DIGESTIVE CARE CENTER
Razi Arifuddin, MD
Joshua Beirne, MD
A. Michael Lustberg, MD
85 Brookwood Avenue, Suite 10
Santa Rosa, CA 95404
707.303.8349 Tel
707.303.2694 Fax
TRILYTE (PEG 3350) PREP INSTRUCTIONS FOR YOUR COLONOSCOPY
TWO DAY PREP INSTRUCTIONS FOR YOUR COLONOSCOPY
**This preparation needs to be modified if you have chronic kidney disease or take regular antiinflammatory medications due to the potential serious risk of increased magnesium blood levels.
Arrival Date:_______________ Arrival Time:___________Procedure Time: _____________
ASC
525 Doyle Park Dr. 2nd floor
(707) 547-4600
Doctor:
Arifuddin
Endoscopy Center
1200 Sonoma Ave #2
(707) 571-2192
Beirne
Memorial Hospital
1165 Montgomery Dr.
(707) 525-5224
Lustberg
Patient Financial Responsibility
Please note, when appropriate, we will preauthorize your procedure. This means we have gained approval for
your procedure from your insurance company; however, this is not a guarantee of payment.
It is your responsibility to contact your insurance company to find out your payment obligations. We can
provide the appropriate procedure and diagnosis codes to assist you if needed. The charges that may be billed
to your insurance company for your procedure include the physician’s professional fee, the facility fee where
the procedure is performed, and pathology fee or anesthesiologist’s fee if applicable. You may contact us with
any questions.
7 Days Before the Exam:
 If you are taking Coumadin (Warfarin), Plavix, Lovenox, Aggrenox, Pradaxa, Effient or any other
blood thinning medication, make sure you know if and when you are to stop these medications. Call
the office TODAY if you are unsure. You may continue to take a single aspirin tablet daily.
 Purchase the prep ingredients from your pharmacy: one 10 oz. bottle of Magnesium Citrate, one gallon
TriLyte (PEG), or equivalent, and 4 Dulcolax 5 mg (bisacodyl) laxative tablets. **If you have chronic
kidney disease or take regular anit-inflammatory medications then purchase one and a half
gallons of Trilyte (PEG) instead of Magnesium Citrate.
 Purchase soothing wipes and barrier cream such as A&D ointment to help with anal irritation. Do not
use Desitin.
 Please return your patient history and demographics form to the office, not the procedure facility.
4 Days Before the Exam:
 Stop NSAIDS (Ibuprofen, Motrin, Advil, Naprosyn, Aleve, Relafen or the like).
Two Day Prep, page 2
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Stop iron supplements.
Stop eating nuts, seeds, popcorn, tomatoes, peanuts, corn, berries, and breads or crackers with visible
seeds.
3 Days Before the Exam (**This instruction applies only to people taking a modified prep with one and a
half gallons of Trilye and no Magnesium Citrate)
 In evening fill both TriLyte containers with water and a flavor packet (or Crystal Light lemonade flavor)
and refrigerate.
2 Days Before the Exam (Begin the prep):
 If you are diabetic and taking insulin or using an insulin pump, use ½ your daily dosage today. If you are
taking oral diabetic medications, take ½ the dosage you usually take.
 Begin clear liquid diet. Do not eat anything solid. Drink only clear liquids the entire day. Clear liquids
include: coffee, tea, (both without any milk or milk products), jello, popsicles, sport drink(nothing red,
orange or purple in any product), broth, white grape juice, white cranberry juice, soda, vitamin waters
(not colored)

