Preparing for colonoscopy: fortrans, diet, features of the procedure

Colonoscopy is a diagnostic procedure of the colon performed using a colonoscope. This type of study helps to examine the entire colon for tumors and fistulas. Colonoscopy is prescribed for patients with chronic abdominal pain, blood in the stool, ulcerative colitis, diarrhea, and those suffering from unexplained weight loss. What should be the preparation for a colonoscopy with the drug Fortrans?

pharmachologic effect

Manufacturer: BOFUR IPSEN INDUSTRY (France)
Release form: powder for solution for oral administration

Active ingredient: macrogol 4000

Analogues: Movitrep, Lavacol, Endofalk

The medicine is a high-molecular compound in the form of a linear polymer. Fortrans has the ability to retain the absorption of water from the stomach and intestines, which leads to an increase in osmotic pressure and an increase in the volume of intestinal contents. Frequent urge to defecate leads to accelerated release from feces. The water-electrolyte balance in the body is maintained and does not change due to the action of the drug.

If the colonoscopy is planned from 14:00 to 19:00

On the eve of the study, you can have breakfast, lunch and even a light dinner, but the last meal should be no later than 18:00. It is not recommended to drink carbonated drinks. Dissolve the contents of each Fortrans package in 1 liter of boiled water at room temperature. From 20:00 to 22:00 on the eve of the study, you need to drink 2 liters of solution; over 1 hour, gradually, no more than ¼ cup, drink 1 liter of solution. This is important because if you try to drink it quickly, the cleansing of the intestines will be incomplete (the solution will come out quickly and will not have time to mix sufficiently with the contents of the intestines).

Approximately 1.5–2 hours after taking the first liter of solution, loose stools will appear, which is a natural consequence of taking this drug. Loose stools will periodically repeat several more times until approximately 24:00. After this, as a rule, the urge to bottom stops, and the first stage of preparation is considered complete. Before going to bed the night before, as well as at 7:00 on the day of the study, you can drink up to 300–400 ml of still water or weak tea. On the day of the study, the second stage of preparation is carried out - taking two liters of Fortrans solution from 8:00 to 10:00. After this, there will be loose stools several times again, which, as a rule, stops by 13:00. If the drug is poorly tolerated the day before, it is permissible to replace the solution taken on the day of the study with two cleansing enemas with a volume of 1.5–2.0 liters each at 8:00 and 10:00. Appear for the examination on an empty stomach at the appointed time (as an exception, you can take 200–300 ml of water or tea, but no later than 2 hours before the examination, if anesthesia is not planned).

Important!

There is no need to fast the night before or the day of the test. You can drink broth, tea, still mineral water, juice. In the days of preparation for a colonoscopy, it is possible and even necessary to take the medications you need, with the exception of iron supplements and activated carbon. When preparing patients with diabetes, consultation with a doctor is necessary.

Fortrans - instructions for use

According to the instructions for use of Fortrans, the medication is prescribed for internal use. The contents of 1 package must be dissolved with boiled water, volume 1 liter per 15–20 kg of body weight. On average, a patient will need 3–4 liters of solution, which is taken once or in small doses. That is, 2 liters of the drug are consumed in the evening and 1-2 liters in the morning 3-4 hours before an instrumental examination of the intestines.

If the laxative solution is taken in full in the evening, an hour break is possible after drinking half the liquid. You need to drink Fortrans solution at a rate of 250 ml every 10–15 minutes, that is, on average 1-1.5 liters per hour.

Preparing for colonoscopy using Fortrans

It is extremely important that during the procedure the intestines are cleared of feces that make examination difficult. The most common and reliable method is to cleanse the intestines using Fortrans. This drug is intended specifically to prepare the body for such procedures, for intestinal examination or surgery. The solution has a pleasant fruity taste. If the taste does not seem very pleasant, you can drink the drug with water. This effective medicine ensures complete bowel movement without resorting to enemas and without abdominal pain. One-stage preparation is carried out as follows:

• The day before going to the endoscopist, you should not eat foods such as vegetables and fruits, as well as anything that causes fermentation processes in the stomach, such as black bread.
• On the day of the study, it is advisable to switch to drinking (only tea and water, it is advisable to exclude even juices)
• On the same day, you need to dilute Fortrax in boiled water: 1 sachet per 1 liter of water. The instructions will help you correctly calculate the dose based on your weight.
• Drink the solution in fractional portions. Take no earlier than 2 hours after meals, drink slowly.
• The intestines begin to empty 1-1.5 hours after taking Fortrans, stool stops after 2-3 hours.
• It is necessary to calculate the time of taking the drug so that the colonoscopy is performed no earlier than 4 hours after the last dose of Fortrans.

