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?  
Plenvu is a strong bowel cleanser, which comes in 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. Sometimes bowel prep other than Plenvu is provided, for example Moviprep.
Why do I need bowel preparation?  
Plenvu is given to ensure your bowel is as clean as possible before surgery.
Before taking Plenvu  
Please read the back of the Plenvu 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?  
- Do you suffer from any kidney disease?  
- Do you suffer from Phenylketonuria (PKU)?  
Take all your medication as directed at your pre assessment appointment.
If you are diabetic – 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.
- 220ml 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, 111 or local A & E department.
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 diarrhoea.  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 Plenvu more slowly.  
Rarely people are allergic to Plenvu, 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 surgery 
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 Plenvu 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).
You can have unlimited amounts of clear fluids which can include water, clear soup, diluted cordials/clear fruit juice (without pulp), tea or coffee. Please avoid milk and alcohol.
Take your first set of antibiotics.
2pm: Take dose 1 of bowel preparation (only 1 sachet).
Fill a jug with 500ml of water.
Empty the contents of one sachet of Plenvu into the water. 
Stir until the powder is completely dissolved and the solution is clear. You can add clear diluted juice. You can store the jug of Plenvu in the fridge if you wish. 
It should take you no more than 60 minutes to drink the solution.
An additional 500ml of clear fluid should also be taken over the same 60 minute period.
Alternating between the Plenvu drink and clear fluid.
3:30pm: Take second set of antibiotics. 
5pm: Take your dose 2 of bowel preparation (2 sachets, A & B).
Fill a jug with 500ml of water.
Empty the contents of sachet A and B of Plenvu into the water.
Stir until the powder is completely dissolved and the solution is clear.
An additional 500ml of clear fluid, should also be taken over the same 60 minute period. Alternating between the Plenvu drink and clear fluid.
You should be starting to have watery bowel motions, stay near a toilet. 
You have now taken all sachets.  
6:00pm: Drink four of the carbohydrate loading drinks. This is your evening meal replacement at your own pace.
10pm: Take your third set of antibiotics.
What do I do the morning of my hospital admission?
6am: Drink two of the carbohydrate loading drinks up to 2 hours before surgery.
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 dose 1 bowel preparation (only one sachet ) |
| 3:30 pm | Take second set of antibiotics |
| 5pm | Take dose 2 of bowel preparation ( 2 sachets, A & B ) |
| 6:00pm | Drink four carbohydrate loading drinks |
| 10:00 pm | Take third set of antibiotics |
| The day of surgery: 6:00 am | Drink two carbohydrate loading drinks up to 2 hours before surgery |
 If you require any further advice or information regarding your bowel preparation, you can contact:
Gynaecological Oncology Team
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If you feel that your symptoms are urgent, please present to accident and emergency