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Patient Guide to Colonoscopy Using MiraLAX

This information will help you prepare for your colonoscopy at Memorial Sloan Kettering Cancer Center (MSK).

A colonoscopy is an exam of the entire colon (large intestine). Your doctor will use a flexible tube called a colonoscope to see the inside of your colon on a video monitor. During the procedure, your doctor can remove a small sample of tissue (biopsy) for testing, remove a polyp (growth of tissue), and take photos of the inside of your colon.

A Week Before Your Procedure

Ask about your medications

You may need to stop taking some of your medications before your procedure. We have included some common examples below.

  • If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it. Some examples of blood thinners are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®).
  • If you 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 day before and the morning of your procedure.

If you usually take laxatives for constipation, you'll need to increase the amount you take starting 1 week before your colonoscopy. If you're not sure what to take or if you have any questions, call your doctor's office.

Get a letter from your doctor, if necessary

If you have an automatic implantable cardioverter-defibrillator (AICD), you will need to get a clearance letter from your cardiologist before your procedure.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. Please call one of the agencies below if you do not have someone who can do this. They will help find someone to take you home.

In New York:

Partners in Care (888) 735-8913

Prime Care (212) 944-0244

In New York or New Jersey:

Caring People (877) 227-4649

Purchase supplies

Purchase the supplies you'll need to prepare for your colonoscopy, which include:

  • 1 (5 mg) tablet of bisacodyl (Dulcolax®). These are usually sold as a box of 10 tablets.
  • 1 (238 gram) bottle of polyethylene glycol (MiraLAX®)
  • 1 (64-ounce) bottle of a clear liquid that is not red, orange, or purple

Eat a low-residue diet

You must start eating a low-residue diet 7 days before your colonoscopy. A low-residue diet is a diet in which you eat very few foods that are high in fiber or are hard for your body to digest. Fiber is made up of plant material that can't be completely digested by your body. Examples of foods high in fiber include whole-grain breads and cereals, nuts, seeds, and raw or dried fruits. By avoiding these foods before your colonoscopy, you can make sure your colon will be cleaned out for your procedure.

  Eat Avoid

Grains

  • White bread
  • Plain crackers, such as saltines
  • Cooked cereals, such as cream of wheat or grits
  • Cold cereals, such as corn flakes or puffed rice
  • White rice, noodles, and pasta
  • Seeds, nuts, and coconut
  • Whole-grain products, such as pasta, cereals, crackers, and breads

Fruits and Vegetables

  • Well-cooked fresh or canned vegetables without seeds, such as asparagus tips, beets, green beans, carrots, mushrooms, spinach, squash (no seeds), and pumpkin
  • Cooked potatoes without skin
  • Ripe bananas
  • Melon, such as cantaloupe and honeydew
  • Canned or cooked fruits without seeds or skin, such as applesauce or canned pears
  • Avocado
  • Most raw vegetables
  • Most raw or dried fruits, such as pineapple, raisins, and figs
  • Certain cooked vegetables, including peas, broccoli, winter squash, brussel sprouts, cabbage, corn (and corn bread), onions, cauliflower, and potatoes with skin

Meats and Protein

  • Lean and tender meats, including beef, lamb, chicken, fish, and pork
  • Eggs
  • Beans
  • Lentils
  • Tofu

Snacks

  • Plain cakes and cookies
  • Gelatin, puddings, custard, and sherbet
  • Ice cream and popsicles
  • Hard candy
  • Pretzels
  • Vanilla wafers
  • Peanut butter
  • Jam, marmalade, and preserves
  • Popcorn

Drinks

  • Coffee and tea
  • Carbonated beverages
  • Milk
  • Apple juice, no-pulp orange juice, and cranberry juice
  • Strained vegetable juices
  • Fruit juices with pulp or seeds
  • Prune juice
  • Nectars

This is also a good time to stock up on clear liquids to drink the day before your procedure.

3 Days Before Your Procedure

A few days before your procedure, you will receive a telephone call from an endoscopy nurse. He or she will review the instructions in this guide with you and ask you questions about your medical history. The nurse will also review your medications and tell you which to take the morning of your procedure. Use the space below to write them down.

The Day Before Your Procedure

Follow a clear liquid diet

You will need to follow a clear liquid diet the day before your procedure. ​

  • Do not drink anything red, purple, or orange the day before your colonoscopy.
  • Make sure to drink plenty of liquids other than water, coffee, and tea. Drinking enough liquids is an important part of your colonoscopy preparation. Try to drink at least 1 (8-ounce) glass every hour while you're awake.
  • If you have diabetes, you should drink only sugar-free clear liquids and check your blood sugar level often. If you have any questions, talk with your healthcare provider.

