Preparing for your colorectal surgery

Your surgeon needs you to attend required appointments for testing, imaging and clearance before your surgery.

• Pre-admission testing
• Pre-operative labs
• Pre-operative imaging, as ordered by your surgery team. (A chest X-ray is required if you are over 60 years old or have a history of smoking.)
• If requested by your surgeon: A primary care and/or cardiology appointment for medical clearance.

Fill your prescriptions (to take the day before surgery):

• Erythromycin - 1 g (for 3 doses)
• Neomycin - 1 g (for 3 doses)

Purchase “bowel prep” supplies:

• 510 g or 525 g of Miralax (or generic substitute)
• 64 oz of liquid (non-red) Gatorade, Powerade or Propel Water
• 20 oz of (non-red) Gatorade or Powerade, for the day of surgery

Discuss with your doctor(s) which medications to take/hold before your surgery:

• Speak with your surgeon about holding NSAIDs (e.g. ibuprofen, naproxen) for 7 days before surgery.
• Speak with your surgeon about holding Plavix for 7 days before surgery.
• Speak with your cardiologist about holding Coumadin in other anticoagulation medications for 5 days before surgery.
• Speak with your doctor about holding Methotrexate/Remicade/Humira.

Continue to take any other normal medications (including aspirin) not listed.

Stay on top of pre-surgery logistics by signing up for Penn Medicine’s patient portal MyChart by myPennMedicine to contact your doctor’s office with questions about your surgery and care plan.

• Do not drink alcohol for at least 24 hours before surgery. Alcohol can react with some of the medicine you will be given at the hospital.
• Drink only clear liquid the day before surgery. You may continue to drink clear liquids up until 2 hours before you are scheduled to arrive at the hospital for your surgery.

• 3 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.
• 4 p.m.: Mix the Miralax in 64 oz of your choice of liquid Gatorade, Powerade, or Propel Water. Drink one 8 oz glass of the mixture every 20 minutes until you drink all of the mixture. If nauseated, slow down your drinking by increasing the intervals between glasses.
• 5 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.
• 7 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.

Only drink clear liquids after 6 p.m. You may continue to drink clear liquids up until two hours before your surgery.

To prevent infection, you must shower before going to bed the night before your scheduled surgery. Please shower around 9 p.m.

You will be provided with one bottle of HIBICLENS body wash.

• Have a fresh, clean towel ready near shower.
• With mild soap, shower and wash thoroughly as you normally would. Rinse head and entire body.
• Shut off the water.
• Pour HIBICLENS soap onto clean washcloth.
• Wash thoroughly all areas listed below for two minutes. Caution: Do NOT apply HIBICLENS soap to face, and do NOT allow it to get in your eyes or ears.
• Turn water back on and rinse off fully.
• Pat yourself dry with a clean towel.
• Change into clean pajamas and go to sleep on clean bedding.

Do not bathe again, or apply cosmetics, deodorant, or lotions before your surgery.