MiraLAX Preparation for Colonoscopy

MIRALAX PREPARATION FOR COLONOSCOPY

To achieve an accurate evaluation of your lower gastrointestinal (GI) tract, it is important that you properly prepare for the procedure.

Doctors obtain the clearest view of the bowel when it is flushed completely free of waste material. The thoroughness of this intestinal cleaning depends on you! Without your cooperation, the examination cannot accomplish its purpose and may have to be repeated.

If you are taking anticoagulants or blood thinners such as (but not limited to) those listed below, please discuss this with your Health Care Provider. In most circumstances, these medications are temporarily discontinued prior to your procedure.

• Coumadin (warfarin)
• Plavix (clopidogrel)
• Persantine (dipyridamole)
• Aggrenox (aspirin-dipyridamole)
• Effient (prasugrel)
• Pradaxa (dabigatran etexilate)
• Xarelto (rivaroxaban)
• Eliquis (apixaban)

If you have questions, or you need to reschedule or cancel your procedure, please call 717-761-0930.

SUPPLIES

• Two (2) 5mg Dulcolax (bisacodyl) laxative tablets. Purchase these over the counter.
• Two (2) 28-ounce bottles of Gatorade. Do not drink Gatorade that is red, pink, purple or dark blue in color. A few common examples include:
  • Cherry
  • Wild berry
  • Fruit punch
  • Grape
• One (1) 238-gram bottle of Miralax (GlycoLax) powder. You may purchase this over the counter at a grocery or drug store.

7 DAYS BEFORE PROCEDURE

Do not take the following supplements:

• Gingko Biloba
• Garlic
• Fish Oil
• Dong Quai

5 DAYS BEFORE PROCEDURE

Do not consume any foods that contain corn, seeds, or nuts. These foods take longer to pass through the bowel.

Do not take any ibuprofen products (nonsteroidal anti-inflammatories – NSAIDS). Tylenol (acetaminophen) is allowed.

Do not take oral iron supplements.

Follow a low fiber diet. Examples of low fiber foods include:

• Breads made with refined flour (white-bread)
• Cereals that are low in fiber
• White pasta
• White rice
• Low fiber fruits (cantaloupes, honey dew melons, watermelons, nectarines, papayas, peaches, plums, bananas, canned fruits)
• Vegetable juice without pulp
• Low fiber vegetables (carrots, beets, asparagus tips, string beans, lettuce, cucumbers without seeds or skin, zucchini, canned vegetables)
• Potatoes without skin
• Fish
• Shellfish
• Poultry
• Egg
• Tofu
• Ham
• Creamy peanut butter
• Milk
• Yogurt
• Soft, mild cheese
• Olive oil

2 DAYS BEFORE PROCEDURE

At 7:00 p.m., take the two (2) Dulcolax laxative tablets with at least eight (8) ounces of clear liquids.

DAY BEFORE PROCEDURE

Follow a clear liquid diet the entire day before your procedure. A clear liquid is one that can be seen through. Some examples include:

• Clear juices without pulp
• Clear soda
• Chicken or beef broth
• Popsicles
• Jell-O
• Italian ice
• Tea
• Coffee (without milk products)
• Clear hard candy

Products to avoid completely include:

• Dark colored liquids (red, blue, purple)
• Milk products
• Alcohol
• Vegetables
• Breads or grains
• Meats
• Fats or oils

If you are diabetic, drink regular (non-diet) liquids in MODERATION throughout the day. If you are an insulin dependent diabetic; only take HALF of your EVENING dose of insulin.

It is important to prevent dehydration before, during, and after your bowel preparation. The more clear liquids you drink throughout the day, the better you will feel and the more effective your bowel prep will be.

Mix HALF the bottle of Miralax powder into each of the two (2) Gatorade bottles. It is recommended to mix the Gatorade and powder in a separate container because the powder will take up space in the bottles. Shake bottles until the Miralax is dissolved. Refrigerate.

At 5:00 p.m., begin drinking one of the two bottles of Gatorade. Drink an 8-ounce glass every 10 to 15 minutes. It is best to drink the whole glass rapidly, rather than sipping small amounts continuously. Drink the entire solution.

It is normal to feel very full or bloated during your prep. If you experience nausea and vomiting, wait about 30 minutes before resuming. This will likely disappear once bowel movements begin. If the vomiting resumes, please call our office at 717-761-0930.

SECOND DOSE OF PREPARATION

Seven (7) hours before the procedure, begin drinking the second bottle of the Miralax-Gatorade mixture. Drink an 8-ounce glass every 10 to 15 minutes. Drink the entire solution over 2 hours.

If you are scheduled for an early morning procedure, you will need to set your alarm to assure the preparation is taken at the correct time. We are aware of the inconvenience, but the two-stage prep provides a superior cleansing of the colon. You must finish with the prep within four (4) hours of your procedure time.

If your bowel movements are not clear or pale yellow after drinking the entire solution, please call our office at 717-761-0930.

DAY OF THE PROCEDURE

Do not have anything to eat.

At 6:00 a.m., take any prescribed heart and blood pressure medications that you would normally take in the morning (except for blood thinners, as listed above). Take them with just enough water to get it down.

If you are diabetic, do NOT take your diabetic medications (pills or insulin) the morning of your procedure. If you normally monitor your blood sugars at home, check your blood sugar the morning of your procedure. If your blood sugar is over 200 or below 90, please contact the West Shore Endoscopy Center at 717-975-2430. An anesthesia specialist will provide you with further instructions.

Stop drinking clear liquids four (4) hours prior to the procedure.

No chewing gum, hard candy or chewing tobacco at least four (4) hours prior to the procedure.

Please report to your appointment at the scheduled time. Except to be at the procedure center for about 2 – 2.5 hours.

AFTER YOUR PROCEDURE

A driver must come with you to drive you home after the procedure. You will be sedated for your colonoscopy. You may not work or drive for twelve (12) hours after the procedure. You will be provided with discharge instructions, and it is important that you follow them carefully.

For afternoon procedures, drivers must be present no later than 4:00 p.m. to pick you up.