This leaflet contains instructions for 2 types of bowel preparation along with antibiotics. The first line bowel preparation is called Moviprep and the second line bowel prep is called Plenvu. You will only take one of these preparations as directed by your surgeon.
Your specialist nurse will go through this leaflet with you in detail and there is a number to contact should you have any questions.
Background
There is now increasing evidence that having your bowel emptied and taking oral antibiotics before your bowel surgery may reduce the risk of developing an infection (NICE guidelines NG125).
Please follow the instructions below which will guide you through when and how to take your bowel preparation alongside your antibiotics. It is important that you follow these instructions carefully and correctly.
Your bowel preparation is a very strong laxative that will empty and clear your bowels of stools/waste.
You are advised not to go to work on this day, as you would expect frequent bowel motions.
When you are taking your bowel preparation you will experience:
- Urgency to open your bowels
- Diarrhoea/loose watery stools
- Some people experience a loss of control of their bowels
- Some people experience stomach cramping, nausea and sometimes vomiting
- PLEASE ensure you are near the toilet once you start taking your bowel preparation
- PLEASE continue to drink a glass of water every hour whilst you are still opening your bowels, this will help to stop you feeling dehydrated
- You can drink unlimited amounts of clear fluids which include water, clear soup, diluted cordials/clear fruit juice, black tea and black coffee. Please avoid milk and alcohol
Please report all your allergies to your medical team.
If you require any further advice or information regarding your bowel preparation and antibiotics, please contact the Colorectal and Enhanced Recovery Nursing team on 0161 206 1249.
Please follow the times and instructions carefully as outlined in this information.
MOVIPREP Instructions
2 days BEFORE SURGERY - Low fibre diet (a list of appropriate foods is provided at the end of this leaflet)
Day BEFORE surgery
8am - Have a low fibre breakfast (a list of appropriate foods is provided at the end of this leaflet)
☐ 12.30pm - Prepare the first jug of MoviPrep
Empty sachet A and sachet B into your jug and add 1 litre (1000ml) of lukewarm drinking water and mix this up until the powder has dissolved.
If preferred, mix the solution ahead of time and refrigerate prior to drinking. Do not store for more than 24 hours.
☐ 1pm - Take the 1st dose of antibiotics AND drink your 1st dose of MoviPrep
- Every 15-30 minutes drink a quarter (250ml) of the jug. It should take you 1-2 hours to drink all the MoviPrep
- After drinking all the MoviPrep, please drink a further 500ml of water
The antibiotics are:
Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Ciprofloxacin 750mg and Metronidazole 400mg
☐ 2pm - Take the 2nd course of antibiotics Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Metronidazole 400mg
☐ 3.30pm - Prepare your 2nd jug of MoviPrep
Empty Sachet A and Sachet B into your jug and add 1 litre (1000ml) of lukewarm drinking water and mix this up until the powder has dissolved. You may put it in the fridge until ready to drink to make it colder.
☐ 4pm - Drink the 2nd course of MoviPrep
- Every 15-30 minutes drink a quarter (250ml) of the jug. It should take you 1-2 hours to drink all the MoviPrep
- After drinking the 2nd 1000ml of MoviPrep solution, please drink a further 500ml of water or clear fluid
☐ 8pm - Take your 1st sachet of PRELOAD (carbohydrate drink) - Not suitable for diabetics
Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink 1 sachet.
☐ 10pm - Take your 2nd sachet of PRELOAD (carbohydrate drink) - Not suitable for diabetics
Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink 1 sachet AND take the 3rd and final dose of antibiotics.
Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Ciprofloxacin 750mg and Metronidazole 400mg
After 2am - Drink water only
On the MORNING of your operation:
☐ 5am - Finally take your 3rd sachet of PRELOAD (carbohydrate drink) - Not suitable for diabetics
Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink the PRELOAD.
Please ensure that you finish this glass of PRELOAD by 6am.
After 6am you must NOT HAVE anything by mouth.
PLENVU Instructions
2 days BEFORE SURGERY - Low fibre diet (a list of appropriate foods is provided at the end of this leaflet)
Day BEFORE surgery
8am - Have a low fibre breakfast (a list of appropriate foods is provided at the end of this leaflet)
☐ 12.30pm - Prepare the 1st jug of Plenvu
Empty the sachet labelled dose 1 into your measuring jug and add 500mls of water. Stir the powder until it has dissolved, which can take up to 8 minutes.
☐ 1pm - Take the 1st dose of antibiotics AND drink your 1st dose of Plenvu
- Drink a glass every 10 to 15 minutes. It should take you 30-60 minutes to drink all the Plenvu
- Also drink a minimum of 2 glasses of water. You can drink this in between the glasses of Plenvu
The antibiotics are:
Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Ciprofloxacin 750mg and Metronidazole 400mg
☐ 2pm - Take the 2nd course of antibiotics
Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Metronidazole 400mg
☐ 3.30pm - Prepare your 2nd jug of Plenvu
- Empty dose 2 sachet A and dose 2 sachet B into your jug and add 500mls of water. Stir until the powder has dissolved, which can take up to 8 minutes
☐ 4pm - Drink the 2nd dose of Plenvu
- Drink a glass every 10 to 15 minutes. It should take you 30-60 minutes to drink all the Plenvu
- Also drink a minimum of 2 glasses of water. You can drink this in between the glasses of Plenvu ☐
☐ 8pm - Take your 1st sachet or PRELOAD (carboydrate drink) - Not suitable for diabetics
- Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink 1 sachet
☐ 10pm - Take the 2nd sachet of PRELOAD (carbohydrate drink) - Not suitable for diabetics
- Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink 1 sachet AND take the 3rd and final dose of antibiotics
Neomycin1000mg and Metronidazole 400mg.
If Neomycin is unavailable or unsuitable you will take:
Ciprofloxacin 750mg and Metronidazole 400mg
After 2am - Drink water only
On the MORNING of your operation
☐ 5am - Finally take your 3rd sachet of PRELOAD (carbohydrate drink) - Not suitable for diabetics
Empty the sachet into a jug and add 400mls of water, mix until the powder has dissolved and then drink the PRELOAD.
Please ensure that you finish this glass of PRELOAD by 6am.
After 6am you must NOT HAVE anything by mouth.
Low fibre diet Foods allowed
🗹 White bread
🗹 Pasta, rice, potatoes well cooked (no skin) couscous
🗹 Butter or margarine
🗹 White meat, skinless chicken, grilled or poached
🗹 Well cooked meats, for example lamb, beef, veal, turkey, ham
🗹 Cheese, eggs, tofu, feta, avocado
🗹 Well-cooked or pureed root vegetables, for example carrots, turnips or swede
🗹 Jam/marmalade (without seeds)
🗹 Croissants
🗹 Cooked fruit without seeds, soft tinned fruit (no pips)
🗹 Cereals without grains, seeds, dried fruit or added fibre for example coco pops, frosties, cornflakes or rice crispies
🗹 Plain crackers, such as cream crackers, water biscuits and rice tea
🗹 Ice cream, jelly, custard, rice pudding, semolina
🗹 Clear soups or strained fruits
🗹 Juices should be clear or strained
Avoid
🗷 Bread containing seeds, nuts and dried fruit for example multigrain, wholewheat, brown
🗷 Brown pasta, brown rice, pearl barley, quinoa
🗷 Potato skin, jacket potato, chips
🗷 Tough gristly meat or meat with skin, for example pork crackling
🗷 Nuts, beans, pulses, lentils, dried fruit
🗷 Fish with bones
🗷 All vegetables not listed above. In particular, sweetcorn, peas, peppers, onions, tomatoes, leeks and lettuce
🗷 All fruits not listed above. In particular, berries, fruit with skins, dried fruit, prunes
🗷 Snacks containing seeds, nuts and dried fruit, for example flapjacks, Ryvita and popcorn
🗷 Vegetable or chunky soups
Clear fluids Allowed
🗹 Water/squash
🗹 Black tea/coffee
🗹 Marmite/Bovril mixed into a weak drink
🗹 Clear watery and strained soup
🗹 Fruit juice (without bits)
🗹 Forti juice carton
Avoid
🗷 All drinks containing milk, including hot chocolate
🗷 Fruit juice with bits/smoothies
🗷 Soups with bits in
🗷 Tomato juice
🗷 Fizzy drinks
Low fibre Diet - Breakfast the day BEFORE surgery Allowed:
🗹 White bread
🗹 Egg
🗹 Shredless marmalade/jam
🗹 Croissants
Avoid:
🗷 All breakfast cereal
🗷 Mushrooms/tomatoes/baked beans
🗷 Brown/granary bread
🗷 Yoghurt
Date of Review: March 2026
Date of Next Review: March 2028
Ref No: PI_SU_2209 (Salford)