What Can You Do To Ensure A Clean Colon For A Colonoscopy

This information will assist you lot become ready for your colonoscopy using polyethylene glycol (MiraLAX^®).

A colonoscopy is a exam that lets your dr. come across within your colon (large intestine). Your doctor volition use a colonoscope (flexible tube with a photographic camera on the end) to come across the within of your colon on a video monitor. During your process, your doc can:

Remove a minor sample of tissue (biopsy) for testing
Remove a polyp (growth of tissue)
Take photos of the inside of your colon

Before your procedure, you must follow these instructions advisedly. Yous volition need to do a bowel training to empty your colon before your procedure. It's very important that your colon is empty for your colonoscopy. If at that place's stool (poop) within your colon, your doctor may not be able to encounter polyps or other issues inside your colon and you may have to repeat the process. If you have any questions, contact your doctor's function.

one Week Before Your Procedure

Adjust for someone to take you lot abode

You must have a responsible intendance partner take yous home after your procedure. A responsible care partner is someone who tin can help you get dwelling house safely. They should be able to contact your care team if they have whatsoever concerns. Make certain to plan this before the day of your procedure.

If you don't accept a responsible care partner to have you lot home, phone call one of the agencies below. They'll send someone to get domicile with yous. There's often a charge for this service, and you'll need to provide transportation. It's OK to apply a taxi or car service, but you yet need a responsible care partner with you.

Ask about your medications

You may need to stop taking some of your medications earlier your procedure. Talk with your doctor about which medications are safe for you to stop taking. We accept included some mutual examples beneath.

Anticoagulants (blood thinners)

If you have a claret thinner, such as to treat blood clots or to forestall a heart assault or stroke, ask the physician who prescribes information technology for you when to stop taking information technology. Examples are listed in the "Common anticoagulants (blood thinners)" table. There are others, so check with your doctor if you're non sure.

Common anticoagulants (blood thinners)
apixaban (Eliquis^®) cilostazol (Pletal^®) clopidogrel (Plavix^®) dalteparin (Fragmin^®)	enoxaparin (Lovenox^®) fondaparinux (Arixtra^®) heparin	rivaroxaban (Xarelto^®) tinzaparin (Innohep^®) warfarin (Coumadin^®)

Medications for diabetes

If y'all take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes your diabetes medication what you should do the twenty-four hour period before and the morning of your process. Tell your doctor you volition be drinking a sugar-gratis clear liquid diet the 24-hour interval before your procedure.

If yous accept metformin (such equally Glucophage^®or Glumetza^®) or a medication that contains metformin (such as Janumet^®), don't accept it the day earlier or the day of your procedure.

Tell your md if you have an AICD

Tell your Memorial Sloan Kettering (MSK) doc if you accept an automatic implantable cardioverter-defibrillator (AICD).

Become a alphabetic character from your doctor, if needed

If you have an automatic implantable cardioverter-defibrillator (AICD), y'all will need to get a clearance letter from your cardiologist (centre doctor) before your procedure. A clearance letter is a letter that says you can safely have the procedure.
If you've had chest pain, dizziness, problem breathing that's new or worse, or have fainted in the last 6 weeks, you demand to exist examined by your doctor, and get a clearance letter from your doctor before your procedure.

Your MSK medico'due south office must accept your clearance alphabetic character at least ane day before your procedure.

Purchase supplies

You will demand to buy the following supplies for your bowel preparation:

4 (5 mg) tablets of bisacodyl (Dulcolax^®). These are normally sold as a box of ten tablets.
1 (238 gram) bottle of polyethylene glycol (MiraLAX ^®).
64 ounces of whatsoever clear liquid that isn't red, purple, or orange. You will need to mix this with the MiraLAX. Keep it at room temperature.
- A sports drink like Gatorade^® or Powerade^® is a proficient option. Sports drinks will assist supervene upon electrolytes that y'all will lose during the bowel training.
- If you take diabetes, be sure to get sugar-free clear liquids.

