Colonoscopy

MIRALAX PREP

YOU ARE RESPONSIBLE FOR READING ALL THE INSTRUCTIONS CAREFULLY!

**PLEASE BRING A RESPONSIBLE ADULT TO TAKE YOU HOME.  YOU CANNOT DRIVE OR WALK HOME AND WILL NOT BE RELEASED TO A TAXI OR PUBLIC TRANSPORTATION SYSTEM.

Please make every effort to keep your appointment.  You may cancel or reschedule if absolutely necessary, however, we ask that you give a ONE WEEK notice.  This allows us to offer the appointment to another patient and due to the nature of the preparation of the procedure; it can be challenging to fill appointments on short notice. Unless there is a clear emergency or illness, there will be a $100 cancellation fee for appointments cancelled with a notice less than 3 business days (less than 72 hours).  Failure to follow prep instructions will not be a valid plea.

CHECK WITH YOUR INSURANCE carrier to be familiar with your financial responsibility for this procedure.  You will need to contact your insurance carrier in order to be aware of your benefits for a “screening as well as a diagnostic colonoscopy in case a polyp is found.  The procedure will be performed in the Primary Care Physician’s Office.”  If you are having problems or have had a prior polyp (adenoma), it will be considered a DIAGNOSTIC colonoscopy.  There is a customer service number located on the back of your insurance card.  Please contact your insurance carrier IMMEDIATELY in case questions arise or the procedure is not covered.

PRE‐PROCEDURE INSTRUCTIONS:
‐ Stop all aspirin, aspirin products (such as Advil, Naproxen, Ibuprofen, Aleve…etc) and blood thinners ONE WEEK prior to the procedure.
‐ Do not eat whole grain breads, corn, raw vegetables or fresh fruit THREE DAYS prior to the
procedure.

PURCHASE THESE ITEMS AHEAD OF TIME:
‐ FOUR Dulcolax tablets.  (No prescription necessary)
‐ One 238G bottle of Miralax or generic equivalent.  (No prescription necessary)
‐ Tucks pads or Vaseline.  These are used to protect the anal area especially if you have
hemorrhoids.
‐  64oz or 1920mL bottle of Gatorade or Powerade electrolyte replacement drink. (DO NOT
purchase red, blue or purple colored drinks.

ONE DAY BEFORE THE EXAM

BREAKFAST:

‐ CLEAR LIQUID BREAKFAST:  You may have as many clear liquids as you want, such as water, tea, coffee (no cream or milk), clear soda, ginger ale, apple or white grape juice, clear soup broth, gelatin or sports drinks.  Although not clear, you may have Ensure or Slim‐Fast Lactose Free.
‐  Desserts may include Italian Ice, popsicles and hard candy.
***NO RED, BLUE OR PURPLE DRINKS OR DESSERTS***
‐ Mix the bottle of Miralax in 64oz of Gatorade or similar product you previously purchased.  NO RED, BLUE OR PURPLE colors.  Shake the solution until Miralax is dissolved.  Place in refrigerator to chill for better flavor.
‐ Diabetics: You may use a sugar free electrolyte product equivalent to mix the Miralax.

LUNCH:

‐ CLEAR LIQUID LUNCH.  (Same as breakfast)

THROUGHOUT THE DAY:

‐ It is VITAL you are hydrated.  Make sure to drink AT LEAST EIGHT glasses (2 quarts, 64oz or 2 liters) of fluids such as Gatorade or a similar product, preferably not plain water. ***The MINIMAL total fluid intake required is 2 quarts PLUS the 64oz of Miralax mixture***

3pm‐6pm:

‐ Take FOUR Dulcolax tablets by mouth that you previously purchased.  It will take
approximately 2‐3 hours for the affects of the medication to take place.
‐ If you are a frequent laxative user (natural or otherwise), please start with DOUBLE your
USUAL effective Dulcolax dose.

5pm‐8pm:

‐ TWO HOURS after taking the Dulcolax, start drinking the chilled Miralax cocktail.  Drink 8
ounces every 10‐15 minutes until the entire solution is gone.
‐ Feelings of bloating, chills and/or nausea are common after the first few glasses, due to the
large volume of fluid ingested.  This is temporary and will improve once bowel movements
begin.  Most patients have a bowel movement within an hour or two of starting the laxative.
There can sometimes be a delay up to four hours.  Be patient, but remember to stay close to a
bathroom.
‐ Tucks/baby wipes and petroleum jelly may help with irritation after numerous bowel
movements.

DAY OF THE EXAM:

MORNING:

‐ You may take your medications with sips of water but otherwise NOTHING BY MOUTH AFTER
4am for the 8am procedure and 7am for the 11am procedure.
‐ *Diabetics: Do not take your pills until after the colonoscopy.  If you are on insulin, take ½ the
usual NPH and no regular insulin.  Take the remaining doses after the colonoscopy.

Frequently Asked Questions

1. I have constipation. Should I add anything to the preparation?
You may use a mild laxative, such as Milk of Magnesia, on the day BEFORE your procedure. It is best to take the laxative at 12:00pm. Please follow the instructions on the bottle.

2. I am taking the prep and having loose, watery stools. Do I still have to take the rest of the prep?
Yes, you may have solid stool higher in the colon that needs to be eliminated.

3. I see a yellow color in the toilet bowl and a few flecks. What do I do?
If you drank the entire solution or if your last bowel movements were clear enough that you were able to see the bottom of the toilet, you should be fine. It is okay if you have some flecks of material. The yellow color is a result of bile that normally colors the feces. This should not interfere with the examination.

4. My bottom is sore. What can I do?
To clean the area, avoid rubbing! Gently pat with a wet washcloth or toilet grade wet wipes. Apply Vaseline, tucks pads or Desitin liberally.

5. Can I drink alcoholic beverages?
We strongly suggest you do not drink any alcoholic beverages prior to your procedure since they can cause dehydration and some wines may thin your blood.

6. Can I drink any nutritional supplements?
You may drink Ensure (Chocolate or Vanilla) or Slim-fast with Soy Protein/Lactose free. These drinks are water based, not milk based.

7. Can I chew gum or suck candy?
Yes, but nothing with soft centers or red color.

8. Can I have a colonoscopy if I am on my menstrual period?
Yes, the procedure can still be performed. We ask that you use a tampon if possible but not absolutely necessary.

9. How long will the procedure take?
The colonoscopy itself takes about 30 minutes or longer if polyps are found and removed. In all you will be here for about 2-2 ½ hours.

10. When can I eat afterwards?
You can eat as soon as you leave. It is best to start off with liquids (not coffee) and progress to bland, light foods. Your gastric system has had a rough two days. Be kind to it. Soup, sandwiches, breads, and starches are fine. Heavy foods such as red meat, fried food or rich sauces can cause abdominal cramping, nausea and even
vomiting.

11. How will I learn the results of my test?
The doctor will discuss the preliminary results of your test with you on the day of the exam. If a biopsy was performed, we will notify you with the results as soon as they have been reviewed by the physician. This generally takes about a week and the nurse will call you with the results.