Plenvu and Oral Antibiotic Bowel Preparation for Patients with Diabetes before Surgery

For your operation it is necessary for the bowel to be empty. This enables the surgeon to perform a cleaner operation with less risk of infection. Please follow the instructions for the Plenvu bowel cleansing, antibiotics and four pre-op drinks that you have been given carefully.

One week before your operation

Unless advised otherwise continue to take prescribed medication as usual. If you take iron tablets stop taking them one week before the examination/operation.

Two days before your operation

Avoid a high protein or fatty evening meal and do not drink alcohol.

The day before your operation

The time to take the medications is different depending on whether you are having morning or afternoon surgery. The day before your surgery you should have light, low fibre foods only as described below. You must avoid heavy meals and alcohol. You will have been given Plenvu bowel preparation. Both doses should be mixed with 500ml of water. These will make you want to go to the toilet, usually within three hours of the first dose. This can be often and urgent. We recommend a day at home within easy reach of the toilet. Try and stay hydrated with clear fluids.

Menu for the day before your operation

Please follow these instructions very carefully. Only the following food is allowed the day before your operation:

Breakfast (8am – 9am)
One boiled egg, one or two slices of white bread or toast with butter or low fibre cereal such as cornflakes or Rice Krispies. Tea or coffee (milk allowed). Follow your usual morning diabetic care regime.

Mid-morning
Two rich tea or other biscuits.

Lunch (12 noon – 1.30pm)
A small portion of grilled or poached (not fried) white fish or chicken with cooked white rice, followed by plain yoghurt or clear sugar-free jelly. No potatoes, vegetables or fruit are allowed. Tea or coffee (without milk). Drink plenty of diluted fluids during the afternoon. No further food must be taken after this point. Finish the four pre-op drinks by the evening.

Evening medication
Follow pre-operative diabetic medication guidelines through the evening and finish before you go to bed. Monitor blood glucose in the evening and before bed.

Day of your operation

Unless advised otherwise you should take your normal medications with a sip of water. Check your blood glucose level before leaving home. If below 4mmol, take 5-7 dextrose tablets, 1-2 tubes of glucogel or 3-4 spoons of sugar dissolved in water.

Morning operation – coming into hospital for 7am – nothing to drink after 6am.

Afternoon operation – coming into hospital for 11am – only water until 11am.

For patients having bowel surgery in the morning

For patients having bowel surgery in the afternoon

About this leaflet

Author: Nathan Curtis, Consultant Surgeon
Written: November 2023
Updated and approved: June 2024
Review date: June 2027
Edition: v1.1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk