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Colonoscopy Instructions Using Miralax and Gatorade, with Magnesium Citrate

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Colonoscopy Instructions Using Miralax and Gatorade, with Magnesium Citrate Procedure Locations: The Vancouver Clinic Ambulatory Surgery Center 700 NE 87th Ave Suite 320 Vancouver, WA 98664 Legacy Salmon Creek Hospital Patient Name:_________________________ 2211 NE 139th St. Vancouver, WA 98686 Appointment Date:_____________________ (2nd floor, Surgery Patient Check-in) Arrival Time:__________________________ Peacehealth SW Medical Center 400 NE Mother Joseph Place Provider:______________________________ Vancouver, WA 98664 (5th Street entrance, Short Stay Unit) Please call our office at (360) 397-3805 with any questions Colonoscopy instructions using Miralax and Gatorade, with magnesium citrate. Bowel preparation (cleansing) is needed to perform a high-quality colonoscopy. Any stool remaining in the colon can hide important findings and result in the need to repeat the procedure. It is critical that you follow the instructions as directed. It is important that you follow the prep instructions as below, and not those located on the prep kit packaging. Prior to and during the procedure you will receive sedation (unless you request otherwise) through and IV. The sedation interferes with forming memories, so most patients do not even remember the procedure. Your physician will discuss any findings of your procedure with you in the recovery room. If biopsies are taken or polyps removed, you will receive a letter or MyChart message in 2-3 weeks detailing the final results and recommendations. If your results require a change in your current treatment plan, you may receive a phone call from the office. We make every effort to keep your appointment at the scheduled time, however unexpected delays may occur and your wait time prolonged. Please note that you may be asked to come in earlier than your scheduled time to accommodate changes that occur in the schedule. We give each patient the attention needed for his or her procedure and appreciate your flexibility. Make sure that you arrange for an adult to drive you home from your procedure (you will not be able to drive for 24 hours after your procedure). Your procedure will be postponed if you do not have a driver who is over 18 years of age present. Taxis, Uber, Lyft and public transportation is not allowed unless you have an adult traveling with you. Medical transport is an option. Page 1 of 4 Please review the following information if you are diabetic or take any of the following medications: Coumadin, Plavix, Effient, or any other anticoagulants: Diabetes: Check with your health care provider who manages your diabetes if you have questions. Inform your doctor that you will be on clear liquids the day prior to your procedure. Check your blood sugar frequently while taking the prep solution and on the morning of your procedure. On the day before the procedure: DO NOT TAKE ANY DIABETES PILLS REDUCE YOUR MORNING AND EVENING DOSES OF LONG ACTING INSULIN BY ONE HALF. On the day of the procedure, DO NOT TAKE ANY DIABETES PILLS DO NOT TAKE ANY LONG ACTING INSULIN DO NOT TAKE ANY SHORT ACTING INSULIN UNLESS YOU ARE USING A SLIDING SCALE. Hard candy or clear soft drinks are ok if your blood sugars are too low. Coumadin, Plavix, Effient and other anticoagulants: If you have been instructed by your gastroenterologist to discontinue your anticoagulant, please ask the physician who prescribed the medication how to take it before and after your procedure. Please do not assume that you can safely follow the same medication adjustments that have been made for your previous procedures. If you cannot contact your physician, call us at least 7 days before your exam. CONTINUE TO TAKE YOUR OTHER PRESCRIBED MEDICATIONS (such as heart or blood pressure medications) AS USUAL. If you have any questions about your medications, please contact the prescribing physician. 5 DAYS PRIOR:__________ Go to your pharmacy (if you have not already done so) to purchase your supplies 64 ounce bottle of Gatorade (NO red or purple colors) 238 gram bottle of Miralax (this is available over the counter) One 10 ounce bottle of magnesium citrate solution (clear in color)- this is over the counter 3 DAYS PRIOR:__________ Begin a low fiber diet. Examples of foods that ARE allowed on a low fiber diet include: White bread or rolls without seeds White rice and plain white pasta such as egg noodles or macaroni Saltine crackers Refined cereals such as cream of wheat Pancakes or waffles made from white refined flour Most canned or cooked fruits without skins, seeds or membranes Fruit and vegetable juice with little or no pulp, fruit flavored drinks and flavored waters Page 2 of 4 Canned or well cooked vegetables without seeds, hulls or skins such as carrots, mashed potatoes, tomatoes that are peeled and seed free Meat, poultry and fish Eggs Tofu Creamy peanut butter Milk and foods made from milk such as yogurt, pudding, ice cream, cheeses and sour cream Butter, margarine, oils and salad dressings without seeds Desserts with no whole grains, seeds, nuts, raisins or coconut Examples of foods NOT allowed on a low fiber diet include: Whole wheat or whole grain breads, cereals and pasta Brown or wild rice and other whole grains such as oats, kasha, barley, quinoa Dried fruits Raw fruit, including those with seeds, skins or membranes, such as berries Corn Dried beans, peas and lentils Seeds and nuts, and any food containing them Coconut Popcorn 2 DAYS PRIOR:__________ Continue low fiber diet. Approximately two hours after your evening meal, drink 10 ounces of magnesium citrate followed by 8-10 ounces of water. Chilling or drinking over ice may improve the taste. You may begin to have bowel movements in 30 minutes to 3 hours. Later that evening, drink two additional glasses of water to help prevent dehydration. 1 DAY PRIOR:__________ Before 10:00 am you may eat a low fiber breakfast. If preferred, you may mix the prep solution now by adding the ENTIRE bottle of Miralax to the 64 ounces of Gatorade (this may need to be done in a separate, larger container), making sure to mix or shake until dissolved, and place in the refrigerator for use later. At 10:00 am, begin a clear liquid diet. NO SOLID OR SOFT FOODS. Drink at least 64 ounces (about 2 liters) of clear liquids throughout the day. Clear liquid diet examples: As a rule, if you can see through it, you can drink it. Water Ice popsicles Strained fruit juice (no pulp) Lemon-lime soda Broth or bouillon Sports drink (Gatorade or similar) Ginger ale Plain Jell-O with no added fruit or toppings Lemon Sorbet Tea Crystal Light Black coffee ALCOHOL AND RED OR PURPLE COLORED LIQUIDS ARE NOT ALLOWED! Page 3 of 4 At 7:00 pm the EVENING BEFORE the procedure: If you have not already mixed the prep solution, add the ENTIRE bottle of Miralax to the 64 ounces of Gatorade (this may need to be done in a separate, larger container) and mix or shake until dissolved. You may pour this solution over ice before drinking if you desire. Drink one 8 ounce glass every 10-15 minutes until half of the solution is gone. Make sure that you refrigerate the remaining solution, as this will be used later. NOTE: Individual responses to laxatives do vary. This prep should cause multiple bowel movements and often works within 30 minutes, but may take up to 3 hours. Procedure day: Five hours prior to your arrival, drink one 8 ounce glass of the remaining solution every 10-15 minutes until it is gone. You may continue to drink water or clear liquids after completing the bowel prep. *** YOU MUST STOP DRINKING CLEAR LIQUIDS 2 HOURS PRIOR TO YOUR ARRIVAL TIME*** You may brush your teeth and shower prior to leaving home for your procedure. You may also take any medications you need with a small sip of water. DO NOT wear jewelry or bring any valuables to your procedure. Page 4 of 4 .
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