Colonoscopy with Miralax

Preparation:

There are many things a person would rather do than undergo a bowel prep for a colonoscopy, but your efforts at cleansing your colon are essential for an accurate procedure. These instructions are designed to maximize the ease, safety and success of your preparation. Please read these instructions carefully at least one week prior to your exam. Obtain the recommended prep.

Medication and Diet Instructions:

Most of the time, we recommend continuing aspirin (and aspirin-containing products). However, please discuss whether or not you should continue or stop this medication prior to your procedure with your gastroenterologist.
If you are taking Plavix (clopidogrel), Coumadin (warfarin) or any other blood thinners, discuss with your gastroenterologist prior to your procedure if you need to stop this medication.
If you are a diabetic taking insulin, please discuss with your primary care physician or endocrinologist regarding dosing prior to your procedure.

One week before the procedure:

    • If you are taking iron supplementation (ferrous sulfate), please discuss with your doctor if you should stop this one week before the procedure.

Three days before the procedure:

    • Stop taking anti-inflammatory medicines such as Aleve, Motrin, Advil, Ibuprofen and Naproxyn.
    • Avoid eating nuts, seeds, popcorn, grapes, green peas, beans and tomatoes. Fibers from these foods can clog the colonoscope.

On the day before the examination:

You may have a regular breakfast. After breakfast, you will need to go on a clear liquid diet. You can drink clear liquids up to 2 hours prior to the appointment. Avoid juices with pulp such as orange or grapefruit juice. No dairy products, cream or soy. Avoid red or purple colored liquids. You may use sugar or lemon. It is important that you drink as much fluid as you can throughout the day. It is also worthwhile to get a supply of aloe wet wipes and Desitin ointment to ward off a sore bottom.

On the day of the examination:

  • Do not drink anything 2 hours before the procedure.
  • You must be accompanied by a friend or relative to drive or assist you home. You will not be allowed to drive for 12 hours after the procedure.
  • You should take your regular medications with sips of water unless you are instructed otherwise.

Special Instructions:

Be sure to remember any allergies to medications and to Latex, or conditions that would make you sensitive to sedation such as sleep apnea syndrome.

Acceptable clear liquids for hydrating include:

  • Water
  • Black coffee or tea
  • Clear broth or bouillon
  • Sports drink: Gatorade or PowerAde
  • Soda: Sprite, 7-Up, Gingerale
  • Clear juices: such as apple or white grape juice, lemonade
  • Plain Jell-O
  • Frozen juice bar

Commonly Asked Questions:

How do I know if my colonoscopy prep is successful?

The stool should be watery in consistency. It does not have to be clear in color like water since digestive juices will continue to tint the stool yellow and small flecks of debris are not a problem as long as the stool is not muddy or thick. If there is any question, you can self administer a fleet enema prior to leaving home for the procedure.

What side effects may I expect?

Since the prep works by flooding the intestinal tract with fluid, abdominal bloating and cramping may occur, as well as some nausea and vomiting. This is usually temporary, and as the diarrhea develops, symptoms will gradually improve. Weakness can also occur, especially if you have not taken enough fluid with the prep, and can be remedied by increasing fluid intake (especially with the sports drinks such as Gatorade or Powerade).

Will the prep interfere with my other medications?

Medications taken at least an hour before beginning the prep should be adequately absorbed, but thereafter, they are likely to be washed away by the prep.

What if I have other questions?

Call our office to address any other concerns not answered here.

For this prep, you will need:

  • One 238 gram bottle of Miralax (available over the counter without a prescription)
  • Four Dulcolax tablets
  • 64 ounces of your favorite clear liquid (preferably Gatorade or Crystal Light,) – do not purchase a red colored liquid

Patients having their procedure before 11am

Afternoon Before the Procedure (5 PM)

  • Take two (2) Dulcolax tablets with 8 ounces of water. Swallow the tablets whole with a full glass of water.
  • Mix bottle of Miralax in 64 ounces of clear liquid. Shake the solution until the Miralax is dissolved and refrigerate it.

Evening before Procedure (8 PM)

  • Shake the solution again to make sure the Miralax is dissolved.
  • Drink 8 ounces of the solution every 10-15 minutes until you have finished about ¾ of the solution. You may drink as much clear liquids as you wish prior to going to sleep.

Evening before Procedure (10 PM)

  • Take two (2) additional Dulcolax tablets with 8 ounces of water. Swallow the tablets whole with a full glass of water.
  • Drink the remaining solution

Patients having their procedure after 11am

Afternoon Before the Procedure (8 PM)

  • Take two (2) Dulcolax tablets with 8 ounces of water. Swallow the tablets whole with a full glass of water.
  • Mix bottle of Miralax in 64 ounces of clear liquid. Shake the solution until the Miralax is dissolved and refrigerate it.

Evening before Procedure (10 PM)

  • Shake the solution again to make sure the Miralax is dissolved.
  • Drink 8 ounces of the solution every 10-15 minutes until you have finished about ¾ of the solution. You may drink as much clear liquids as you wish prior to going to sleep.

Morning of Procedure (6 AM)

  • Take two (2) additional Dulcolax tablets with 8 ounces of water. Swallow the tablets whole with a full glass of water.
  • Drink the remaining solution

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