Scheme of preparation for colonoscopy with the drug "Fortrans"

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The presence of contraindications should be checked with a doctor.

If the preparation is carried out using the drug “Fortrans”, there is no need for cleansing enemas. 2 days before the colonoscopy, you need to switch to a special (slag-free) diet, excluding vegetables and fruits, potatoes, herbs, berries, mushrooms, legumes, and black bread from the diet. Allowed: broth, semolina porridge, egg, boiled meat, boiled sausage, fish, cheese, butter, fermented milk products, except cottage cheese.

It is advisable to start taking the Fortrans solution no earlier than 2 hours after eating. For effective preparation, you need to purchase 3 or 4 packages of the drug at the pharmacy. Four packages must be purchased for those patients who have a large body size, constipation, adhesive disease of the abdominal cavity, previously identified lengthening or prolapse of the colon (during the passage of barium through the intestines, irrigation or colonoscopy).

Composition of Fortrans

The active component is macrogol 4000. It is this ingredient in the drug that causes its laxative effect. Among the auxiliary components used in the production of Fortrans:

• sodium chloride (table salt);
• sodium bicarbonate (soda);
• sodium saccharinate;
• sodium sulfate anhydrous.

The medicine is available in the form of a powder packaged in paper bags, which must be dissolved before use. The weight of each sachet is 73.69 g, of which 64 g is macrogol, the rest is filled with auxiliary components.

The powder has a white color and a fine structure, due to which it dissolves almost instantly. There are 4 sachets in one package, their total cost is about 150 rubles. Fortrans is produced in France.

Mechanism of action of the drug

Fortrans is a laxative with osmotic action. Macrogol refers to polymer compounds with many intermolecular bonds. This structure of synthetic polyethylene glycol ensures the attraction of water and its retention, due to which macrogol quickly swells, greatly increasing the total volume of intestinal contents. As a result, intestinal peristalsis is activated, active contraction occurs and feces move towards the rectal sphincter, after which emptying occurs.

Features of the pharmacological mechanism of action of Fortrans include:

• The effect of the drug is only on the intestinal contents
  . Once in the body, macrogol passes unchanged into the intestines, where it begins to attract water. The components of the laxative do not penetrate the bloodstream, which means they do not have a systemic effect on the body.
• Using only the water needed to soften feces is what is in the intestines
  . Due to this, Fortrans does not lead to dehydration.
• Powerful cleansing effect
  . The drug begins to act from the uppermost parts of the colon, that is, all accumulated toxins are completely removed from the digestive system.

• Rapid development of laxative effect
  . The first urge to defecate appears within an hour and a half after taking the first portion of the dissolved powder.

The auxiliary components contained in the drug maintain water and electrolyte balance and replenish the loss of fluid excreted in the stool.

Fortrans must be dissolved in the amount of water recommended by the manufacturer, this ensures the most pronounced laxative effect.

The medicinal components of the drug do not remain in the body and are released along with the contents of the intestine. The laxative effect after taking the last dose of Fortrans lasts for 2-6 hours.

One-stage preparation scheme

It is recommended when conducting the study in the morning before 11:00.

1. 3 and 2 days before the test, follow a slag-free diet.
2. 1 day before the test, before 13:00, take only liquids and do not eat solid food.

From 16:00 to 20:00 - take 1 liter of Fortrans (for 4 hours, 1 glass every 15 minutes).

On the day of the examination, during the procedure without painkillers, you can drink tea with honey or still water. When performing the procedure under sedation (with pain medication), you must avoid eating and be on an empty stomach.

The indicated administration time can be changed, but it is important to remember that it is recommended to finish taking the last dose of Fortrans 3-4 hours before the start of the study.

In what cases is it used?

Doctors primarily prescribe drinking Fortrans to cleanse the intestines during the period of preparation for diagnostic procedures, such as:

• irrigoscopy;
• colonoscopy;
• irrigography.

Complete cleansing of the large intestine improves the visualization of its location and pathological changes, which allows you to make the most accurate diagnosis. Fortrans is often prescribed instead of a cleansing enema before operations on the digestive and pelvic organs.

For constipation, Fortrans is not recommended to be used too often - maximum 2-3 times a year.

Frequent use of Fortrans for chronic or episodic problems with bowel movements can cause microflora disturbances, colitis and other digestive problems. The medicine can be used up to 3 times a year to cleanse the body in order to remove accumulated toxic compounds and toxins.

The procedure improves liver function, helps cleanse the skin, and has a positive effect on digestion.

General admission rules

The medicine is intended for oral administration. Before use, the powder is diluted in water - one liter of clean water is needed for each packet of powder. The dosage is calculated based on weight - for every 15-20 kilograms, 1 packet of Fortrans is required. Thus, an average weight adult (70 kg) may need 3-4 sachets to cleanse the intestines. Rules of use:

• The entire required volume of Fortrans should be dissolved in the required volume of water. That is, for 4 bags you will need to take 4 liters of boiled water.
• The drug should be taken 2 hours after dinner. It is also recommended to review the timing of taking the medications used; their evening dose should also be taken no later than 2 hours before cleansing.

• The entire prepared solution should be drunk during the evening. The rate of its intake is 1 liter over one hour.
• Fortrans is drunk in small sips in a glass. The break between drinking a glass of laxative solution should be 10-15 minutes.

The total dose of the medicine can be divided into 2 times, half taken in the evening and the other in the morning. But this option of using a laxative is allowed only if the study or surgical intervention is scheduled for the daytime or evening hours.

Fortrans begins to act in most cases within an hour and a half and the laxative effect after taking the last portion lasts up to 3, less often 4-5 hours.

Due to the rapid and long-lasting laxative effect, it is better to start using this medication no later than 18:00 in the evening. In this case, complete cleansing of the intestines can be achieved before 11-12 am.

General rules for using Fortrans

The drug can be taken orally by adults and children over 15 years of age. Fortrans should be taken no earlier than two hours after meals.

The dosage of Fortrans is calculated individually depending on body weight, and is rounded up to the whole sachet. The dose is calculated based on the ratio of 1 sachet per 15–20 kg of weight.

For example, a person weighs 70 kg, which means that he will need 70 kg / 15 kg = 4.67 sachets or 70 kg / 20 kg = 3.5 sachets to perform intestinal lavage. In both cases, the result is a fractional number that must be rounded up to a whole number. That is, 4.67 is rounded up and you get 5 bags. And 3.5 is rounded up to whole numbers and you get 4 bags. This means that for a person weighing 70 kg, 4–5 sachets of Fortrans are needed to carry out the lavage procedure.

How many specific sachets should be used for the procedure is determined by the doctor who prescribed Fortrans. However, at present, most often the calculation is based on the ratio of 1 sachet for every 20 kg of body weight. Practitioners have found that the ratio of 1 sachet per 20 kg of weight is subjectively better tolerated, but provides the same effect as 1 sachet per 15 kg of weight. Therefore, the patient is offered the lowest effective dosage.

Having calculated the required number of bags, it is necessary to prepare clean, boiled water in sufficient quantity. For 1 sachet of Fortrans powder you will need 1 liter of water. All powder should be dissolved in the required amount of water, for example, 2 sachets in two liters of water, 3 sachets in 3 liters, etc. To avoid confusion, it is recommended to dissolve each packet of powder in a separate jar or any other container.

The entire prepared solution should be taken at one time. However, this does not mean that you need to drink all 3 - 4 liters of solution in one go. It is recommended to pour the solution into a glass and drink it in small sips. Drink the next glass in 5 – 10 minutes, etc. Thus, taking breaks between glasses of the solution for 10 - 20 minutes, you need to drink the entire prepared volume of Fortrans. On average, this can take from 2 to 4 hours. The intake rate of Fortrans should be approximately 1 liter per hour.

