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Global IT outage update - Monday 22 July

The issues affecting the supplier that provides our chemotherapy and immunotherapy treatments have now been resolved.

We want to thank our patients for being understanding and bearing with us and we apologise for any delays caused by this. Unless our teams contact you, please attend your appointment as planned. Throughout this incident, we have prioritised the most clinically urgent patients.

The Christie provides care and treatment for hundreds of people every day. The global IT outage last Friday (19 July 2024) affected many organisations but to put it into context, this affected less than a third of our patients.

Our staff have worked tirelessly over the weekend to deliver as many chemotherapy and immunotherapy treatments as possible and continue to do so to catch up on rescheduled treatments this week.

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Instructions for taking PLENVU® bowel preparation

If you have been prescribed an oral bowel cleansing agent (also known as bowel preparation), it is important to follow these instructions carefully. This is to ensure that you take this bowel preparation in a safe manner and also have a clear bowel so that good views are obtained during your test.

There is a risk of developing dehydration, low blood pressure or kidney problems with this medication. The doctor prescribing the oral bowel preparation will have assessed your risk and identified the most appropriate medication for you. You may also have had a blood test to assess your kidney function.

You should make sure that you drink enough fluids while you are taking the bowel preparation to avoid dehydration. The symptoms of dehydration include dizziness or light-headedness (particularly on standing up), thirst or a reduced urine production. Try to drink a glass of water every hour that you are awake.

Medications

You should follow any specific advice that you have been given regarding your regular medications.

Medications that you may have been asked to temporarily discontinue include:

  • antihypertensives (to lower your blood pressure, such as ACE inhibitors like ramipril)
  • diuretics (“water tablets” such as furosemide)
  • non-steroidal anti-inflammatory drugs (a type of painkiller, such as ibuprofen)
  • iron preparations (for anaemia, such as ferrous sulphate)
  • aspirin, dipyridamole, clopidogrel, warfarin, apixaban and rivaroxaban (these are medications that thin your blood; you may have been asked to discontinue them depending on the nature of the procedure that is planned).

If you have diabetes, please discuss this with your treatment team.

If you have not received specific advice regarding your regular medications, then you should continue to take them as normal. However, you may need to change the timing as it is preferable to avoid taking them less than 1 hour either side of bowel preparation.

Patients taking immunosuppression for transplanted organs should seek the advice of their doctor before taking bowel preparation.

Patients taking the oral contraceptive pill should take alternative precautions during the week following taking any bowel preparation.

We would like you to follow the following instructions while taking your bowel preparation as it is so important that we obtain a good view when you have your test. You may notice that there are some other instructions in your box of bowel preparation but we feel that you will have a better result by following these instructions.

3 days before colonoscopy

What to eat and what to avoid

You may eat

You should avoid

Cereals: Cornflakes, Rice Krispies, Sugar Puffs and Coco Pops

Wheat bran, All-bran, Weetabix, Shredded Wheat, oat bran, bran flakes, wheat flakes, muesli, Ready Brek, porridge

White bread (you may use butter/margarine)

Wholemeal, high-fibre white, soft grain or granary bread, oatbread

White pasta, white rice

Wholemeal pasta, brown rice

White flour

Wholemeal or granary flour, wheatgerm

Potatoes (no skin)

Fruit and vegetables

Savouries: chicken, turkey, fish, cheese and eggs

All red meat

Puddings, pastries, cakes. Milk puddings, mousse, jelly (not red) sponge cakes, Madeira cakes, rich tea, wafer biscuits

Those containing wholemeal flour, oatmeal, nuts, dried fruit, fruit cake, Ryvita, digestives or Hobnob biscuits

Preserves and sweets: sugar, jelly jam, jelly marmalade, honey, syrup, lemon curd

Jam or marmalade with pips, skins and seeds, sweets and chocolate containing nuts/ fruit, muesli bars

Soup: Clear or sieved soups

Chunky vegetable, lentil or bean soups

Miscellaneous: salt, pepper, vinegar, mustard, salad cream, mayonnaise

Nuts, Quorn, fresh ground peppercorns, hummus, anything containing seeds

The day before colonoscopy

PLENVU® is a strong laxative which will cause diarrhoea and empty the bowel. It is wise to stay near to a toilet once you have taken this medicine. Avoid travelling or going to work.

