ERCP Prep
IMPORTANT GLP-1 DRUG INFO
The following weight loss / diabetic drugs should be held as instructed prior to procedure:
- Liraglutide: Victoza (weekly) and Saxenda (daily)
- Dulaglutide: Trulicity (weekly)
- Exenatide: Bydureon (weekly) and Byetta (daily)
- Semaglutide: Ozempic (weekly), Wegovy (weekly) and Rybelsus (daily)
- Tirzepatide: Mounjaro (weekly) and Zepbound (weekly)
- Lixisenatide: Adlyxin (daily)
The medication will need to be stopped seven (7) days prior to your procedure if you are on a weekly dose or the day of your procedure if you are on a daily dose.
Prep Instructions for ERCP
If you are having only an ERCP follow these instructions.
If you are having both an upper endoscopy and a colonoscopy follow the instructions on the prep sheet for the colonoscopy.
- Nothing should be consumed for 8 hours before the test, except medications as directed by your doctor.
- Aspirin, non-steroidal anti-inflammatory drugs (aspirin substitutes), blood thinners, anticoagulants, and iron supplements should not be taken for five days before the test to reduce the risk of bleeding.
- Some patients may receive antibiotics prior to the test.
- Arrangements should be made for someone to drive you home after the test.
Diabetic Prep
Medications
- If you take oral medications for your diabetes, do NOT take your diabetes pills on the day prior to your procedure (prep day) or on the day of your procedure (until your procedure is complete and you resume a normal diet).
- If you take non-insulin injectable medications (Byetta, Bydureon, Victoza, Trulicity, Tanzeum, Symlin), do not take the medication if your injection day is the day prior to your procedure (prep day). You can resume it after the procedure is complete.
- If you take insulin, reduce your dose by 50% (half) of your normal dose on the day prior to your procedure and the day of your procedure. You can resume your normal dose after the procedure when you resume normal diet.
- If you use an insulin pump, contact your diabetes doctor for instruction. Generally, most patients will need to reduce their basal rate to 80% of the normal rate.
Diet
- You should aim for 45-60 grams of carbs with each meal. Although you may ordinarily avoid sugars, they are ok to take when you are prepping for your colonoscopy as these will be the main source of calories when you are on a clear liquid diet.
- For snacks, try to include other fluids that contain electrolytes such as broth.
- Examples of clear liquids with carb amounts are listed below. Note, if you experience low blood sugar (<60) during the 2 hours before your procedure, you can take 3 teaspoons of soda or clear juice to raise your sugar. Do NOT take solid foods or non-clear liquids, as your procedure will be cancelled.
| FLUID | AMOUNT | CARBS |
|---|---|---|
| Juice | 1/2 cup | 15 g |
| Jello | 1/2 cup | 15 g |
| Soda | 1 can | 40 g |
| Popsicle | 1 double stick | 15 g |
| Gatorade/Powerade | 1/2 cup | 15 g |
| Broth (veg/chicken/beef) | any | 0 g |
| Clear Protein Drinks | any | 0 g |