If it is not possible to drink the entire solution at one time, then you can divide it into two equal portions, one taken in the evening and the second in the morning. For example, drink 2 liters in the evening, and another 2 liters in the morning of the next day.

Since the solution can cause a gag reflex due to a subjectively unpleasant taste, it is recommended to drink it in quick small sips without holding it in the mouth. And immediately after the last sip from the next glass, it is recommended to put a piece of lemon in your mouth or take a sip of lemon juice, which will immediately relieve the gag reflex and eliminate nausea.

Since after the last dose of Fortrans, defecation may continue for another 2 to 3 hours, it is recommended to calculate the time of use of the drug. It is best to take Fortrans in the evening, on the eve of the upcoming examination in the morning. If the study will be carried out in the afternoon or evening, then you can drink Fortrans in the morning, but the last glass should be taken 3 - 4 hours before the procedure.

Stool begins to be released approximately 1.5 - 2 hours after the first glass of Fortrans. At this point, the entire volume of the solution may not have been drunk yet. In this case, you should continue to drink the Fortrans solution in glasses until the entire prepared volume has been taken. Doctors usually recommend taking another glass of Fortrans after each bowel movement.

An overdose of Fortrans is impossible, since the drug is not absorbed into the bloodstream and is excreted unchanged. When Fortrans is taken simultaneously with other medicinal substances, their effect is significantly weakened.

Fortrans – preparation for colonoscopy or irrigoscopy

Proctologists, radiologists and endoscopists believe that it is better to cleanse the intestines with Fortrans not on the eve of the upcoming procedure, but directly on the day on which it is planned. However, to do this you will have to get up early in the morning, at about 5:00, if the procedure is scheduled for 10:00. So, the evening before irrigoscopy and colonoscopy, you should prepare the required amount of water, bags of Fortrans powder and lemons. In the morning, you need to dilute the powder in water and drink the solution within 2 - 3 hours - from approximately 5-00 to 8-00 am. It is recommended to drink one glass of the solution every 5 to 15 minutes.

The first portion of stool will be released 1 - 2 hours after starting to take Fortrans, and will end 2 - 3 hours after taking the last glass of the laxative drug. 4 hours after taking the last glass of Fortrans, you can perform irrigoscopy or colonoscopy.

However, if the irrigoscopy or colonoscopy procedure is scheduled for earlier hours, for example, at 7-00, 8-00 or 9-00 in the morning, then it is recommended to cleanse the intestines with Fortrans the night before. In this case, it is optimal to start taking Fortrans at 17:00 or 18:00 in the evening and finish by 20:00 or 21:00.

How long does it take for Fortrans to work?

The first portion of stool is released 1 to 2 hours after taking the first glass of Fortrans solution. That is, we can say that the drug begins to act 1 – 2 hours after administration.

Duration of action of Fortrans

After taking the last glass of Fortrans solution, stool excretion may continue for 2 to 4 hours, depending on the individual characteristics of the human body. This means that in total Fortrans lasts approximately 6 – 8 hours, depending on the amount of solution drunk.

special instructions

Fortrans is considered one of the most powerful laxatives. To ensure that the drug does not have a negative effect and does not worsen your well-being, it must be taken correctly:

• It is imperative to accurately calculate the dosage of the medicine. To do this you need to know your weight.
• After starting to take a laxative, you should not eat. But you can and should drink - filtered water, tea, compote.
• Dissolved Fortrans has a not very pleasant taste, which causes nausea and vomiting in many people. To reduce their severity, you should drink the medicine in small sips, and after taking it, dissolve a slice of lemon or orange in your mouth, wash down the medicine with plain or acidified water.

• The day after cleansing, it is advisable to follow a rice diet. Eating rice has a strengthening effect and thus prevents the development of diarrhea.

Some doctors recommend taking probiotics for 7-10 days after taking the medication. Their use will eliminate the risk of developing dysbiosis and improve the restoration of normal intestinal function. Medicines from this group are especially necessary for people with chronic diseases of the digestive system.

After starting to use Fortrans, it is not advisable to go outside, since defecation can happen at the most inopportune moment.

