Why have I been given this medication pack?
This medication pack has been given to you as you will soon be having an operation to insert a peritoneal dialysis (Tenckhoff®) catheter, to enable you to start peritoneal dialysis.
It is important that you are not constipated before you have the peritoneal dialysis catheter inserted. It is also important that you do not become constipated following the operation and whilst you are on peritoneal dialysis.
Therefore, it is recommended that you take the fibre supplement OptiFibre® which is dissolved into food and drink. You should start to use this before your operation and continue to use it afterwards – your dietitian will discuss with you how long for. Also, if necessary, you may need to take senna tablets for a short time before and after your operation. Your consultant will advise you on this.
Before surgery it is important that your bowels are completely empty. Therefore, you will need to take a sachet of Picolax®, a bowel cleansing solution, between 14:00 and 17:00 on the day prior to your operation.
What is in this pack?
This pack contains the following items:
- 16 sachets of OptiFibre®
- 40 senna tablets
- One sachet of Picolax®
The pack also contains a letter for your GP which you will need to hand in at your GP surgery as soon as possible. This letter informs your GP about the new medications you are taking and enables them to continue to prescribe these for you as necessary.
- The pack contains enough Resource Optifibre® and senna tablets for approximately 14 days.
How do I take these medications?
1 - OptiFibre®
OptiFibre® is a soluble form of fibre. Fibre helps to maintain good bowel function.
OptiFibre® can be added to hot or cold foods and liquids. It is tasteless and will not affect the colour or texture of the food or drink.
The OptiFibre® is mixed into the food or drink using a whisk, spoon or fork until it is completely dissolved.
How do I take my OptiFibre®?
OptiFibre® comes in both sachets and tins, so depending on the type you have been given you need to follow the instructions below on how to introduce this into your diet. Your dietitian will also be able to advise you on how much OptiFibre® to take if you are unsure.
- Day one to three
Add one serving (one scoop or one sachet) of OptiFibre® per day to tea, coffee, cold liquids or soft pureed food.
- Day four to six
Increase OptiFibre® to two servings (two scoops or two sachets) per day, staggered throughout the day by adding to tea, coffee, cold liquids or soft, pureed food.
- Day seven to nine
Increase OptiFibre® to three servings (three scoops or three sachets) per day, staggered throughout the day by adding to tea, coffee, cold liquids or soft pureed food.
- Day 10 to 12
Based on individual requirements, the Optifibre® may be increased to four servings (four scoops or four sachets) per day, staggered throughout the day by adding to tea, coffee, cold liquids or soft pureed food.
- Day 13 to 20
If more fibre is still needed, increase the OptiFibre® at a rate of one scoop or one sachet every three days, staggered throughout the day by adding to tea, coffee, cold liquids or soft pureed food. You should not exceed ten scoops or ten sachets per day.
Are there any side effects?
It is unlikely that you will experience any side effects whilst taking the OptiFibre® but if you have any concerns about any side effects, please contact your GP, your peritoneal dialysis specialist nurse or dietitian for advice.
2 - Senna
Senna tablets are used to treat and prevent constipation.
If you do not normally have one or more bowel movements a day, it is recommended that you take these senna tablets for a short period of time before and following your operation – your doctor/ nurse will let you know how long. If you have one or more bowel movements a day then there is no need to take the senna tablets before your operation but you should take them for seven days after your operation when they will be reviewed by the peritoneal dialysis team.
How do I take my Senna tablets?
Before the operation - If you do not normally have one or more bowel movements a day you should take two senna tablets at bedtime for five days before your operation.
After the operation - If you do not normally have one or more bowel movements a day you should take two senna tablets at bedtime for seven days after your operation. After seven days you should discuss with the peritoneal dialysis team whether or not you will need to continue to take these tablets.
If you normally have one or more bowel movements a day you should take two senna tablets at bedtime for seven days after your operation only. (You will not need to take them before the operation.) After seven days you should discuss with the peritoneal dialysis team whether or not you will need to continue to take these tablets.
Are there any side effects? - Mild diarrhoea is a side effect of senna. If diarrhoea occurs, stop taking the senna tablets and contact the peritoneal nurse specialist or your GP as soon as possible.
3 - Picolax®
Picolax® is a medicine which empties the bowel before your operation.
- You should take the contents of one sachet dissolved in a glass of water (approximately 150ml).
- Stir for two to three minutes and drink the solution.
- If it becomes hot, wait until it cools enough to drink.
- Once the Picolax® starts to work you will need to go to the toilet frequently. Once you start going to the toilet you should drink one glass of water (approximately 150ml) every hour until you stop needing to go to the toilet.
You need to take the Picolax® on the afternoon of the day before your surgery.
Are there any side effects?
The most common side effects with Picolax® are diarrhoea, nausea and vomiting.
These side effects should be mild but if you have any concerns about these or any other side effects please contact the peritoneal dialysis nurse specialist or your GP as soon as possible.
Further information about all your medicines can be found in the patient information leaflet found in the tablet/ capsule box or on the container.
Are there any symptoms that I should look out for?
If you suffer from any of the symptoms listed below whilst taking any of the medications, please contact the peritoneal dialysis specialist team as soon as possible:
- Abdominal pain
- Excessive diarrhoea
- Constipation alternating with diarrhoea
- Bleeding from the rectum
- Passing of mucus rectally
- Weight loss
How do I get more supplies of this medication?
Enclosed in this pack is a letter for your GP. Please hand this letter in at your GP surgery as soon as possible as this letter is to let your GP know what medications you have been given.
Once your GP has this letter they will be able to prescribe the Resource Optifibre® for you and if needed, further supplies of senna tablets if you are advised to keep taking these tablets.
Who should I contact for help or advice?
If you need any help or advice please contact the peritoneal dialysis team via their office which is open Monday to Friday from 09:00 to 17:00 hours. The phone number is 01223 400184. If you get an answering machine please leave a message and phone number and a nurse will ring you back.
Out of these hours please contact your GP if you require any help or advice.
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/
Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
Telephone +44 (0)1223 245151