1. Peglyte 4L jug
Peglyte is the “go-to” option for my surgeon. It is widely available at all pharmacies and is the cheapest at $28CAD. You get a large 4L jug with some powder at the bottom. Fill it up, shake and you are ready. Peglyte does not include a laxative, so you will need to buy and use this (Ducolax) separately.
Instructions: At 7pm drink half the bottle (2L) within one hour. Drink another 2L of fluid within the next 3-4 hours. Six hours prior to your procedure, drink the other half (2L) within an hour, and continue to drink clear fluids up until 2 hrs before your procedure.
Side Effects: This liquid tastes terrible. Drinking 2L of it within 1 hour as well as another 2L of fluids, for a total of 4L, caused significant stomach cramps and vomiting. For a small person this was very painful.
Result: If you can tolerate it, this prep will do the job. Boston Bowel Preparation Scale was 9/9, was adequate and therefore acceptable.
Analysis: An effective prep kit, but comes with side effects of stomach cramps and vomiting. There was some post traumatic stress disorder PTSD from using this kit.
2. Kleanlyte 177ml bottles
Kleanlyte comes in a kit of 2 177ml bottles and a large cup. At $40CAD it is a little more expensive. As it is not as commonly used, you will need to custom order this at your pharmacy and wait for your order. You pour one Kleenlyte bottle into the cup, add 296ml of water and you get a 473ml concoction. This is the total chemical ingested with this kit.
Instructions: The first bout should be taken 10-12 hrs before the second bout, which is taken before your procedure. You take the first bout (177ml chemical and 296ml of water), followed by 2 473ml cups of water from the same cup. After this you must also drink a minimum 2.5L of any clear liquid, for a minimum total of 4L of liquid. The second bout should be taken before your procedure, but it does not say how long before. You also need to drink additional clear liquids after your second bout. Kleanlyte contains a laxative, so you need not add Dukolax.
In addition to drinking, we started a low fiber diet, with the hopes of making the colon cleaning easier. The results were not apparent. Beans should no be eaten nor pureed as hey contain a lot of fiber. One of the benefits of Kleanlyte is that you can drink whatever clear liquid you like. We bought apple juice (1.5cp 36g sugar), Gatorade (1.5cp 25g sugar), Ginger Ale (1.5cp 36g sugar) and made lemon water (lemon slices in water, 0g sugar).
Side Effects: This kit has a lemon flavour and is much easier to drink than Peglyte. The first bout did not have any side effects. The second bout, however, there was a little vomiting, but far less and far less violent than with Peglyte. We suffered form a bit of dehydration and could not physically drink enough clear liquids, as there was not enough stomach room and we needed some sleep.
Result: This kit is better tolerated than Peglyte. There is much less noxious chemical to drink, and you can supplement with the clear liquid of your choice. Interestingly sucking on a lemon wedge helped balance the added sugar of the drinks. On the Boston Bowel Preparation Scale we got a 6/9, adequate and therefore acceptable.
Future changes: The second bout should be taken far earlier, possibly 10-12 hrs before your procedure, to allow the chemical to work and to minimize stress on the stomach. Further, clear liquids still need to be taken after the second bout, just as the first, but if your stomach is already full, this may be quite difficult. Further, you also need to sleep some time during this prep. This constrains how much time you have to prep.
Analysis: Kleanlyte still did an adequate job but with far less stomach cramps and vomiting, as well as PTSD. The results are not as effective as Peglyte, but good enough. The choice of clear liquids is very desirable. We will continue to use this kit in the future, if we need to do another colonoscopy.
Kleanlyte is preferable to Peglyte because there is far less chemical to drink. The volumes of liquid are roughly the same, at 4L, but with Kleanlyte you get to choose your clear liquids. Kleanlyte induces no stomach cramps, far less vomiting and PTSD. This, for us, is the better colonoscopy kit.