one – at 7pm the day before your test 

  • Pour the contents of the single sachet for dose one into a jug.
  • Make the solution up to 500mL with water. 
  • Stir the solution well. 
  • Drink the solution over a period of 60 minutes. 
  • Alternate sips of the solution with sips of clear fluids as outlined below. 
  • Aim to drink an additional 500mL of clear fluids in between sips of the Plenvu solution.

Dose two (Sachet A and B) – at 6am the day of your test 

  • Pour the contents of the two sachets (sachet A and B) together in a jug.
  • Make the solution up to 500mL with water.
  • Stir the solution well. 
  • Drink the solution over a period of 60 minutes.
  • Alternate sips of the solution with sips of clear fluids as outlined below.
  • Aim to drink an additional 500mL clear fluids in between sips of the Plenvu solution.

Diet

You must start the special diet from three days before the test. This is a low-residue diet which limits the amount of fibre and other foods that increase bowel activity.

An example of a low residue diet is shown below.

You may eat freely from the foods contained in this list, unless you are allergic or have been advised to avoid certain foods. 

Please avoid taking any food or drink that is not contained within the list of foods/drink you can consume. 

No solid food should be taken after 9am on the day before your test but you should continue to drink clear fluids. 

An example of clear fluid drinks is shown further in this leaflet.

Foods you can eat

  • White meat, skinless chicken, grilled/boiled/poached or steamed white fish.
  • Potato without skin boiled/mashed/chips.  
  • Eggs, cheese, tofu.
  • White - bread, croissants, pasta, rice, cous cous, pastry (white flour)  
  • Cornflakes, Rice Krispies, Frosted Flakes
  • Smooth yoghurts
  • Crisps
  • Butter/margarine
  • Seedless/shredless marmalade or jam.
  • Marmite, honey, rich tea biscuits, chocolate, yoghurt
  • Plain ice-cream, custard, clear jelly (no red or blackcurrant jelly), boiled sweets
  • Sponge cakes without fruit or nuts, rice pudding/semolina.

 Foods you should avoid

  • Wholemeal or granary bread, wholemeal flour, wholemeal pasta, brown rice, pearl barley, bran, quinoa.
  • All whole-wheat cereals e.g. Branflakes, Weetabix, Shreddies etc.
  • Porridge and Muesli (all containing dried fruit and nuts)
  • Yogurts or cheese containing fruit or nut pieces.
  • Red meat or fish that is tough or gristly, skin and bones of fish and chicken, pies, egg dishes containing vegetables.
  • Vegetables, salad, baked beans, split peas, lentils, peas, sweet corn, celery, All seeds, tough skins, potato skins.
  • All fruit including dried fruit, citrus fruit and berries, prunes, smoothies, fruit juices with bits.
  • Avoid all nuts including coconut and almond
  • Puddings, cakes and biscuits made with wholemeal flour, dried fruits or nuts.
  • Chocolate or toffee with dried fruits or nuts, Popcorn, Marzipan, Digestive biscuits.
  • Marmalade with peel or jam with seeds.

 

  • Lentil and vegetable soups, Pickles and chutneys, Horseradish, Relish.

 The day before and the day of the procedure, MILK in any form should be avoided.

 

What can I drink?

Clear Fluids: 

  • Water, mineral/fizzy, fizzy drinks (including Lucozade), fruit squash (not blackcurrant), chicken stock cubes, clear soup, tea/coffee (to be taken black the day before and day of the procedure), herbal/fruit teas
  • Sweetener may be added to food/drinks.  
  • Oxo, Bovril, clear soup (watery without bits in it).

You must drink at least one glass of fluid from the list every hour (throughout the daytime) during the diet preparation period.

Alcohol: 

We advise to minimise alcohol consumption, in line with national guidance. If alcohol consumption is desired the following can be drank. 

  • Lager / Beer
  • Spirits with light coloured mixer i.e., Lemonade / Tonic
  • White wine

Alcoholic drinks to be avoided:

  • Red / Rose Wine
  • Dark Mixers including Cola.
  • Guinness

 

Example of low residue diet:

Breakfast 

  • One boiled or poached egg
  • One to two slices of white bread, butter or margarine or honey
  • Tea or coffee

Midday

  • Steamed or grilled white fish or chicken
  • One medium boiled potato (no skin) or two tablespoons of boiled white rice
  • Small plain jelly

Evening

  • As midday, or other foods from the low residue foods list           
  • Small plain jelly

It is important to drink plenty of fluids in-between mealtimes

Summary of the Bowel Preparation Regime:

Please follow the regime outlined below

Day 

Date 

Diet

Laxative Treatment

Three days before the test

 

Low residue diet 

Nil required

Two days before the test

 

Low residue diet

Nil required

One day before the test

 

Low reside diet until 9am then no solid foods (clear fluids only)

Dose one of Plenvu at 7pm 

 

Day of the test

 

Continue with clear fluids until two hours before your appointment time. You are allowed to continue with sips of clear water only.  

 

Do NOT eat anything until after the procedure

Dose two of Plenvu (sachet A+ B) at 6am

 

What do I do on the day of my capsule test?

Remember you are not allowed to eat anything until four hours after your test. 

  • You may continue to take all your other usual medications as normal.
  • Do not take your medication an hour either side of swallowing your capsule.  
  • Do not take tablets for diabetes on the day of your test but bring your medication with you.
  • If you take insulin, please take this as instructed by your diabetes nurse.
  • If you normally monitor your blood sugar, please check it every two hours. 
    • If you feel dizzy, sweaty or irritable (signs of low blood sugar) take two to three teaspoons of sugar, or six glucose tablets, or one glass of Lucozade.
    • You should feel better almost immediately, if not repeat the above treatment. If symptoms persist, contact your doctor.

Attend the gastroenterology department at your appointment time.

 

Feedback

Your feedback is important to us and helps us influence care in the future.

Following your discharge from hospital or attendance at your outpatient appointment you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point.  Your co-operation is greatly appreciated.

Further information

Contact the Gastroenterology Unit at the Royal Liverpool Hospital

Monday – Sunday: 8am – 6pm

Telephone: 0151 706 2819 / 2726 / 2656

Text phone number: 18001 0151 706 2819 / 2726 / 2656

 

Author: Gastroenterology and Pharmacy Departments

Review date: May 2028

PI 3161 V2