Colonoscopy Preparation Instructions: Gatorade® and Miralax® Split Dose

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 today if you are unsure.

You may not drive following the exam for the remainder of the day. You must arrange for transportation and have a driver, whom you know, pick you up following your exam. If you do not have someone to drive you home your procedure will be canceled. You may take a taxi or other non-medical hired service only if you are accompanied by a responsible adult.

Your procedure will last approximately two hours from the time you arrive to the time you’re released. You may confirm your release time with the facility when you arrive.

4 Days Before Your Colonoscopy

• Stop NSAIDs (ibuprofen, Motrin^®, Advil^®, Naprosyn^®, Aleve^®, Relafen^® and the like). You may continue to take a single aspirin (81 mg tablet) daily and/or Tylenol^®.
• Stop using iron supplements.
• Stop eating nuts, seeds, popcorn, tomatoes, peanuts, corn, berries, and breads or crackers with visible seeds. This will assist with the bowel preparation results.

2 Days Before Your Colonoscopy

• Purchase the prep ingredients:
  • Gatorade: 2 quarts (64 ounces). No red, orange or purple flavors. Low-calorie G2 is OK.
  • Miralax: one 8.3-ounce (238 grams, 14 dose) bottle. Generic brand is OK.
  • Dulcolax^® (bisacodyl): two 5-mg laxative tablets.
• Consider purchasing soothing wipes and barrier cream, such as A+D Ointment^® , to help with anal irritation. Do not use Desitin^® .
• Evening: Mix 2 quarts (64 ounces) Gatorade with entire 8.3-ounce bottle of Miralax and refrigerate.

1 Day Before Your Colonoscopy (Prep Day)

• Before 10:00 am, you may have a small, light breakfast. Examples of a light breakfast are: eggs, soup or broth with noodles (no meat or vegetables), white crackers, white rice, white potatoes, white bread, Boost^® or Ensure^®.
• At 10:00 am, begin a clear liquid diet. Do not eat anything solid. No red, orange or purple products. No dairy products or creamers. Clear liquids include water, tea, coffee, apple juice, white grape juice, white cranberry juice, sports drinks, vitamin waters, Jell-O^®, broth and soda.
• 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.
• If you are diabetic and taking insulin or using an insulin pump, use half your daily dosage today. If you are taking oral diabetic medications, take half the dosage you usually take. Otherwise, take your regular medications, including the day of the exam.
• At 5:00 pm, begin drinking the Gatorade-Miralax mixture. Drink one 8-ounce glass every 10-15 minutes until half of the entire container is finished (1 quart). This will take about an hour.
  
  It is best to drink each whole glass quickly. You may add ice to your glass.
• 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 an hour after the first glass of the Gatorade-Miralax mixture. Don’t worry if this doesn’t happen for three or four hours. Everyone is different.
• Bowel movements will occur that are watery and frequent until the bowel is fully cleansed. The end result should be clear or pale yellow liquid.

Day of Your Colonoscopy

• Four hours prior to your colonoscopy start time: Begin drinking the remainder of the Gatorade-Miralax mixture. Drink one 8-ounce glass every 10-15 minutes until the remainder of container is finished. You must be finished drinking three hours prior to your scheduled procedure start time.
• Three hours prior to your scheduled start time, stop all liquids. You must be finished drinking any other clear fluids three hours prior to your scheduled appointment time.
• If you are diabetic, do not take your daily diabetic medication this morning.
• Wear loose comfortable clothing and a short-sleeved shirt.

Important Bowel Preparation Reminders

The success of the colonoscopy exam is dependent on your colon being empty of fecal matter. The end result should be clear or pale, typically yellow liquid. Please complete the bowel preparation as instructed.

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

Remain hydrated throughout your bowel preparation. You may drink clear fluids throughout the entire preparation up until three hours prior to your scheduled appointment. Please do not drink red, orange or purple products, dairy products or creamers.

The hardest part is over! After you arrive for your colonoscopy, you’ll 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’ll be given medication to sedate you and keep you comfortable during your colonoscopy. You will recover after your procedure for about 30 minutes and will be given a written report with instructions to take home.