Another preparation option is called two-stage:

• The morning before the procedure, a light breakfast is allowed: porridge or yogurt.
• The rest of the day, take only liquid food: broth, tea, boiled water.
• Fortrans should be taken in small portions in the afternoon.
• The next morning (on the day of the test), take another 1 liter of solution with 1 sachet of the drug. Compliance with all the rules guarantees excellent preparation of the body for colonoscopy.

Analogues of Fortrans

The pharmaceutical market is represented by a wide range of Fortrans substitutes from domestic and foreign manufacturers. These drugs are sold by the pharmacy chain in the form of: generics, synonyms, and combination drugs.

List of Fortrans analogues with price and country of origin

The price of Fortrans analogues fluctuates over a wide range. Some imported drugs are more expensive compared to medicines from domestic manufacturers. The amount of payment for the medicine does not affect the expected result of bowel cleansing. There are cheaper analogues of Fortrans for colonoscopy, which also give good results from the action of the medication.

What else can replace Fortrans for colonoscopy, what effective drugs? You can supplement the list of analogues with the following medications:

• Picoprep;
• Fleet Phospho-soda;
• Esiklen;
• Moviprex;
• Guttasil;
• Exportal;
• Osmogol;
• Sodium thiosulfate.

This is not a complete list of drugs used in medical practice. The doctor will make a recommendation regarding which analogue will be best, taking into account objective data on the condition of the intestines or the upcoming instrumental examination.

Salt-based laxatives

Drugs without macrogol, which act in a similar way, are in no way inferior in effect.

Picoprep

A trio of sodium picosulfate, citric acid and magnesium oxide provides the same osmotic effect. Orange taste. The result of intestinal cleansing is excellent, it acts gently and quickly. Use only 2 packets, each dissolved in 150 ml of water. But they additionally supplement the volume with 2 liters of drinks - green tea, compote, mineral water. It is comfortable to drink, since the medicine is only 2 partial glasses, the rest is ordinary liquids. Can be used by children over 9 years old under medical supervision. It costs from 600 to 800 rubles in pharmacies.

Kolokite

Sodium hydrogen phosphate and dihydrogen phosphate in tablets. Every 15 minutes, take 4 pieces with a glass of water, about 32 pieces in total. It is highly recommended to drink plenty of fluids afterwards to avoid dehydration. Gives excellent cleansing results and does not cause taste problems. The cost for 32 tablets is from 490 to 720 rubles.

Fleet Phospho-soda

Sodium hydrogen phosphate and dihydrogen phosphate in the form of a solution concentrate with ginger-lemon flavor. Each of the two bottles is mixed with water in an amount of 120 ml. In addition, according to a special scheme, they drink about 2-2.5 liters of drinks. Allowed for teenagers over 15 years of age. Price in pharmacies is 515-550 rubles.

Preparing for a colonoscopy with Fleet soda is very simple and does not require drinking 3-4 liters of nasty solutions. But many experts consider the drug to be insufficiently effective. To get a good effect, we advise patients to strictly follow a diet and also drink herbal laxatives before taking Flit, then there will be both comfort and a good cleansing result.

Fortrans or Moviprep

Manufacturer: NORGIN LIMITED (Great Britain)
Release form: powder for solution for oral administration

Active ingredient: ascorbic acid, macrogol 3350, sodium ascorbate, sodium sulfate, (potassium chloride, sodium chloride)

Both drugs are prescribed as a laxative in preparation for a colonoscopy. The analogue of Moviprep is a more modern medicine of the latest generation and its use is a priority, since one of the active substances in the composition is macrogol 3350. It is safer and acts more gently, without causing irritation or damage to the mucous membrane of the rectum and sigmoid colon due to diarrhea.

The Fortrans substitute for colonoscopy has the best taste. When preparing for an instrumental study with Moviprep, it is necessary to take 2 liters of solution orally, and add the rest of the liquid (up to 4 liters) with tea without milk, compote, boiled water or other clear liquid, excluding carbonated and colored drinks without gas.