Some people may need other supplies. To encounter if you demand any other supplies, reply the questions below:

Do y'all tend to be constipated (have fewer bowel movements than what's normal for you lot) or take fewer than 3 bowel movements per week?
Do you have narcotic (opioid) medications such equally fentanyl (Duragesic^®, Subsys^®) morphine (DepoDur^®, Duramorph^®), hydrocodone (Vicodin^®) or oxycodone (Oxycontin^®, Percocet^®)? If you're not certain, inquire your healthcare provider.
Have you had a colonoscopy with a poor prep in the by? This means that during your colonoscopy, your healthcare provider withal saw stool in your colon.

If you answered yes to any of the questions, you must as well purchase the post-obit supplies:

three (17 gram) doses of MiraLAX (for a total of 51 grams).
- You lot can buy 1 additional modest bottle (119 grams) or the packets.
More than liquids for a full liquid diet.
- Examples of what you can potable are listed in the section called "2 Days Before Your Process."

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five Days Before Your Process

Stop taking iron supplements

If yous have an atomic number 26 supplement, yous'll need to terminate taking it 5 days before your process. Iron supplements can cause color changes in your stool, which can make it harder for your medico to run into your colon conspicuously.

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three Days Earlier Your Procedure

Avoid sure foods

Y'all should follow a low-fiber diet starting iii days before your colonoscopy. During this time, practise not eat:

Raw (fresh) fruits and vegetables
Whole kernel corn, including canned corn
Whole grains (such as oatmeal, dark-brown rice, quinoa, or wheat bread)
Seeds (such as poppy or sesame)
Nuts

Talk with your endoscopy nurse

A few days before your procedure, you'll become a telephone call from an endoscopy nurse. They will review the instructions in this guide with you and inquire you questions about your medical history. The nurse will also review your medications and tell yous which to take the morning of your procedure.

Use the space below to write them down.

Use this space to write down your medications

2 Days Before Your Procedure

Don't start your clear liquid nutrition until the day before your procedure if you:

Aren't commonly constipated
Don't take narcotic (opioid) medications
Haven't had a colonoscopy with poor prep in the past

Avoid raw fruits and vegetables, whole kernel corn, grains, seeds, and basics. Skip to the next section "The Day Before Your Procedure."

If yous're commonly constipated, accept narcotic medications, or accept had a colonoscopy with a poor prep in the past:

Take i capful (17 grams) of MiraLAX mixed with viii ounces of liquid at breakfast, lunch, and dinner.
Follow a full liquid diet. On a full liquid diet, you may eat and drink the following:
- Yogurt (without whatsoever pieces of fruit)
- Fruit juices without pulp
- Soda
- Broth or cream soups that accept been strained so in that location are no vegetable pieces
- Nutritional supplements
- Ice cream and fruit ices (without any pieces of fruit)

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The Twenty-four hours Before Your Procedure

Set up your MiraLAX bowel preparation

On the morning time of the day before your process, mix all 238 grams of the MiraLAX powder with 64 ounces of a room temperature clear liquid until the MiraLAX pulverization dissolves.

One time the MiraLAX is dissolved, you tin can put the mixture in the refrigerator. Many people find it tastes better when it's chilled.

Don't mix the MiraLAX before than the morning time of the 24-hour interval before your process.

Follow a clear liquid diet

You will need to follow a clear liquid nutrition the twenty-four hours before your procedure. Examples of clear liquids are listed in the table in this section.

Don't consume whatever solid foods.
Don't drink annihilation ruddy, regal, or orangish.
Brand sure to drink plenty of liquids other than just water, coffee, and tea. This helps to make sure that yous get plenty calories and is an important function of your colonoscopy preparation. Try to drinkable at to the lowest degree one (viii-ounce) glass of liquid every hr while you're awake.
If you have diabetes, you should drink only sugar-free clear liquids and cheque your claret sugar level oftentimes. If you accept any questions, talk with your healthcare provider.