You may also drink Boost (Vanilla only), or a similar product, until 5 p.m. Use the sugar free version if
needed.
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2 pm: Drink the 10 oz. bottle of Magnesium Citrate. **If you have chronic kidney disease or take
regular anti-inflammatory medications, do not take the Magnesium Citrate. Instead, begin
drinking TriLyte one 8 oz. glass every 10-15 minutes for a total of 8 glasses.
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Bowel movements may begin within 30 minutes or may take up to 6 hours.
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In the evening, fill the TriLyte container with water and a flavor packet (or Crystal Light lemonade
flavor) and refrigerate.
1 Day Before the Exam (Start the second prep day):
 Continue clear liquid diet. Do not eat anything solid. Drink only clear liquids the entire day. Clear
liquids include: coffee, tea, (both without any milk or milk products), jello, popsicles, sport drink
(nothing red, orange or purple in any product), broth, white grape juice, white cranberry juice, apple
juice, soda, vitamin waters (not colored). More liquids will result in a better colon prep and ensure
hydration. Try to drink at least 6 to 8 glasses of clear liquid on this day before 5 pm.

You may also drink Boost (Vanilla only), or a similar product, until 5 p.m. Use the sugar free version if
needed.

If you are diabetic and taking insulin or using an insulin pump, use ½ your daily dosage today. If you are
taking oral diabetic medications, take ½ the dosage you usually take. Otherwise, take your regular
medications, including the day of the exam.

2 pm: Take 4 Dulcolax 5 mg (bisacodyl) laxative tablets.

5 pm: Begin drinking TriLyte. Drink one 8 oz. glass every 10-15 minutes until the entire container is
finished. This takes about 4 hours. It is best to drink the whole glass quickly. A straw may help as well
as sucking on a lime after you drink.
**If your procedure is scheduled for 10 a.m. or later, drink ONLY half the Trilyte tonight. You
will drink the second half early tomorrow morning--see below.**
Two Day Prep, page 3
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Chills, bloating, cramping, nausea and vomiting may occur. If so, take a break from drinking the prep
for 30 minutes. Resume drinking the container of prep until it is finished, taking breaks as needed.

A bowel movement will usually occur within an hour after the 1st glass of TriLyte. Don’t worry if this
does not happen for 3-4 hours. Everyone is different.
Day of Exam:
 **If your procedure is scheduled for 10 a.m. or later, drink the second half of the TriLyte. You
must finish this by no later than 2 hours before your test!** PLEASE COMPLETE THE ENTIRE PREP. A
CLEAN COLON INCREASES THE CHANCES THAT A PRECANCEROUS POLYP WILL BE REMOVED.
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Do not drink anything beginning 2 hours before your exam until the exam is complete. You may
have clear liquids before that on the day of your exam.
Bowel movements will occur that are watery and frequent until the bowel is fully cleansed. The end
result should be clear or pale yellow liquid. If you are not passing clear fluid let us know.
If you are diabetic, do not take your daily diabetic medication this morning
Wear loose comfortable clothing, a short sleeved shirt, and warm socks.
You must have a driver to pick you up. You cannot drive yourself home. If you do not have someone
to drive you home, your procedure will be canceled. You may take a taxi home if you are accompanied
by a responsible adult.
The hardest part is over!
After you arrive for your colonoscopy, you will meet with a nurse who will talk to
you about your medical history, start an IV so you can get fluids, and get you settled. After you meet with your
doctor, you will be given medication to sedate you and keep you comfortable during your colonoscopy.
You will recover after your procedure for about 30 minutes and be given a report with the findings and
instructions to take home.
After the examination YOU MAY NOT DRIVE, WORK OR OPERATE MACHINERY for the remainder
of the day. Your procedure will last approximately 2-3 hours from the time you arrive to the time you are
released. PLEASE NOTE, the procedure facility may contact you if necessary to adjust your appointment
time within 48 hours of the exam. You may confirm your release time with the facility at the time of arrival.
Your appointment will be confirmed before the procedure. If it is not confirmed 2 business days in
advance, we may change your appointment. If you are unable to keep this appointment please give us a 1
week notice, or a cancellation fee of $150 may be charged. You may call the office at 707-303-8349 during
our business hours—8:30AM to 12:00 PM and 1:30 to 4:30 PM Monday to Friday.