Miralax AM Prep

Please read through all the following information.  Contact the office if you have any questions.

Good visualization of your colon requires a clean colon. To clean your colon it is important that you carefully follow the instructions outlined below. No food, plenty of clear liquids and the colon prep will clean your colon.

Purchase at your pharmacy prior to your procedure: 2 bottles of Miralax powder 8.3 oz (238g) or the generic equivalent. Plenty of clear liquids that include:  coffee or tea without dairy/non-dairy creamers; all carbonated beverages and non-carbonated beverages such as Gatorade or vitamin water, fruit juices without pulp, broths, jello, popsicles and Italian ice.  Avoid any clear liquid that is red or purple in color such as cranberry or grape juice. (Optional): Aloe baby wipes, Desitin ointment for perirectal irritation, straws.  Drinking your prep solution using a straw sometimes is helpful.

Please arrive at your designated facility 30 minutes prior to your procedure. Please bring identification, your insurance cards, the medical form from this office and a medication list.

***Because of the sedation, you must have someone drive or accompany you home after your procedure. No exceptions can or will be made to this. You cannot drive, operate machinery, nor should you sign any legal documents for 24 hours after your procedure. ***

If you are on anticoagulants such as Couomadin (Warfarin), Pradaxa(Dabigatran), Eloquis (Apixaban), or Xarelto (Rivaroxaban or are on anti-platelets such as Plavix (Clopidogrel), Ticlid (Ticlopidine, Effient (Prasugrel)or Persantine (Dipyrimadole) you will also need to contact your prescribing physician regarding any adjustment to your medications or additional blood tests prior to your colonoscopy.  Please then let my office know your medication adjustment.  Without my office knowing this information your procedure may need to be rescheduled.

If you have a history of constipation; if you regularly take narcotics such as morphine, OxyContin, Fentanyl or Vicodin contact my office. Your prep may need to be adjusted.

Diabetics should contact the physician who oversees your diabetes for your medicine or insulin schedule for the day of your colonoscopy prep.

Check with your insurance company prior to your procedure to assure that you understand your insurance benefits and coverage.  Your colonoscopy is considered to be a screening or routine if have you have no GI symptoms.  If you are experiencing GI symptoms (i.e. abdominal pain, bleeding, diarrhea, constipation, anemia) your colonoscopy is considered to be diagnostic.   If a polyp or tissue is removed during the procedure your colonoscopy may no longer be considered a screening but a surgical procedure.    Information on insurance claims adheres to your medical record.

 Miralax or the generic solutions are laxatives.   The medicines will cause multiple bowel movements.  They may cause cramps, gas or nausea.  It may start to work in as little as 30 minutes, but it can several hours.  You should stay within close reach of toilet facilities. 

FOLLOW OUR INSTRUCTIONS. Do not follow the instructions on the Miralax bottle

Two days prior to your colonoscopy increase your liquids and follow a low residue diet Foods:  Soup, fish, chicken, eggs, white rice, bread, crackers, plain yogurt, pasta, potato with no skin, gelatin, broth, bouillon, all liquids  Avoid:  fresh and dried fruit, all vegetables, raisins, dried fruits, nuts, seeds, any other meat besides what is listed above. Drink: The more liquids the better. Increase your liquid intake to at least 12oz every 2 hours. You will drink two solutions of Miralax. 8:00AM: mix one capsule of Miralax in 8oz of water and drink it all. Repeat this again at 6:00PM: mix one capsule of Miralax in 8oz of water and drink it all. Avoid: Do not drink liquids that are red or purple or have pulp.

The day before your colonoscopy:  take all your medications as scheduled.    Mix the other bottle of Miralax powder in 64 oz of a clear liquid, mix until dissolved, refrigerate.

DO NOT CONSUME ANY SOLID FOOD OR MILK.  You are to drink clear liquids over the day, at least 12 oz of clear liquids each hour. Some of these should contain sugar, even if you are a diabetic. You may have gum and hard candies.  It is best to avoid alcoholic beverages as these are dehydrating liquids.

6:00- 8PM:  Drink or sip through a straw 8oz of the Miralax or generic solution every 10-15 minutes until half (32 oz) of the solution is gone. Continue to drink 12oz of a clear liquid until bedtime.  Anytime you get up during the night to go to the bathroom, have a drink of clear liquid.

6 hours before your colonoscopy:  Drink or sip 8oz of the Miralax or generic solution every 10-15 minutes until the remaining 32 oz of the solution is gone.  You must drink it all. Continue to drink clear liquids up until four hours prior to your colonoscopy.

Nothing  to drink for the four hours before the exam your colonoscopy.  You can take all necessary medications the morning of your colonoscopy with a sip of water except for diuretics such as Lasix, hydrochlorothiazide or any medication ending in HCT.  You can take those specific medications after your procedure.

Please plan three hours from drop off to discharge though this estimate may vary from patient to patient.  Every attempt is made to adhere to the schedule though there are occasions when unavoidably the schedule may run behind.  Your patience and understanding are appreciated.

***Your colonoscopy brings together an endoscopy team that provides you the best possible care available.  If you are not able to keep your procedure appointment we request at least a 72 hour notice.   Less than 72 hours may result in a $50 cancellation fee.***