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Colonoscopy with Miralax


 

Colonoscopy 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.
  • Stop taking Advil, Aleve, ibuprofen, Motrin, Bufferin, Excedrin etc. Only Tylenol is suggested for pain management. Also, stop taking Iron supplements and Pepto-Bismol at this time. You may continue to take aspirin if you are required to for cardiac reasons, but please inform your doctor and our staff in advance of your procedure.
  • You may continue to take aspirin if you are required to for cardiac reasons, but please inform your doctor and our staff in advance of your procedure.
  • If you take clopidogrel (Plavix), warfarin (Coumadin), Dabigatrin (Pradaxa), Rivaroxaban (Xarelto) Apixaban (Eliquis) or any other blood thinner, please inform your doctor immediately.
  • If you are a diabetic taking insulin, please discuss with your primary care physician or endocrinologist regarding dosing prior to your procedure.

 

Three days before the procedure

  • You will need to purchase a 238 gram bottle of Miralax (available without a prescription) and 4 Dulcolax tablets. Please purchase at least 3 days prior to your procedure.
  • Avoid eating nuts, seeds, popcorn, grapes, green peas, beans and tomatoes. Fibers from these foods can clog the colonoscope.

 

Five days before the procedure

    • We advise that you begin a diet of easily digestible foods such as: white rice, white bread, pasta, fish, chicken, pork, eggs, potatoes, well-cooked vegetables, fruits without the skin, yogurt and cheese.
    • Avoid eating high fiber/high roughage foods, whole wheat bread products, red meat, foods with seeds (tomatoes, strawberries, grapes, and oranges), yogurt with fruit mixed in, nuts, olives, beans and corn (foods with a skin). Fibers from these foods can clog the colonoscope.

 

On the day before the examination

You may have a light breakfast before 9am (oatmeal, toast with jam, eggs, protein shake, yogurt, instant breakfast but no seeds/nuts or large portions). After this meal, you will start a clear liquid diet. Keeping well-hydrated before you begin taking the prep will improve the preparation of your procedure.

On the day of the examination

      • You may consume clear liquids up to 4 hours before your procedure.
      • Please avoid liquids that are heavily colored, such as red cranberry juice, cherry Gatorade, grape soda etc. as these dyes will affect the color of the stool. Avoid juices with pulp.
      • 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
      • White cranberry juice
      • Coffee and tea (without milk or creamer)
      • Clear broth or bouillon
      • Sports drink: Gatorade or PowerAde
      • Soda: Sprite, 7-Up, Gingerale
      • Clear juices: such as apple juice, lemonade
      • Plain Jell-O
      • Frozen juice bar

 

Colonoscopy Frequently 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 12 PM:/span>

Afternoon/Early Evening Before Your Procedure: (4-6 PM 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 on or after 12 PM:

Afternoon/Early Evening Before Your 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

Click here to download prep instructions