Cleaning products used

The best way to speed up the process of endoscopic examination is preparations for colonoscopy. However, they can only be prescribed by the attending physician, who takes into account the history of concomitant diseases and selects the optimal dosage. In modern medicine, many medications from this group are used before colonoscopy. Among them:

• Espumisan. an auxiliary drug and is not used as a means of preparation, but we recommend adding it to any regimen. Its standard dose: 2 capsules 3 times a day, as well as another 2 capsules on the day of the procedure. The main advantage of Espumisan is the reduction of surface tension at the interface, which complicates the formation and promotes the destruction of gas bubbles in nutrient suspension and mucus.
• Movieprep. An excellent drug for bowel preparation: 1 liter in the evening + 0.5 ordinary water and 1 liter in the morning + 0.5 ordinary water. Many patients know the benefits of this medication for cleansing the colon in preparation for a colonoscopy. This means a smaller amount of drug solution, significantly less preparation time and a pleasant lemon taste.
• Fortrans. Its recommended dose is 1 sachet of powder / 1 liter of solution per 15-20 kg of body weight. It is characterized by a rapid onset of effect (due to active absorption) and a small list of contraindications, so it can be prescribed to people of various categories. But drinking less than 4 liters is not recommended.
• Endofalk. With a one-stage regimen, it is taken in a dose of 200-300 ml immediately 3-4 hours in the evening before the procedure, and with a two-stage regimen - half the day before and half in the morning on the day of the procedure. Endofalk has a pleasant taste due to the absence of sodium sulfate in its composition.
• Picoprep. Adults should take the contents of the sachet diluted in water in the evening the day before the endoscopic examination. It has a rapid onset of effect and a minimal number of side reactions, but has several restrictions on use (pregnancy, breastfeeding).
• Lavacol. There are 2 methods of administration: one-stage and two-stage, therefore medical consultation is required. It is characterized by a low likelihood of developing such undesirable reactions, free sale (without a prescription) and the absence of an unpleasant taste.
• Kolokite. The evening before, 20 tablets are taken, and in the morning on the day of manipulation - 12 tablets. The advantage of Kolokite is that there is no need for a large amount of liquid to drink, but the disadvantage is that the tablet dose is large (32 tablets).
• Plenvu. A promising drug - only 1 liter, but not yet sold in Russia

Fortrans or Lavacol

Manufacturer: JSC MOSCOW PHARMACEUTICAL FACTORY (Russia)
Release form: powder for the preparation of solution for oral administration

Active ingredient: macrogol 4000

Fortrans and its analogue Lavacol contain identical active substances that provide an osmotic laxative effect. The preparations differ in their taste. Fortrans has a taste similar to mineral water, that is, salty with a sweetish aftertaste. Fortrans also has a salty taste, but after 2-3 glasses of the solution, it provokes vomiting, which is drowned out by citrus juice.

The laxative effect of both medications is equivalent, but the domestic drug is much cheaper than the imported one, and the difference in the time of onset of their action is 1–2 hours.

Fortrans or Eziklen

Manufacturer: BOFUR IPSEN INDUSTRY (France)
Release form: concentrate for the preparation of a solution for oral administration

Active ingredient: potassium sulfate, magnesium sulfate, sodium sulfate

Esiclene is an osmotic laxative containing a complex of mineral salts. Taking the drug and a large amount of liquid (according to the instructions, up to 3 liters) provokes profuse watery diarrhea. Esiclene for colonoscopy has a mild effect on the intestines and is safer, without irritating the mucous membrane of the intestines and anus and without causing discomfort in the patient.

Fortrans or Endofalk

Manufacturer: LOZAN PHARMA GMBH (Germany)
Release form: powder for the preparation of solution for oral administration

Active ingredient: macrogol 3350, sodium chloride, potassium chloride, sodium bicarbonate

Both drugs provide a laxative effect. But the advantage for bowel cleansing before colonoscopy will remain with Endofalk. The drug is safe because it contains the active component of the 2nd generation macrogol 3350 with a lower molecular weight. Endofalk has a mild effect, has improved taste, and is easier to tolerate by patients.

Other ways to prepare for a colonoscopy

Fortrans must be prepared strictly according to the instructions.

For persistent constipation, if there has been no bowel movement for several days, you can use the following colon cleansing regimen before colonoscopy. A couple of days before the key moment, you need to start following a special diet called a slag-free diet. It allows cereals, eggs, boiled lean meat, broths, and low-fat fermented milk products.

1. On the day of going to the hospital, only liquid food is allowed: water, broth (clear) and tea.
2. The day before you need to drink 2 tablespoons of castor oil. It's not easy, but this oil will help cleanse the intestines quickly and effectively.
3. After you go to the toilet, you need to do an enema, preferably two. You may feel like your bowels have completely emptied, but this is not always the case. The colonoscopy procedure requires complete cleansing. Therefore, use plain water at room temperature for enemas.
4. The next morning you need to do 1-2 more of the same enemas. In this case, clear water without feces should flow out. Now you are ready for the procedure.

It is also possible to cleanse the intestines with the laxative Lavacal. It is necessary to dissolve 1 sachet of powder in 200 ml of clean water. Drink this solution on an empty stomach the day before the procedure. In total, you need to drink 3 liters of Lavacal solution, 200 ml every 20 minutes. After this, only liquid food is allowed. In the evening, after 10 o'clock it is not advisable to eat. In rare cases, side effects are possible when taking Lavacal: nausea, vomiting. In this case, the drug must be stopped.

