Miralax Gatorade

Patient Education

If you have diabetes, ask your regular doctor for diet and medication restrictions.
If you take a medication to thin your blood and have not already discussed this with our office, please call us at 612-871-1145.
If you take aspirin, you may continue to do so.

Other Medications: The following medications may interact with the sedation used for your procedure. If you take any of these medications please call our office at 612-871-1145: crizotinib (Xalkori), enzalutamide (Xtandi), isocarboxazid (Marplan), linezolid (Zyvox), moclobemide, phenelzine (Nardil), procarbazine (Matulane), rasagiline (Azilect), selegiline (Emsam, Eldepryl, Zelapar), tranylcypromine (Parnate), mifepristone (Korlym, Mifeprex), boceprevir (Victrelis), conivaptan (Vaprisol), efavirenz (Sustiva), ketoconazole, sodium oxybate (Xyrem), telaprevir (Incivek) 

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.
You must arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled.
If you must cancel or reschedule your appointment, please call 612-871-1145 as soon as possible.

ADVANCED DIRECTIVES
If you have an Advance Directive, please bring a copy of your Advance Directive with you to your endoscopy appointment. Advance Directives are not honored at MNGI facilities, and in the event of a life-threatening situation, life support measures will be instituted in every instance and our patient will be transported to a higher level of care facility (i.e. , hospital). In the unlikely event that you require an emergency transfer, your Advance Directive should accompany you to that facility.

PREPARATION
To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

Before your exam:
If a health history form is enclosed, please complete the form and bring with you on the day of your appointment.


Purchase the following over-the-counter supplies at your local pharmacy:

  • 2 tablets bisacodyl, each containing 5 mg of bisacodyl (Dulcolax® laxative NOT Dulcolax® stool softener)
  • 1-8.3 oz. bottle Polyethylene Glycol (PEG) 3350 powder (Miralax® , smoothLAX®, ClearLAX® or generic equivalent)
  • 64 oz. Gatorade® liquid (NOT red; NOT powdered). Regular Gatorade®, Gatorade G2®, Powerade®, PoweradeZero® or Pedialyte® are acceptable. Alternatively, you may purchase two 2.12 oz packets of powdered Gatorade® that can be mixed with water to a total volume of 64 oz of liquid.
  • 1-10 oz. bot tle Magnesium Citrate (NOT red). Alternatively, you may use a 0.5 oz package of powdered magnesium citrate (17 grams) mized with 10 oz of water.

7 days before your exam:
Discontinue fiber supplements or medications containing iron. This includes multivitamins with iron, Metamucil® and Fibercon®.

3 Days prior to your exam:
Stop eating all high-fiber foods and begin a Low-Fiber Diet. A low fiber diet helps make the cleanout more effective.

Examples of a Low Fiber Diet include:

  • White bread, white rice, pasta, potato without skin, plain crackers
    Fish, white meat chicken, eggs, peanut butter without nuts
  • Clear beverages (apple juice, white grape juice, Sprite®, sparkling water, Gatorade®)
  • Cooked carrots, cooked green beans, cooked spinach
  • Milk, plain yogurt, cheese
  • Jelly, salt, pepper, sugar

Avoid: Raw fruits or vegetables, whole wheat or high fiber foods, seeds, nuts, popcorn, bran or bulking agents
       
Additional low fiber diet recommendation can be found at www.mngastro.com/lowfiber

2 days before your exam:

  • Continue Low Fiber Diet.
  • Drink at least 8 glasses of water throughout the day.
  • Refrigerate the Gatorade® or Powerade®, if you wish to drink it cold.
  • Stop eating solid foods at 11:45 pm.

1 day prior to your exam:
Start a Clear Liquid Diet

Examples of a Clear Liquid Diet:

  • No red liquids; No alcohol; No dairy products
    Water: drink at least 8 glasses of water during the day
  • Coffee or tea (do not add milk or creamer)
  • Clear broth or bouillon
  • Gatorade®, Pedialyte® or Powerade® (No red)
  • Carbonated and non-carbonated soft drinks (Sprite®, 7-Up®, Gingerale)
  • Strained fruit juices without pulp (apple, white grape, white cranberry)
  • Jell-O®, popsicles, hard candy (No red)

At 12 Noon:  Take the 2 bisacodyl (Dulcolax®) tablets

Between 4 and 6 p.m.:

  • Mix 1 bottle of Miralax®  (8.3 oz) with 64 oz. of Gatorade® in a large pitcher.
  • Drink 1 - 8 oz. glass of the Miralax®/Gatorade® solution.
  • Continue drinking 1 - 8 oz. glass every 15 minutes thereafter until the mixture is gone.

After 6 pm: Continue clear liquid diet

Colon Cleansing Tips

  • Drink adequate amounts of fluid before and after your colon cleansing to prevent dehydration.
  • Chill the Miralax®/Gatorade® solution in the refrigerator. DO NOT add ice to the solution or your drinking glass.
  • Set a timer for every 15 minutes. Drink each 8 - oz. glass of solution quickly to help flush your colon.
  • Stay near a toilet! You will have diarrhea.
  • Even if you are sitting on the toilet, continue to drink the cleansing solution every 15 minutes.
  • Drink all of the solution until it is gone.
  • If you feel nauseated or vomit, rinse your mouth with water, take a 15 to 30-minute break and then continue drinking the Miralax®/Gatorade® solution.
  • You will be uncomfortable until the stool has flushed from your colon (in about 2-4 hours). You may feel chilled.
  • You may suck on a few hard candies (NO red).
  • Alcohol-free baby wipes or Vaseline® may help ease skin irritation.
  • Over-the-counter hydrocortisone creams, hemorrhoid treatments or Tucks may be used if desired.

The day of your exam:

  • Continue clear liquid diet. Do not eat solid foods.
  • You may take all of your morning medications.

4 hours before your procedure:

  • Drink 10 oz. of Magnesium Citrate.

2 hours before your procedure:

  • Stop drinking clear liquids.
  • Do not take anything by mouth during this time. (No gum, no tobacco products, no hard candies)
  • Allow extra time to travel to your procedure as you may need to stop and use a restroom along the way.

You are ready for the exam, if you followed all instructions and your stool is no longer formed, but clear or yellow liquid. If you are unsure whether your colon is clean, please call our office at 612-871-1145 before you leave for your appointment.

  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms  that might be required by your insurance company.

DESCRIPTION OF COLONOSCOPY

What is a colonoscopy?
A colonoscopy is the most accurate test to detect colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

To produce the best and most accurate results, your colon must be completely clean. You will drink a special bowel cleansing preparation to help clean out your colon. You will also need to follow a special diet several days prior to your scheduled colonoscopy.


What happens during a colonoscopy?
Plan to spend up to two hours at the endoscopy center the day of your colonoscopy. The actual procedure takes about 20 to 40 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you, and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to help you relax and feel drowsy.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible tube – called a colonoscope – into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
  • During the procedure, you may experience some cramping. This is normal.
  • If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the colonoscopy.
  • You may have some cramping or bloating after the procedure. This is normal and should disappear quickly by passing gas.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from a colonoscopy?
Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential risk warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear through the lining of the colon
  • Bleeding from a biopsy site if tissue was removed
  • Reaction to medications used during the procedure

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