Don't forget to purchase MiraLAX and Bisacodyl tablets at your pharmacy.
It is very important for you to carefully follow these instructions. A complete colonoscopy cannot be performed on an unclean colon!
Ahead of time
- Purchase MiraLAX (238 gram bottle) and bisacodyl tablets. You will need four 5mg bisacodyl tablets. Ask the pharmacist if you have trouble finding MiraLAX or the Bisacodyl tablets. Generics are okay.
- Purchase 64 oz of Gatorade/Powerade or a similar sports-hydration drink. You will be mixing the MiraLAX powder in 64 oz of clear liquid such as Gatorade. We prefer the use of a “sports drink” such as Gatorade due to its electrolyte content.
- Purchase one 10 oz bottle of Magnesium Citrate. (Equate brand at Walmart is 98¢).
5 days prior to your exam
- Ideally, anti-clotting medications are stopped 5 to 7 days prior to your colonoscopy to reduce the risk of bleeding during or after your procedure. If you take anti-clotting medications such as Coumadin, Plavix, PRADAXA, Effient, Brilinta, or Xarelto, then please discuss these medications with the prescribing physician (e.g. cardiologist, neurologist, or primary care provider). You are on these medications for an important clinical reason (e.g. heart disease, cardiac stent, atrial fibrillation, stroke, mechanical heart valve, history of blood clots). Please let us know if you are not allowed to stop these medications or if you are advised to use Lovenox or Heparin prior to your colonoscopy.
- If you have diabetes, your primary care provider will advise you how to manage your medications prior to the colonoscopy (e.g. insulin).
3 days prior to your exam
- Avoid nuts, seeds, whole wheat bread, beans, corn, raw vegetables or fruits with seeds or skin, as they may adversely influence the quality of your exam.
2 days prior to your exam
- Drink only “Clear Liquids” for Breakfast, Lunch and Dinner. This means liquids you can see through such as apple juice, water, Sprite, Jell-O, coffee (no creamer), tea, clear chicken or beef broth, clear Gatorade/Powerade, or Crystal Light. No milk or pulp products: Avoid anything with red dye.
- At 7:00 pm drink the 10 oz. bottle of Magnesium Citrate. You may continue to drink clear liquids.
1 day prior to your exam
- Restrict your diet to clear liquids. No solid food until after the procedure. Stay hydrated!
- At 12:00 pm (noon) take four 5 mg Bisacodyl tablets.
- At 5:00 pm mix the 238 gram bottle of MiraLAX with 64 oz clear liquid. Shake the solution until the MiraLAX has dissolved. Then drink an 8 oz glass of the solution every 10-15 minutes until ¾ of the solution is gone. If you become nauseated, you may need to slow the pace at which your drink. Put the remaining MiraLAX solution in the refrigerator. You may continue to drink clear liquids or water to stay hydrated.
The day of your exam
- Remember not to have any food until after your procedure!
- At least 5 hours before your procedure start time, finish drinking the MiraLAX solution. Be sure to finish all of it. This may require you to get up in the middle of the night, if you have an early morning exam.
- You may have only clear liquids up until 4 hours prior to your procedure start time. We must insist on this “nothing by mouth” time for patient safety. Do not have anything by mouth after this point, as your stomach must be completely empty at the time of the procedure.
- If you have diabetes, test your blood sugar before coming in for your exam and bring the reading with you. If you take oral medications for your diabetes, don’t take them the morning of your procedure unless otherwise instructed by your doctor. If you take insulin, take only ½ of your usual morning dose and bring the insulin with you to the procedure.
- You may take your usual medications (e.g. for blood pressure). Any medications taken the day of your procedure may be taken with a small sip of water, at least 4 hours prior to your procedure time.
- You may apply zinc oxide or petroleum jelly to anal area to prevent irritation from the prep. Baby wipes or adult diapers may be considered.
- You must have someone available to drive you home after your colonoscopy. If you are planning to take a taxi home, then a friend or family member must accompany you. Plan on spending 2-3 hours at the facility.
- You may receive up to 4 separate bills: 1-facility, 2-physician, 3-pathology, 4-anesthesia.
- Wear comfortable clothing. Bring your glasses, hearing aids, insurance cards and completed information forms, if applicable. Avoid bringing valuables. We will expect payment of co-pays, co-insurance and deductibles at the time of service.
- If you must cancel or reschedule your procedure, then you must give notice 2 full business days in advance. Failure to do so will result in a $100 cancellation fee.