PLEASE MAKE SURE TO REVIEW THESE MIRALAX COLONOSCOPY PREPARATION INSTRUCTIONS A WEEK BEFORE YOUR PROCEDURE!
Make sure to arrange for an escort for the day of the procedure.
- Discuss with Dr Gutman and your cardiologist any blood thinners you are on including Plavix, Ticlid, Effient, Coumadin, Warfarin and Lovenox. You may stay on aspirin therapy up to 325 mg daily.
- Discuss the use of arthritis and pain medications with Dr. Gutman.
- Avoid arthritis medications for 2 days before the test. These include naproxen (Naprosyn, Aleve), ibuprofen (Motrin, Nuprin) and many others. Mobic, Celebrex, and acetaminophen (Tylenol) do not need to be discontinued.
- Avoid over the counter blood thinners such as Vitamin E and ginkgo biloba.
- Stop binding medications one week before including iron, multiple vitamins with iron, cholestyramine, colestid, Questran, Imodium, and Lomotil.
- All other prescription medications are permitted, except if specifically instructed.
- Avoid foods with seeds for 3 days before the colonoscopy. Seeds tend to stay in the colon for days.
- Pick up your prescription for one 255g bottle of Polyethylene Glycol (PEG-3350). It is also available without a prescription as Miralax 238g.
- Purchase a 64 oz (2 quarts) bottle of Apple Juice, Snapple (or make your own ice tea) or Gatorade (ANY FLAVOR EXCEPT FOR A RED OR PURPLE COLOR). You may split the Miralax between two different drinks as long as it adds up to 2 quarts.
- Also, purchase 2 Dulcolax Laxative (Bisacodyl) 5 mg tablets.
- READ ALL PAGES OF THE INSTRUCTIONS
- Confirm that you have a ride.
If you have diabetes, do not take your insulin or diabetic pills on the day of the test.
Please advise the nurse to check the blood sugar before the test.
On the day before colonoscopy diabetics do not take metformin as it may cause side effects when you are dehydrated due to the laxatives. This is not a concern with upper endoscopy of the stomach.
Diabetics still need calories. On the day of preparation for colonoscopy, you should have non dietetic items. If you have only sugar-free products you may become faint, or pass out.
Do not take fast acting insulin such as Novolog. It is ok to take Lantus and similar long acting insulin.
Be sure to check your blood sugars the day you are preparing for your procedure and call your doctor with any problems.
Please take heart medications or blood pressure medications, other than water pills, with a glass of water 4 hours before the scope or the night before. Most other medications can be delayed until after the procedure. Any diuretics or fluid pills you may take would be best to take after the procedure and not before.
Tranquilizers or relaxing medications should not be taken on the morning of the test because of the potential interaction with sedatives.
A FEW DAYS BEFORE COLONOSCOPY
Stock up on clear fluids such as ice tea, broth, Jell-O, soda, lemonade, as your tastes prefer.
THREE DAYS BEFORE THE COLONOSCOPY
No fibrous vegetables, nuts, seeds, salads for 3 days.
THE DAY BEFORE THE COLONOSCOPY
- 24 hours before the colonoscopy stop eating most solid foods and dairy.
- You may have clear liquids, coffee, tea, small milk in your coffee, up to two eggs, plain deli turkey slices (up to 3 slices) without skin, Ensure or Boost (one can).
- Stay on a clear liquid diet for the entire day beginning 24 hours before your colonoscopy.
- Hydrate vigorously before the laxatives, and after. Drink often, and drink more. After the colonoscopy you should drink at least a quart in the next 8 hours. Hydration leads to a high quality preparation, higher detection of precancerous polyps, fewer complications, and improved tolerance of the preparation.
- A clear liquid is any liquid you can see through. A list of clear liquids is provided on the attached sheet. Clear liquids include water, tea, coffee, ices, clear soups, broth, Jell-O, fruit juice, and carbonated beverages. NONE OF THESE SHOULD BE RED OR PURPLE IN COLOR.
- Avoid dairy products.
- DO NOT EAT ANY SOLID FOOD, except those listed, beginning 24 hours before the procedure. The protein supplements listed above are to avoid low blood sugar (hypoglycemia) if you are predisposed.
- Mix the entire amount of Miralax or PEG-3350 into two quarts of apple juice, ice tea, Gatorade Ice, Snapple, Crystal Light or similar clear beverage.
THE AFTERNOON OR EVENING BEFORE THE COLONOSCOPY
- Begin drinking one quart of the mix, having one 8 oz. glass every 10 to 15 minutes until it is finished for total of four glasses.
- Two hours later, take two Dulcolax pills at once with water.
- Continue to drink as much water or other fluids as possible until bedtime.
5 TO 6 HOURS BEFORE COLONOSCOPY
Begin drinking one quart of the mix, having one 8 oz. glass every 10 to 15 minutes until it is finished for total of four glasses.
4 HOURS BEFORE THE COLONOSCOPY
Please take heart medications or blood pressure medications, other than water pills, with a glass of water 4 hours before the scope.
DO NOT EAT OR DRINK 4 HOURS BEFORE SCOPE (except medications with small sips of water) until after the colonoscopy.
Please Bring the Completed Anesthesia Questionnaire with you.
You MUST have an escort to pick you up after the procedure. If you do not have an escort, the procedure will be cancelled or rescheduled!
If you have concerns about this requirement, please discuss it with Dr. Gutman.
QUESTIONS? Call the office if you have any questions.
DAVID GUTMAN, MD (516) 739-4604