Before Surgery

Bowel Preparation – Abdominal Surgery

What is abdominal surgery?

Abdominal surgical procedures are performed for conditions affecting the small bowel, colon, rectum, anus, abdominal cavity, and abdominal wall.  Such procedures are done for conditions such as cancer, inflammatory bowel disease, diverticulitis, complex colorectal fistulas to bladder or vagina, abdominal tumors, bowel obstruction, appendicitis and tumors of the appendix, rectal prolapse, constipation, and hernia.  Dr. Maher Abbas is a minimally invasive surgery expert and offers all these operations with laparoscopic surgery for the majority of his patients.  For a minority of patients with very complex conditions and prior abdominal operations, an open surgical approach is done.   For most minimally invasive surgical procedures, the usual average hospital stay is 3 to 5 days and for open surgery 5 to 10 days.

How do you prepare for the abdominal surgery?

All patients are encouraged to remain active and be physically fit prior to abdominal surgery.  From a dietary standpoint the majority of patients will remain on a regular diet until the evening prior to surgery when a full liquid dinner is advised.  Depending on your condition and the nature of your operation, Dr. Maher Abbas or his nurse will provide you with instructions for your bowel preparation.   If you have severe constipation (less than 2 bowel movements per week), kindly inform Dr. Maher Abbas.  Unless customized for your specific case, typically you will be asked to do 1 of the following 3 bowel preparations:

Preparation 1 – No bowel cleansing

Remain on a regular diet until the evening prior to the day of surgery.  For dinner, have a liquid diet (any type of liquids).   Then you can have clear liquids only (see list below) until 4 hours prior to your surgery beyond which you should be completely fasting.

Preparation 2 – Rectal enemas

Same as preparation 1.  In addition, in the evening of the day prior to your surgery, do 1 fleet enema [see section on How To Do An Enema].  In addition, on the day of your operation, perform 2 enemas 1 hour prior to leaving your home.

Preparation 3 – Bowel cleansing

The day prior to your operation follow the following steps:

Starting at 8:oo am (morning), begin a clear liquid diet for breakfast and lunch (see below diet). NO SOLID FOOD or thick liquid.

At 1:00 pm (afternoon), begin the Klean-Prep®.  Dissolve each sachet of the Klean-Prep® in 1 liter of water.  Administer at a rate of 250 ml (about a medium size mug) every 10-15 minutes until the total volume is consumed (4 liters, 1 liter per hour).  You can flavor with apple juice.    After the preparation is done you can drink water, apple juice, white grape juice, light tea, filtered coffee (Not Turkish coffee), and carbonated beverages until 4 hours prior your operation beyond which you need to be completely fasting.   If prescribed oral antibiotics pills, take Neomycin 500 mg 2 pills with Metronidazole 400 mg 1 pill at the completion of the preparation and repeat in 6 hours prior to going to bed.


The type of liquids you can see light through such as: water, clear fruit juices (apple, white cranberry, white grape), beef or chicken broth, ginger ale, carbonated beverages (Sprite, 7-UP, tea (no milk), filtered coffee (no Turkish coffee), Popsicles, and Jelly.

General Instructions For Surgery Day

For a complete list of what to do and expect, kindly check the section on Surgery Day.

Kindly arrive 2 hours prior to your scheduled time in order to prepare you for your operating room.   If you arrive late, you risk having your procedure delayed or cancelled as Dr. Maher Abbas runs a busy and tight schedule of patients.

Any questions?  Contact Dr.  Maher A. Abbas’ office nurse here.