MiraLAX Prep

MiraLAX Preparation for Colonoscopy

In order to achieve an accurate evaluation of your lower gastrointestinal (GI) tract, it is important that you properly prepare for the procedure. Doctors are able to 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)

Certain weight reduction and diabetic medications can slow the emptying of the stomach and increase the risk of aspiration when sedated for the procedure. Some of these medications need held up to a week before the procedure. If you have not reviewed your medications with us, please contact the office to review. Using your patient portal is the best and most efficient way to communicate with us.

If you have questions or you need to reschedule or cancel your procedure, please message us through your patient portal or call (717) 761-0930.

Supplies

1. Two (2) 5mg Dulcolax (bisacodyl) laxative tablets. Purchase these over the counter.
2. Two 32-ounce bottles of Gatorade or similar sport drink. NOTE: Do not drink Gatorade that is red, pink, purple or dark blue in color, i.e. cherry, wild berry, fruit punch, grape, etc.
3. 238-gram bottle of MiraLAX or generic GlycoLax powder. You may purchase this over the counter at a grocery or drug store.

5 Days Before Procedure

1. Do not take any ibuprofen products (nonsteroidal anti-inflammatories – NSAIDS). Tylenol (acetaminophen) is allowed.  If you are on aspirin, you may continue the aspirin.
2. Do not take oral iron tablets.
3. Avoid foods that contain seeds or nuts. These foods take longer to pass through the bowel and should be avoided.

2 Days Before Procedure

1. You may eat your regular diet.
2. Take two (2) 5mg Dulcolax (bisacodyl) laxative tablets about 6 pm.  Note, you may have abdominal cramps from the Dulcolax.  If these develop, they should resolve once you begin having bowel movements.

The Day Before Procedure

1. You will need to follow a clear liquid diet the entire day before your procedure. We ask that you avoid dark colored clear liquids (red, purple, or dark blue). NO milk products, NO vegetables, NO breads or grains, NO meats and NO fats or oils are allowed. By rule of thumb, 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, clear hard candy, etc. If you are diabetic, drink regular (non-diet) liquids in moderation throughout the day.
2. Take regularly prescribed medication (except for blood thinners as detailed above).
3. Mix half the bottle of MiraLAX powder into each of the two Gatorade bottles. Shake bottles until the MiraLAX is dissolved. Refrigerate.
4. At 4:00 p.m., begin drinking one of the two bottles of Gatorade. Drink an 8 oz 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 over 2 hours. Bowel movements usually occur about one hour after the first glass but sometimes it takes longer. NOTE: It is normal to feel very “full” or “bloated” during your prep. Some people may also experience nausea and vomiting. If this occurs, simply wait about 30 minutes before resuming drinking.  Sipping some ginger ale can help.  Walking around can also help move the fluid downstream and relieve the nausea. The nausea will likely disappear once bowel movements begin. If the vomiting becomes persistent, please call our office at (717) 761-0930.

Second Dose of Preparation

1. The timing of the second dose of the MiraLAX-Gatorade mixture is dependent on the time of your procedure.  You will need begin taking the second dose seven (hours) before your scheduled appointment. NOTE: 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.  For example, if you are scheduled for 10:00 a.m., you will need to begin taking the second dose at 3:00 a.m.  We are well aware of the inconvenience and disruption to your sleep, but the two-stage prep provides a superior cleansing of the colon, improves polyp detection and ultimately reduces colon cancer risk.  You must finish with the prep within 4 hours of your procedure time.  For example, if your procedure is scheduled for 10:00 am, you will need to finish the second half of the prep by 6:00 a.m.  If your bowel movements are not clear or pale yellow an hour after drinking the entire solution, please call our office at (717) 761-0930.

On the Day of the Procedure

1. Do not have anything to eat.
2. At 6:00 a.m., take any currently prescribed heart and blood pressure medications (except for blood thinners, as detailed above) with a sip of water.
3. 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, please check your blood sugar the morning of your procedure. If your blood sugar is over 150 or below 90, please contact the West Shore Endoscopy Center at (717) 975-2430. An anesthesia specialist will provide you with further instructions.
4. Remember, you should have nothing by mouth 4 hours before your procedure.  No chewing gum, hard candy or chewing tobacco at least 4 hours prior to the procedure.
5. Please report to your appointment as scheduled. NOTE: Plan to be at the procedure center will for about two to two and one-half hours.
6. A responsible driver must drive you home after the procedure.   By state regulations, taxis and driving services such as Uber and Lyft are not permitted.  You will be sedated for your colonoscopy. You may not drive for 12 hours after the procedure. For later afternoon procedures, drivers must be present no later than 4:00 p.m. The West Shore Endoscopy Center closes at 4:00 p.m.