SUTAB Bowel Preparation Instructions

What is SUTAB^® bowel preparation?

SUTAB^® is a brand name for a medication that contains sodium sulfate, magnesium sulfate and potassium chloride. It cleans out your colon (large intestine) to prepare it for a colonoscopy. SUTAB pulls water into your colon to help you poop faster.

Why is bowel prep important?

Bowel prep completely clears your colon of stool. It’s essential because it gives your gastroenterologist the best view of the lining of your colon so they can detect polyps or cancer. For your provider, a clean colon is like driving on a clear, sunny day. A dirty colon is like driving in a rainstorm.

If you’re a Cleveland Clinic patient, you must follow the instructions for bowel preparation exactly as prescribed or your colonoscopy will be canceled.

How do I use SUTAB?

SUTAB comes in a kit that contains two medication bottles and a cup for water. Each bottle contains 12 tablets (pills). You’ll take 12 pills (one bottle) with water from the cup the night before your exam. Later that evening, drink two more cups of water. Fill the cup to the line each time. Then, six hours before your exam, repeat all three of those steps.

Be sure to follow all the instructions exactly. If you don’t, your provider may need to cancel or repeat your colonoscopy.

Key preparation instructions

The following instructions are key to a successful colonoscopy:

• Your bowel must be empty so that your doctor can clearly view your colon. Follow the instructions you get from your gastroenterologist exactly as they’re written.
• Don’t eat any solid food the entire day before your colonoscopy. Drink only clear liquids.
• Pick up your prep kit at least five days before your colonoscopy.

Transportation on the day of your colonoscopy

A responsible driver must be with you when you check in before your colonoscopy. They must stay in the waiting area until you’re discharged. You must have someone take you home after your colonoscopy. You can’t drive or leave the facility alone. Avoid operating any sort of vehicle, including a bike, car, scooter and more.

Medications

For your safety, you may need to stop or change some of your medications before your procedure. These include:

• Blood thinners. Contact your provider at least two weeks before the procedure about adjusting your medication. Examples of blood thinners include clopidogrel (Plavix^®), warfarin (Coumadin^®), ticlopidine hydrochloride (Ticlid^®), anagrelide (Agrylin^®), rivaroxaban (Xarelto^®), dabigatran (Pradaxa^®), apixaban (Eliquis^®) and prasugrel (Effient^®).
• Insulin and diabetes medication. Always call the provider who orders these medications for instructions on changing the dosage leading up to your colonoscopy. Don’t take your diabetes pills after midnight on the day of your procedure. If you’re taking insulin, like as insulin glargine injection (Lantus^®), insulin lispro (Humalog^®), long-acting insulin like insulin isophane (Humulin N^®, NovolinN^®, ReliOn^®) or 70/30 insulin, take half your normal dose the day before your procedure.
• Weight management medication. If you take medications for weight loss, your dosage may need to be adjusted, or you might need to stop taking them several days to a week before. Contact the doctor who prescribes this medication for further instructions. Weight loss medications that you’ll need to stop include canagliflozin (Invokana^®), dapagliflozin (Farxiga^®, Forxiga^®), dulaglutide (Trulicity^®), empagliflozin (Jardiance^®), ertugliflozin (Steglatro^®), exenatide (Byetta^®, Bydureon^®), liraglutide (Victoza^®, Saxenda^®), lixisenatide (Adylyxin^®), semaglutide (Ozempic^®, Wegovy^®, Rybelsus^®) and tirzepatide (Mounjaro^®, Zepbound^®).
• Iron pills. Stop taking them one week before your colonoscopy.

Medications like aspirin, antibiotics or diuretics should be taken with a sip of water on the day of the exam. If you’re unsure which medications you can continue to take, please get in touch with your healthcare provider.

