Gatorade® and Miralax® Colonoscopy Instructions

Having a colonoscopy is one of the most effective ways to prevent colon cancer. For the best results and to avoid the need to cancel or reschedule your colonoscopy, there are a number of important steps you must take.

If you are taking Coumadin® (Warfarin), Plavix®, Lovenox®, Aggrenox®, Pradaxa®, Effient® or any other blood thinning medication, make sure you know if and when you are to stop these medications. Please contact your doctor if you are unsure.

Arrange in advance for transportation home. You may not drive for the rest of the day following your colonoscopy. You must have a driver, whom you know, pick you up after your exam. If you do not have someone to drive you home your procedure will be canceled. You may take a taxi or other car service only if you are accompanied by a responsible adult. The colonoscopy will last about two hours from the time you arrive to the time you go home.

Contact the doctor’s office at (707) 541-7900 if you experience any difficulties or have concerns during your preparation. An on-call gastroenterologist is available during non-office hours at (707) 541-7900.

Four Days Before Your Colonoscopy

• Stop using nonsteroidal anti-inflammatory drugs (NSAIDS), including Ibuprofen, Motrin, Advil, Naprosyn, Aleve and Relafen. You may continue to take Tylenol or a single aspirin (81 mg tablet) daily.
• Stop using iron supplements.
• Stop eating nuts, seeds, popcorn, tomatoes, peanuts, corn, berries, and breads or crackers with visible seeds. This step will assist with the bowel preparation results.

Two Days Before Your Colonoscopy

Consider purchasing soothing wipes and barrier cream, such as Vitamin A and D ointment, to help with anal irritation. Do not use Desitin. Purchase the prep ingredients, including:

• Two quarts of Gatorade® (no red, orange or purple flavors). Low-calorie G2 is OK.
• One 8.3-ounce (238 gram/14 dose) bottle of Miralax.® (The generic brand is OK.)
• Two 5 mg Dulcolax (bisacodyl) laxative tablets.

To prepare the prep mixture, combine the two quarts (64 ounces) of Gatorade with an entire 8.3-ounce (238 gram/14 dose) bottle of Miralax and refrigerate for use the next day.

One Day Before Your Colonoscopy (Prep Day)

• Before 10:00 am you may have a small, light breakfast, such as eggs, soup or broth with noodles (no meat or vegetables), white crackers, rice, potatoes, bread, Boost or Ensure.
• At 10:00 am begin a clear liquid diet. Clear liquids include water, tea, coffee, apple juice, white grape juice, white cranberry juice, sports drinks, vitamin waters, Jell-O, broth and soda. Do not eat anything solid after 10:00 am. No red, orange or purple products. No dairy products or creamers.
• In the morning, if you are diabetic and take insulin or use an insulin pump, use one-half your daily dosage today. If you are taking oral diabetic medications, take one-half the dosage you usually take. 
• At 2:00 pm take two 5 mg Dulcolax (bisacodyl) laxative tablets.
• Before 5:00 pm try to drink at least six to eight glasses of clear liquid.
• Before 5:00 pm you may also drink up to two vanilla Boost drinks. Use the sugar-free version if needed.
• At 5:00 pm begin drinking your Gatorade and Miralax mixture. Drink one 8-ounce glass every 10 to 15 minutes until half of the container is finished (one quart). This will take about an hour. It is best to drink the whole glass quickly. You may add ice to your glass.
• After 6:00 pm please continue your clear liquid diet over the course of the evening in order to remain hydrated.

Common Gatorade and Miralax Mixture Side Effects

• Chills, bloating, cramping, nausea and vomiting may occur. If so, take a break from drinking the prep for 30 minutes. Resume drinking, taking breaks as needed.
• A bowel movement will usually occur within one hour after the first glass of the Gatorade and Miralax mixture. Don’t worry if this doesn’t happen for three to four hours. Everyone is different. 
• Watery and frequent bowel movements will occur until the bowel is fully cleansed. The end result should be clear or pale, typically yellow liquid.

Day of Your Colonoscopy (Exam Day)

• If you are diabetic, do not take your daily diabetic medication this morning.
• Three hours prior to your scheduled procedure start time (or earlier), begin drinking the last half of the Gatorade and Miralax mixture. Drink one 8-ounce glass every 10 to 15 minutes until the remainder is finished. You must finish the remaining mixture two hours prior to your scheduled procedure start time. To stay hydrated, you may also have clear liquids up to two hours prior to your scheduled procedure start time.
• Two hours prior to your scheduled procedure start time, do not drink anything until after your colonoscopy is complete.
• Wear loose, comfortable clothing, including a short sleeved shirt and warm socks.

After you arrive for your colonoscopy, you will meet with a nurse who will talk to you about your medical history, start an IV so you can get fluids, and get you settled. After you meet with your doctor, you will be given medication to sedate you and keep you comfortable during your colonoscopy. You will recover after your procedure for about 30 minutes, and then will be given a written report with instructions to take home.