Clear Liquid Diet
	Drink	Do Not Drink
Soups	Clear broth, bouillon, or consommé	Whatever products with particles of dried food or seasoning
Sweets	Gelatin, such as Clot-O^® Flavored ices Difficult candies, such as Life Savers^®	Anything red, purple, or orange
Drinks	Articulate fruit juices, such as apple, white cranberry, lemonade, or white grape Soda, such every bit 7-Up^®, Sprite^®, ginger ale, or seltzer Gatorade^® Black coffee Tea H2o	Juices with lurid Nectars Milk or cream Alcoholic beverages Anything red, purple, or orange

Note the time of your procedure

A staff fellow member volition call y'all afterwards apex the day before your process. The staff member will tell y'all what time you should arrive for your procedure. If you're scheduled for your process on a Monday, you will exist chosen on the Friday before. If yous don't receive a phone call, call your doctor'due south office.

If you demand to cancel your procedure, telephone call the medico who scheduled it for you.

First your bowel preparation

Footstep 1: At 4:00 pm on the day before your procedure, take 2 bisacodyl (5mg) tablets by oral fissure with a glass of water.

Stride ii: At four:fifteen pm, start drinking the MiraLAX mixture.

At 4:15 pm , drink ane (8-ounce) glass of the mixture.
At 4:30 pm , potable 1 (viii-ounce) drinking glass of the mixture.
At four:45 pm , drink 1 (8-ounce) glass of the mixture.
At v:00 pm , potable 1 (eight-ounce) glass of the mixture.

Y'all will beverage 4 spectacles of the mixture in full.

When you're finished, half of the MiraLAX mixture will exist left. Save the balance of it in the fridge for the second half of your preparation.
Bowel movements usually begin within 1 hour of drinking the first dose, merely it may take longer for some people.
- Don't worry if yous don't start having bowel movements later drinking the first one-half of the MiraLAX. Proceed to drink liquids and start the second half of the MiraLAX as instructed.
Put petroleum jelly (Vaseline^®) or A & D^® ointment on the skin around your anus after every bowel motion. This helps forbid irritation.
Continue to potable clear liquids to stay hydrated and flush out your colon.

Step three (If you were told to arrive for your procedure before eleven:00 am):

If you were told to make it for your process before eleven:00 am, follow these instructions the nighttime before your procedure:

At eleven:00 pm , take two bisacodyl tablets by mouth with a glass of water. Then, kickoff drinking the 2nd one-half of the MiraLAX mixture.

At 11:15 pm , drink 1 (8-ounce) glass of the mixture.
At 11:30 pm , drink 1 (8-ounce) glass of the mixture.
At xi:45 pm , potable 1 (8-ounce) glass of the mixture.
At 12:00 am (midnight), drink i (eight-ounce) glass of the mixture.

Be certain to finish the entire MiraLAX mixture.

You can continue to drink articulate liquids until 4 hours before your scheduled arrival time.
Don't swallow anything until afterward your procedure.

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The Twenty-four hours of Your Procedure

Footstep 3 (If you were told to get in for your procedure at 11:00 am or later):

If yous were told to arrive for your procedure at eleven:00 am or later, follow these instructions the morning of your procedure:

At half dozen:00 am , have 2 bisacodyl tablets by rima oris with a glass of h2o. And then, start drinking the 2nd half of the MiraLAX mixture.

At vi:15 am , drinkable 1 (8-ounce) drinking glass of the mixture.
At 6:thirty am , beverage ane (8-ounce) glass of the mixture.
At 6:45 am , drink one (8-ounce) drinking glass of the mixture.
At vii:00 am , drink 1 (8-ounce) glass of the mixture.

Exist sure to finish the unabridged MiraLAX mixture.

Yous tin continue to drink clear liquids until 4 hours earlier your scheduled arrival fourth dimension.
Don't eat anything until later on your procedure.

Things to retrieve

Have just the medications you lot were instructed to take the morning of your procedure. Take them with a few sips of water.
Don't utilize any lotions, creams, or powder to your chest or arms.
Remove any jewelry, including trunk piercings.
Leave all valuables, such equally credit cards and jewelry, at home. We don't accept lockers to store your valuables in.
If you clothing contacts, wear your spectacles instead.