Please note that instructions for taking PLENVU® are different if you are having a colonoscopy in the morning (AM colonoscopy instructions), or in the afternoon (PM colonoscopy instructions).

  • You are able to have a light breakfast and light lunch. Do not eat anything after this because your bowel must be completely empty for the colonoscopy. For breakfast and lunch, stick to the low fibre foods mentioned in the above table ‘What to eat and what to avoid’.
  • Stop all intake of food at 3pm.
  • After this, you may only have: clear soup, soft drinks, tea and coffee (without milk). All your drinks must be clear. Avoid milk, fruit and puddings. Do not take solid food.

Prepare each 500ml of your PLENVU® as follows:

  • At 6pm, make up your first 500ml of PLENVU® (Dose 1 sachet) and sip this slowly over 30 minutes. It is important to drink an additional 500ml of water or clear fluids over 30 minutes alongside each dose of PLENVU®.
  • At 8 to 9pm, make up your second 500ml of PLENVU® (Dose 2; sachets A and B) and sip this slowly over 30 minutes. It is important to drink an additional 500ml of water or clear fluids over 30 minutes as well as the PLENVU solution.
  • Allow 2 hours for PLENVU® to work after finishing the second dose. You can go to bed when you stop going to the toilet (for example, 11pm).

  • On the day before your colonoscopy, you can have a light breakfast and light lunch. Do not eat anything after this because your bowel must be completely empty for the colonoscopy. For breakfast and lunch, stick to the low fibre foods mentioned on page above in ‘What to eat and what to avoid’.
  • Stop all intake of food at 3pm.
  • After this, you may only have: clear soup, soft drinks, tea and coffee (without milk). All your drinks must be clear. Avoid milk, fruit and puddings. Do not take solid food.

Prepare each 500ml of your PLENVU as follows:

  • At 6pm, make up your first 500ml of PLENVU® (Dose 1 sachet) and sip this slowly over 30 minutes. It is important to drink an additional 500ml of water or clear fluids over 30 minutes as well as the PLENVU® solution.
  • Allow 2 hours for PLENVU® to work after finishing the first dose. You can go to bed when you stop going to the toilet (for example, 9pm).
  • At 6am, make up your second 500ml of PLENVU® (Dose 2; sachets A and B) and sip this slowly over 30 minutes. It is important to drink an additional 500 ml of water or clear fluids over 30 minutes alongside each dose of PLENVU® during the morning.
  • Once again, you will have watery bowel movements which will stop after 2 hours allowing you to leave home in good time for your appointment. Allow 2 hours for PLENVU® to work before leaving for your hospital appointment.
  • You may drink as much clear fluid as you like until 2 hours before your treatment. This should be in addition to each 500ml PLENVU® dose and the essential 500ml clear fluid you must drink alongside these.

Hints and tips

  1. Sip slowly over 30 minutes.
  2. Once dissolved, (this may take up to 8 minutes), the solution can be refrigerated.
  3. Try using a straw.
  4. Stay hydrated with plenty of clear fluids

On the day of colonoscopy

  • Continue to take plenty of clear fluids until 2 hours before the test.
  • Stop all intake of fluids 2 hours before your colonoscopy.
  • Do not take any solid food.

If you are concerned or worried during preparation for your colonoscopy, please do not hesitate to contact the hospital or your doctor for advice.

Fluids allowed

You may choose from the following:

  • tea with lemon or sugar if desired but without milk
  • black coffee with sugar if desired
  • herbal teas
  • water
  • diluted cordials (but not blackcurrant)
  • clear fruit juice (without pulp)
  • Oxo, Bovril, Marmite (weak)
  • stock cubes
  • clear soups and broths (sieved) or consommé
  • jelly (must be one containing no fruit)

You must not have any milk or any drinks containing milk.

Please do not take any solid food on the day of your colonoscopy.

If you experience problems, advice is available from the Integrated Procedures Unit on 0161 918 2420. Out of hours (7pm to 7am), please contact ward 10 on 0161 446 3860.

Last updated: March 2024