Fortrans or Forlax

Manufacturer: BOFUR IPSEN INDUSTRY (France)
Release form: powder for solution for oral administration

Active ingredient: macrogol 4000

Both drugs are intended to cleanse the intestines and have a laxative effect. They have the same active high molecular weight compound, but different excipients. Replacing Fortrans with Forlax will be more justified in the case of treating constipation not only in adults, but also in children over 8 years of age. Forlax has more pleasant organoleptic properties and action due to additional ingredients in the product.

Fortrans 64 g (73.69 g) N4 powder for solution

Latin name

Fortrans

Release form

Powder for solution for oral administration

Compound

1 sachet contains:

Active substance: macrogol 4000;

Excipients: sodium chloride - 1.46 g; potassium chloride - 0.75 g; sodium bicarbonate - 1.68 g; sodium sulfate anhydrous - 5.7 g; sodium saccharinate - 0.1 g.

Package

4 bags of 64 g.

pharmachologic effect

Fortrans is a laxative.

Pharmacodynamics

The high-molecular compound macrogol 4000 is a linear polymer that holds water molecules through hydrogen bonds. Due to this, the osmotic pressure and the volume of intestinal contents increase.

The electrolytes contained in the drug prevent disruption of the water-electrolyte balance in the body.

Macrogol 4000 is not absorbed into the gastrointestinal tract and is not metabolized.

Indications

Cleansing the colon in preparation of the patient for the following procedures: endoscopic or x-ray examination of the colon; surgical interventions requiring the absence of contents in the colon.

Contraindications

- hypersensitivity to polyethylene glycol, since there are reports of very rare allergic reactions (rash, swelling, in isolated cases - anaphylactic shock) to taking drugs containing polyethylene glycol;

- the patient’s serious condition (for example, dehydration or severe heart failure);

- the presence of a malignant tumor or other disease of the colon, accompanied by extensive damage to the intestinal mucosa;

- complete or partial intestinal obstruction;

- age up to 15 years (due to lack of clinical data).

Use during pregnancy and breastfeeding

Currently, there is insufficient data to assess the effect of macrogol 4000 on the occurrence of fetal malformations when using the drug in pregnant women.

Therefore, Macrogol 4000 can be used in pregnant women only if necessary.

Since macrogol 4000 is not absorbed from the gastrointestinal tract, Fortrans® can be used during breastfeeding.

Directions for use and doses

Inside.

The drug can only be used in adult patients (over 15 years of age).

The contents of one sachet should be dissolved in 1 liter of water and stirred until completely dissolved.

The solution should be taken in a dosage equal to 1 liter per 15–20 kg of body weight, which approximately corresponds to 3–4 liters.

The solution can be taken once (4 liters in the evening, on the eve of the examination or operation) or divided into 2 doses (2 liters the night before and 2 liters in the morning); Taking the drug must be completed 3-4 hours before the procedure.

Side effects

Nausea and vomiting have been reported at the beginning of taking the drug, which ceased with continued use.

Possible bloating.

Very rare cases of allergic skin reactions such as rash and swelling have been reported. Isolated cases of anaphylactic shock have also been reported.

special instructions

Elderly people with poor health should use the drug only under medical supervision.

Drug interactions

Diarrhea caused by the use of Fortrans may impair the absorption of other medications taken at the same time.

Overdose

There is no data on an overdose of the drug Fortrans®.

Storage conditions

Store at a temperature no higher than 25oC, out of the reach of children!

Best before date

5 years.

Magnesium sulfate

Manufacturer: NPO FARMVILAR (Russia)
Release form: powder for the preparation of solution for oral administration

Active ingredient: magnesium sulfate heptahydrate

Magnesium sulfate is an analogue of Fortrans for colonoscopy in powder and has a laxative effect to relieve constipation. The mechanism of action of the drug is aimed at stimulating osmotic pressure in the intestine, which leads to the accumulation of fluid in it, softening of stool and increased peristalsis. An increased urge to defecate stimulates colon cleansing.

Microlax

Manufacturer: FAMAR ORLEANS (France)
Release form: solution for rectal administration

Active ingredient: sodium citrate, sodium lauryl sulfoacetate, sorbitol solution

Microlax is a combined laxative used as an enema. This is a substitute for Fortrans for colonoscopy and constipation. The analogue is safe and has a mild effect due to optimally selected ingredients in the microenema solution. Effectively cleanses the intestines a quarter of an hour after taking the procedure.