What to bring

A list of the medications you take at abode
If you lot have an implanted pacemaker or cardioverter-defibrillator (AICD), bring your wallet card with yous.
Your rescue inhaler (such as albuterol (Proventil^®, Ventolin^®) for asthma), if you lot accept one
A case for your glasses
Your Health Care Proxy grade, if y'all have completed one

Where to get

Your procedure will take place at one of these locations:

Endoscopy Suite at Memorial Hospital (MSK's main infirmary)
1275 York Avenue (between East 67^th and Due east 68^th Streets)
New York, NY 10065
Take the K elevator to the 2^nd Floor. Enter the Endoscopy Suite through the glass doors.
MSK Monmouth
480 Red Loma Road
Middletown, NJ 07748

What to expect

One time you arrive, y'all will be asked to state and spell your proper name and date of nascency many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

When it's time to modify for your procedure, you will go a hospital gown, robe, and nonskid socks to wear.

You will come across with your medico before your procedure. They will explain the process to you and respond any questions you may take.

You will see with your anesthesiologist. They will review your medical history with you and talk with yous virtually the kind of anesthesia (medication to make you lot sleep) you will receive.

In one case it's fourth dimension for your procedure, y'all will be brought into the procedure room and helped onto the examination table. Yous volition prevarication on your left side with your knees bent.

Your anesthesiologist will place an intravenous (4) line into a vein, usually in your arm or manus. Y'all will become anesthesia through your IV, which will brand you autumn asleep. In one case you lot're asleep, your md volition brainstorm the procedure.

Your doctor will place a colonoscope into your rectum. The colonoscope is connected to a video monitor. This lets your doctor to see the inside of your colon. Your doctor will employ air and fluid to move the colonoscope through your colon while looking for anything unusual on the video monitor.

The procedure usually takes less than 60 minutes (ane hr).

Often Asked Questions (FAQs)

I'1000 taking the prep and started having loose, watery stool earlier I finished information technology. Practise I yet need to take the rest of the prep?

Yes. Yous must drink all the prep to fully make clean out your colon for a condom and consummate colonoscopy.

I feel like throwing up (nausea) or did throw up (vomit) later on taking the bowel prep. What should I exercise?

Many people may experience nauseous while drinking the bowel prep. To help with this, try mixing the MiraLAX powder with clear liquids y'all similar drinking.

If you experience similar vomiting, you should drink slowly, and take a suspension. This means y'all should stop drinking the liquid for 30 to 45 minutes to permit your stomach empty. While you take a interruption, put your prep liquid in the fridge. Later on your suspension, try to slowly drink the prep again. Use a straw if you have one.

If you lot practise vomit, have a 30 to 45 minute break. If y'all have anti-nausea medication at home, you can have one dose before starting the prep once more. You can potable any clear liquids you similar to drink to stay hydrated. It'southward of import that you drink all the prep liquid to fully clean out your colon for a safe and complete colonoscopy.

Afterwards Your Process

Your nurse will continue to monitor your heart, animate, and blood force per unit area. Many people feel bloated and have tummy cramps after a colonoscopy. This is normal and goes away by passing gas.

Once you're fully awake, your nurse will remove your IV. If you have someone waiting with you, your nurse will explicate your discharge instructions to both of you before you go domicile.

At home

Yous may begin eating low-cal foods as shortly every bit you're discharged. Avoid spicy, greasy, and fried foods at first. Work your style up to your normal diet. If your medico wants you to limit your diet for a period of fourth dimension, they will tell y'all.
You tin can become back to doing your usual activities 24 hours later your process.
Don't drink alcoholic beverages for 24 hours later on your process.

If you had a biopsy, it's normal to take a modest amount of bleeding from your rectum. There should be no more than a few drops of claret, and the haemorrhage should finish inside 24 hours afterward your procedure.

Subsequently a colonoscopy, information technology'southward normal for your bowel movements to be irregular or different from your usual habits. This may last for up to a week afterwards your procedure.

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When to Phone call Your Healthcare Provider

Call your healthcare provider if you have whatsoever of the following:

A fever of 101° F (38.3° C) or higher
Serious stomach hurting or bloating
Haemorrhage from your rectum that lasts more than 24 hours
Bleeding between bowel movements
Weakness, faintness, or nausea
Heavy bleeding from your rectum

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Source: https://www.mskcc.org/cancer-care/patient-education/how-prepare-your-colonoscopy-using-miralax

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