Preparation for intestinal irrigoscopy with Fortrans begins 2-3 days before the procedure and involves following a special laxative diet.

The patient is asked to exclude heavy foods from the diet, that is, brown bread, potatoes, legumes, meat and fatty foods.

They need to be replaced with vegetable and lactic acid foods, light vegetable soups, and water porridge. On the day of taking Fortrans, the last meal should be no later than 3 o’clock in the afternoon, then from 17-18 o’clock in the evening you can start drinking the dissolved powder.

Two-stage preparation scheme

We invite you to familiarize yourself with the two-step preparation scheme for colonoscopy using the drug Fortrans. Preparation is preferable as it provides better quality of preparation and is easier to tolerate by the patient.

It is recommended when conducting the study at lunchtime after 11:00.

1. 3 days before the test, follow a slag-free diet.
2. 1 day before the test, before 15:00, take only liquids and do not eat solid food.

Stage 1 of taking Fortrans (1 day before the study):

• 18:00-19:00 - take 1 liter of Fortrans (1 glass every 15 minutes).
• 19:00-20:00 - take another 1 liter of the drug (1 glass every 15 minutes).

Stage 2 of taking Fortrans (on the day of the study):

If the examination is carried out without anesthesia (sedation), you can drink tea with honey or still water. If the test is carried out using painkillers, you must be on an empty stomach.

• 5:30-6:30 - take 1 liter of Fortrans (1 glass every 15 minutes).
• 6:30-7:30 - take 1 liter of Fortrans (1 glass every 15 minutes).

Fortrans for weight loss

Laxatives are often used as weight loss aids. Fortrans really promotes weight loss; just taking a single dose, calculated based on body weight, helps to remove an extra 2-3 kilograms. However, such weight loss is due only to the release of accumulated feces and excess fluid from the body. Thus, Fortrans does not affect the reduction of fat in problem areas.

Long-term, that is, daily use of the drug is extremely dangerous. This method of losing weight leads to the fact that the body begins to experience a deficiency of vitamins and microelements, which has an extremely adverse effect on the functioning of internal organs, leads to weakness, apathy, and provokes hair loss, dry skin and other health problems.

However, Fortrans can be used in preparation for weight loss. The medicine is used as a means to cleanse the intestines, which greatly improves metabolic processes and makes it easier to follow a diet for weight loss. The peculiarities of taking a laxative in this case are no different from the recommendations that must be followed when using it before diagnostic procedures and operations.

How to take Fortrans before a colonoscopy

Fortrans is one of the most famous laxatives in Russia, with which you can qualitatively prepare the intestines for colonoscopy. This is a French drug, patients turn to it if the colonoscopy procedure is scheduled in the morning or evening. Colonoscopy is an examination of the lining of the large intestine, so it is very important that the intestinal wall is clean. In this article we will focus on the most popular remedy, which is used both in hospitals and at home, we will tell you how to take Fortrans correctly before a colonoscopy, and whether there is a difference in preparing for the study depending on when the procedure is scheduled - in the morning or in the evening.

Preparing for a colonoscopy examination using Fortrans

Fortrans can be easily purchased at a pharmacy. The medicine is sold in packages in powder form (1 package contains 4 powders). It has a peculiar fruity taste. The drug is not absorbed when consumed, since it is based on Macrogol. It acts only in the intestine, stimulating the contraction of its walls, and is easily excreted from the body, promoting the rapid evacuation of intestinal contents.

Before starting to take Fortrans, it is advisable to sit on a slag-free diet for 2-3 days, which involves excluding foods that cause flatulence (legumes, greens, vegetables, fruits, fatty and fried foods). We talk in detail about the slag-free diet in a separate article.

How to calculate and how to drink Fortrans before a colonoscopy

The medicine packet is diluted in 1 liter of warm boiled water and mixed thoroughly. The calculation is made as follows. For 15-20 kg of body weight, take 1 liter of water. Or you can use the diagram:

• up to 50 kg – take 2 sachets (2 liters of water),
• from 50 to 80 kg – 3 sachets (3 liters of water),
• more than 80 kg - 4 sachets (if weight is more than 100 kg, consult your doctor).

