Download Miralax/Gatorade - University of Utah Health

Endoscopy
Miralax-Gatorade Colonoscopy Preparation Instructions
Because you will be receiving sedating medications, you must have a responsible adult
(18 years or older) accompany you home. If you plan to take public transportation, you will
still need a responsible adult to accompany you. If you fail to arrange acceptable
transportation, your procedure will need to be rescheduled. If these instructions are not
followed, your procedure may need to be rescheduled due to inadequate preparation.
Purchase the following:
• One (1) 238 gram (8.3 oz.) bottle of Miralax powder (over the counter)
• One (1) small box/4 tablets of Dulcolax (bisacodyl) 5mg tablets (over the counter)
• One (1) 64 ounce bottle of sports drink (Gatorade or PowerAde) - NOT RED in color.
• One (1) 10 ounce bottle of magnesium citrate – optional. See day before your exam step 3. If you have
kidney failure, do not take Magnesium Citrate! Please call the endoscopy lab to speak with a
nurse for further instructions.
IMPORTANT:
 The goal of this preparation is to clean out your bowels (pass yellowish to clear liquid when you have a
bowel movement). The cleaner they are, the easier it is to find any problems in your colon.
 If you are frequently constipated or take prescription pain medication that may cause constipation,
please call us for a special set of instructions.
 If you take blood thinners (Coumadin, Plavix, Xeralto, etc.) or anti-platelet medications, contact your
prescribing physician 14 days before your appointment about stopping or taking an alternative
medication. You may need to be off of these medications beginning 7 days before your procedure.
Five (5) days before your exam:
• Stop taking any pills or medications containing IRON including multivitamin with iron.
• If you are not having regular bowel movements daily; begin taking a dose of Miralax in the morning and
in the evening. Mix 1 tsp of Miralax powder into 6-8 oz. of water.
Three (3) days before your exam:
• Stop eating high fiber foods and wholegrains like raw fruits and vegetables, popcorn, quinoa,
wholegrain breads and anything with bran. These foods are not as easily digested.
Day before your exam:
• Step 1: Stop eating anything solid and switch to a CLEAR LIQUID DIET. The more liquids you drink
the better the prep outcome. DO NOT eat anything solid until after your colonoscopy. Clear liquids are
anything you can see through:
Clear Liquids – no red items of any kind:
Juices (white grape, apple, lemonade without pulp, etc.)
Water and Sodas (diet and regular)
Sports drinks (Gatorade/PowerAde or similar)
Coffee and tea (black/no cream)
Chicken, beef, or vegetable broth
Gelatin without fruit
Popsicles and Italian ices (without fruit or cream)
Not Clear Liquids (do not drink):
No red items of any kind
No alcohol
No milk or non-dairy creamers
No noodles or vegetables in soup
No juice with pulp
No orange juice
No liquid you cannot see through
February 2016 ACP
•
•
Step 2: At 4:00pm take 4 Dulcolax (bisacodyl) 5mg tablets. Mix the entire 238-gram bottle of Miralax
in all 64 ounces of your sports drink. Shake the solution until the Miralax has dissolved. Store this in
the refrigerator.
Step 3: At 6:00pm drink one glass (8 oz.) of the Miralax solution every 10-15 minutes until the solution
is half gone. You should drink half of the drink mix (32 oz.) by 7:00pm. Refrigerate the remainder of
the prep solution as you will need it the day of your procedure.
o Plan to stay near a bathroom. This solution makes you pass loose stool as it takes effect.
o You may vomit or feel nauseated. This is normal. Rinse your mouth out with water and take a
break but keep drinking clear liquids. Staying active while drinking may prevent nausea.
o If you do not have a loose stool by 10:00pm, go to the store and buy a 10oz bottle of magnesium
citrate. Drink all of it.
Day of your exam:
• Take your other prescription medications (except those noted above) with small sips of water.
• Four (4) hours BEFORE your appointment time, finish drinking the rest of the drink mix. Drink 8oz
every 10-15 minutes so you finish drinking it all within an hour.
• Three (3) hours before your appointment, stop drinking anything at all.
• If you are a diabetic, reduce your long-acting insulin dose by HALF on the morning of your procedure.
Do not take short-acting insulin on the morning of your procedure. Please contact your primary care
provider for further instructions.
• Please fill out any additional paperwork included and bring it with you to your appointment. We will
need a complete list of your current medications.
If you are following these instructions you should be passing yellowish to clear liquid when you have a bowel
movement. When you have a bowel movement you should be able to see through to the bottom of the toilet.
When this happens, congratulations! You’re now ready for your colonoscopy!
If you have questions regarding your preparation or if you are concerned that you may not be cleared
out, please call the Endoscopy Call Center:
Monday-Friday, 7:00 AM-5:00 PM at (801) 213-9797
For urgent questions after hours, please call (801) 581-2121 & ask for the GI Fellow on call
We strongly encourage you to visit our website at: http://healthcare.utah.edu/gi
Colon Cleansing Tips:
1. Stay near a toilet! You will have diarrhea, which can be quite sudden. This is normal. Also, allow for
extra travel time to your appointment as you may need to make bathroom stops along the way.
2. Continue to drink the prep solution every 15 minutes as directed. Occasionally, this may involve
drinking the solution while sitting on the toilet.
3. Rarely, people may experience nausea or vomiting with the prep. If this occurs, give yourself a small
break, rinse your mouth or brush your teeth, then continue drinking the prep solution.
4. It is common to experience abdominal discomfort until the stool has flushed from your colon (this may
take 2 to 4 hours, and occasionally significantly longer).
5. Anal skin irritation or a flare of hemorrhoidal inflammation may occur and can be treated with a variety
of over the counter remedies including hydrocortisone creams, baby wipes or Tucks pads. Avoid
products containing alcohol. If you have a prescription for hemorrhoid cream, you may use it. Do not
use suppositories.
6. At the end of the preparation, you may see small flecks (sediment) in the bottom of the toilet after
having a bowel movement. This is normal as long as you can still see the bottom of the toilet and the
stool is clear liquid. Your stool may also be varying shades of color (yellow, green, blue, etc) depending
on the flavor of your sports drink.
February 2016 ACP