Three days before your colonoscopy

Stop eating these high-fiber foods three days before your colonoscopy:

• Popcorn
• Beans
• Seeds (flax, sunflower, quinoa)
• Multigrain bread
• Nuts
• Salad/vegetables
• Fresh and dried fruit

One day before your colonoscopy

You should only drink clear liquids beginning the day before your colonoscopy. Don’t eat any solid foods.

You can continue to drink clear liquids until three hours before your colonoscopy. The chart shows what you can and can’t drink:

How to take

Read all the instructions before mixing the bowel prep solution. You’ll take the preparation in two parts, and each part has three steps.

Step 1: 6 p.m. the evening before your colonoscopy

• Fill the supplied cup with 16 ounces of cool water (up to the line)
• Open the first bottle of tablets and swallow each one with a sip of water
• Drink the remaining water

Step 2: 9 p.m. the evening before your colonoscopy

• Fill the cup with 16 more ounces of cool water and drink it over 30 minutes

Step 3: Once you’ve finished step 2, drink a third cup of water

Step 4: Six hours before your colonoscopy

• Repeat steps 1-3 with the second bottle of tablets

Some people’s bowels move slowly. If yours do, you may need different instructions. Please see a provider for personalized bowel prep instructions if you have:

• Medical conditions that need special accommodations
• Had poor bowel prep results or a failed bowel prep in the past
• Had difficulty with anesthesia during a past procedure

Can I drink extra water with SUTAB?

Yes. In fact, you should stay hydrated by drinking at least 12 8-10-ounce servings of clear liquids in addition to the water you drink with your bowel prep medicine. Just be sure to stop drinking all clear liquids three hours before your colonoscopy.

How long will I poop after taking SUTAB pills?

You should stop pooping a few hours after you start. But everyone’s a little different. For most people who take their SUTAB pills on time, diarrhea stops so that you can get some sleep at night. Maybe you’re nervous that you’ll have to stop on your way from the house to the medical office for your procedure. If you follow the directions, you should have very little left in your bowel when it’s time to start your commute.

What if I have constipation?

You may take extra laxatives in the days leading up to your prep. This should help resolve your constipation before your bowel prep day.

What if I’ve had poor prep results in the past?

Contact your physician as you’ll likely need additional bowel prep instructions.

What if I have motility issues from a medical condition?

Certain medical conditions and medications can slow bowel emptying or lead to constipation. Conditions like Parkinson’s, multiple sclerosis (MS) or using a wheelchair can slow down your digestion. Medications like narcotics, gabapentin and anticholinergic medications can also have an impact. Contact your physician and be sure to share your medical history and current medication use, as you’ll likely need extra time and additional laxatives to complete your bowel prep.

What if I can’t drink a large volume of liquid?

Start your prep two to three hours earlier to allow yourself more time to complete the entire prep.

What if I can’t finish my bowel prep?

If you can’t finish your entire bowel prep, you’ll likely need to reschedule your colonoscopy due to poor prep quality.

Do I still have to complete the entire prep if I’ve had bariatric surgery?

Gastric bypass surgery involves your stomach and small bowel. It doesn’t change the length of your colon. You may need to drink smaller amounts of water more slowly. You’ll need to complete the entire bowel prep, it may just take longer.

What if I’m on dialysis?

Please consult your nephrologist prior to scheduling to get instructions that are specific to you. In general, dialysis patients take the Golytely® bowel prep and have the procedure on the same day as their dialysis (colonoscopy in a.m., dialysis in p.m.).

How do I know if something is a clear liquid?

If you can pour it in a glass and you can see through it, it’s considered “clear liquid.”

Can I take Uber^®, Lyft^®, taxi or bus home?

An adult must be present with you at check-in for your colonoscopy and remain in the endoscopy area until you’re discharged. You can hire a driver to take you home only if this adult escort is with you at check-in, remains in the endoscopy area until you’re discharged and takes the hired ride home with you.

Can I “sleep it off” here and drive myself home?

No, you must have an adult with you when you check in. Your responsible adult must remain in the endoscopy center during your procedure and then drive you home. You can’t drive a vehicle for the rest of the day.