The approximate volume of liquid that a person of average weight should drink is 3-4 liters. The entire prepared solution must be drunk within 12-14 hours. The last portion should be drunk 5-6 hours before the test.

How to take Fortrans correctly before a colonoscopy?

The medicine can be taken on the day of the examination. By this day, the patient will have already prepared the intestines for taking Fortrans with the help of a slag-free diet. In the evening of the previous day, it is advisable not to eat after dinner, but you can drink as much as you like (but not alcohol or sparkling water). On the day of manipulation, you should also not eat; you can only drink water or weak tea. The entire volume of liquid with the dissolved medicine should be drunk between 5 and 10 am. Every 15-20 minutes you need to drink 200-250 ml of solution. Defecation begins 60-90 minutes after the first drink and ends 2-3 hours after taking the last glass. Therefore, examination is possible only 4 hours after taking the last portion. You can't eat anything on this day. Fluid intake is not limited. Remember that you must stay at home while taking a laxative. You should not plan any activities on this day.

Preparation for colonoscopy with Fortrans, if the procedure is in the morning.

If a colonoscopy is scheduled in the morning, it is better to prepare in 2 stages. Pre-calculate the amount of liquid and leave 1 packet (1 liter) for the morning. The day before at 16-17 o'clock the first glass is drunk, the last glass at 20 o'clock. Remember that bowel movements end 2 hours after the last medication. In the morning on the day of the study, you need to drink another liter. You must calculate what time to drink yourself, understanding that after taking the medicine you need to stay at home for 2 hours (you will be bothered by the urge to defecate). The examination should be no earlier than 4 hours after the last dose of Fortrans.

Advantages of Fortrans

1. The medicine does not affect the mucous membrane.
2. An electrolyte solution helps maintain water-salt balance in the body.
3. More pleasant taste compared to, for example, Lavacol.
4. There is no need to resort to enemas.
5. There is no need to ask for outside help, as is the case with administering an enema.

Disadvantages of Fortrans.

1. It has a specific fruity taste that not everyone can tolerate.
2. There may be nausea and vomiting.
3. You need to drink a large volume of liquid, and not all patients are able to drink a lot of solution.
4. Fortrans is prescribed to patients over 15 years of age

Recently, in preparation for colonoscopy, the new generation laxative drug “Flit” has become more often used. It has practically no disadvantages and a lot of advantages compared to Fortrans.

If the preparation with Fortrans was carried out correctly, then the last bowel movement will be “clean” water, that is, there will be no feces in the intestines. This means that the endoscopist will be able to examine the colon mucosa carefully and make an accurate diagnosis.

Contraindications and side effects

Undesirable changes in well-being due to the use of Fortrans in the form of nausea and a tendency to vomit occur in almost everyone and are due to the specific taste of the solution. As a rule, they are usually pronounced in the first hour of taking the medicine, then decrease significantly. Other possible adverse reactions to Fortrans include:

• allergic reactions in the form of rashes on the body, swelling, urticaria;
• increased gas formation;
• heaviness in the stomach;
• weakness.

In rare cases, symptoms of anaphylactic shock are recorded. In the first two days after taking it, loose stools may bother you; a rice diet helps speed up the restoration of intestinal functions.

Absolute contraindications to taking Fortrans:

• severe dehydration;
• malignant tumors of the rectum;
• intestinal obstruction;
• erosive and ulcerative pathologies of the gastrointestinal tract;
• perforation of the stomach and intestines;
• hypersensitivity to polyethylene glycol;

• age up to 15 years;
• severe heart and kidney diseases.
• abdominal pain of unknown etiology.

The use of Fortrans during pregnancy is not recommended, as increased intestinal motility can increase the tone of the uterus. It is not advisable to use the drug while breastfeeding - dehydration can lead to disruption of breast milk production.