Introduction 
This leaflet tells you how to prepare your bowel for your surgery using bowel preparation laxatives. The laxatives will work to cleanse your bowel.  
What is the bowel preparation? 
Moviprep is a strong bowel cleanser which comes in two sachets of white powder. The powder must be dissolved in a jug of water, when dissolved it becomes a clear colourless solution which is ready to drink. 
Why do I need bowel preparation? 
Moviprep is given to ensure your bowel is as clean as possible before surgery.
Before taking Moviprep
Please read the back of the Moviprep packet. If you answer ‘yes’ to any of the following questions and they were not discussed at your pre assessment appointment, please contact the nursing team on the telephone numbers provided at the end of this leaflet.
- Are you allergic to any of the ingredients listed on the packets? 
- Are you taking any of the following tablets?; Warfarin, Acenocoumarol, Phenindione, Dabigitran, Apixaban, Rivaroxaban, Clopidogrel, Prasugrel, Ticagrelor       
- Are you a diabetic on insulin or tablets? 
- Do you suffer from any kidney disease? 
- Do you suffer from Phenylketonuria? 
If you are diabetic
You will need to omit your diabetic medication the evening before and the morning of your surgery. Take all your other medication as directed at pre assessment.
If you monitor your blood glucose levels, increase the frequency of this during this time.
During your preparation, if at any time you feel dizzy, sweaty or irritable take ONE of the following:
- 2 teaspoons of sugar dissolved in warm water.
- 5 – 6 glucose tablets.
- 220mls of Lucozade.
This should be followed up with a starchy snack within 20 minutes, for example; a plain biscuit or some white bread. If you recover well, continue with the bowel preparation instructions. If symptoms do not improve then seek medical advice from your diabetic nurse or GP.
What can I expect of bowel preparation? 
The bowel preparation can begin to work within one to two hours of taking it. You will open your bowels frequently and eventually your motions should change from soft to loose and watery. 
Stay close to a toilet all day as you will use it regularly. 
You may experience some abdominal cramp – this is normal in some people. 
The skin around your bottom can become red and sore due to frequent diarrhea.  A barrier cream such as Vaseline or nappy rash preparations can protect the skin. The soreness is temporary and will disappear in a few days. 
Are there any side effects from bowel preparation? 
You may experience headaches, nausea and sometimes vomiting. Abdominal bloating can occur and, less frequently, abdominal cramps. If you feel bloated or get stomach cramps, try taking the Moviprep more slowly. Rarely people are allergic to Moviprep, you may get itchy skin (like nettle rash or hives). 
Oral antibiotics with bowel preparation.
You will have been given some antibiotics to take prior to your surgery.
The antibiotics that are usually prescribed are:
- NEOMYCIN and
- METRONIDAZOLE tablets.
If you think you may be allergic to either of these tablets, please DO NOT take them and call a member of the nursing team prior to starting this preparation.
You will also be given some high calorie drinks as meal replacements to take the evening before your surgery and the morning of your surgery.
Please read the ingredients on the bottles/cartons. If you think you may be allergic to any of the ingredients, don’t take them and call a member of the team prior to starting this preparation.
One day before your appointment  
You are advised not to go to work on this day. You should expect frequent bowel motions within three hours of starting your bowel preparation. Some abdominal cramping is normal, stay within easy reach of the toilet.  
If you take any other oral medication please ensure you take it at least one and a half to two hours before starting your Moviprep otherwise it will be flushed out of the system before it has had a chance to work. 
12 midday: have your lunch (you will have no more solid food until after your surgery) 
12 midday: Take your firstset of antibiotics 
At 2pm: Take first sachet of bowel preparation.
- Fill a jug with one litre (1 ¾ pints) of water
- Empty the contents of one sachet of Moviprep into the water. 
- Stir until the solution is clear. 
- Drink one glass (¼ litre or ½ pint) Moviprep about every fifteen minutes until you have drunk it all. 
- You can take your time with this: it should take you no more than one hour to drink the solution. You can store the jug of Moviprep in the fridge if you wish. 
3:30pm Take second set of antibiotics. 
5pm make up and drink the next sachet in the same way. 
You should be starting to have watery bowel motions, stay near a toilet. 
You have now taken both sachets.  
6:30pm Drink four of the high calorie drinks. This is your evening meal replacement.
10pm Take your third set of antibiotics.
What do I do the morning of my hospital admission?
6am: Drink two of the meal replacement drinks.
At your pre assessment appointment you will have been given a time to stop drinking. You may drink clear fluids up until this time. This is part of the preparation required for your operation and anaesthetic.
Please arrive for your hospital admission at the time stated in your admission letter unless you have been instructed otherwise.
Quick Checklist for Surgery Preparation:
| Day Before Surgery: | Instructions: |
| 12 midday | Lunchtime meal as normal |
| 12 midday | Take first set of antibiotics |
| 2:00 pm | Take first sachet of bowel preparation |
| 3:30 pm | Take second set of antibiotics |
| 5pm | Take second sachet of bowel preparation |
| 6:30pm | Drink four meal replacement drinks |
| 10:00 pm | Take third set of antibiotics |
| The day of surgery: 6:00 am | Drink two meal replacement drinks |
 
If you require any further advice or information regarding your bowel preparation, you can contact:
Gynaecological Oncology Team
Monday – Friday
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If you feel that your symptoms are urgent, please present to accident and emergency.