 

Drink

Avoid

Soups

  • Clear broth, bouillon, or consommé
  • Any products with any particles of dried food or seasoning

Sweets

  • Gelatin (such as Jello®)
  • Flavored ices
  • Sweeteners, such as sugar or honey, may be used
  • Anything red, purple, or orange

Beverages

  • Clear fruit juices, such as white cranberry, white grape, apple
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, Gatorade®
  • Black coffee (no cream)
  • Tea
  • Juice with pulp
  • Nectars
  • Milk
  • Alcoholic beverages

Prepare your MiraLAX® bowel preparation

On the morning before your procedure, mix all 238 grams of MiraLAX® with the 64 ounces of clear liquid until the MiraLAX® powder dissolves. Once the MiraLAX® is dissolved, you can put the mixture in the refrigerator, if you prefer.

Time of your procedure

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call, please call (212) 639-7882.

If you need to cancel your procedure for any reason please call the doctor who scheduled it for you.

Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.

Take your MiraLAX® bowel preparation

Emptying out your colon is a very important part of your colonoscopy. If you have stool in your colon during your colonoscopy, your doctor may not be able to perform the procedure. The MiraLAX® bowel preparation will cause frequent bowel movements, so be sure to be near a bathroom the evening before your procedure.

At 3:00 pm on the day before your procedure, take 1 bisacodyl tablet by mouth with a glass of water.

At 5:00 pm on the day before your procedure, start drinking the MiraLAX® bowel preparation. Drink an 8 ounce glass of the mixture every 15 minutes until the container is empty. When you're finished drinking the MiraLAX® bowel preparation, continue to drink clear liquids until midnight or until you go to bed.

  • Apply petroleum jelly (Vaseline®) or A & D® ointment to the skin around your anus after every bowel movement. This helps prevent irritation.
  • Drink 4 to 6 glasses of clear liquids after you finish the MiraLAX®. You may continue to drink clear liquids until midnight, but it is not required.

The Day of Your Procedure

Things to remember

  • Do not eat or drink anything the morning of your surgery. This includes water, gum, and hard candy.
  • Take only the medications you were instructed to take the morning of your procedure. You may have written them down on the first page of this guide. Take them with a few sips of water.
  • Do not put on any lotion, cream, powder, make-up, or perfume.
  • Remove any jewelry, including body piercings.
  • Leave all valuables such as credit cards and jewelry at home.
  • If you wear contact lenses, wear your glasses instead.

What to bring with you

  • A list of the medications you take at home
  • Your rescue inhaler (such as albuterol for asthma), if you have one
  • A case for your glasses
  • Your Health Care Proxy form, if you have completed one

Where to park

Parking at MSK is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about ¼ block toward First Avenue, on the right (north) side of the street. A pedestrian tunnel connects the garage to the hospital. For questions about pricing, call (212) 639-2338. There are also nearby commercial garages on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues. 

Where to go

Your procedure will take place in the Endoscopy Suite at the main hospital, which is located at 1275 York Avenue. Take the M elevator to the 2nd floor.

If you parked in the garage on 66th Street and York Avenue, follow the signs to the A elevator. Take the A elevator to the 2nd floor and enter the Endoscopy Suite through the glass doors.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.

After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleepy). Your doctor will explain the procedure, and answer any questions you have.

When it's time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. You will lay on your left side with your knees bent.

You will receive anesthesia through your IV, which will make you fall asleep. Once you are asleep, your doctor will examine your rectum. Next, a flexible tube called a colonoscope will be put into your rectum. The colonoscope is connected to a video monitor. This allows your doctor to see the inside of your colon. Your doctor will use air and fluid to move the colonoscope along the length of your colon while looking for anything unusual on the video monitor.

After Your Procedure

In the recovery room

You will wake up in the recovery room. Your nurse will continue to monitor your heart, breathing, and blood pressure. Many patients feel bloated and have stomach cramps after a colonoscopy. This is normal and goes away by passing gas. Once you are fully awake, your nurse will remove your IV. If you have someone waiting with you, your nurse will explain your discharge instructions to both of you before you go home.

At home

  • If you have had a biopsy, you may notice a few drops of blood coming from your rectum. This is normal after a biopsy, however there should be no more than a few drops and it should not last more than 24 hours.
  • You may resume your normal activities in 24 hours after your procedure.
  • Do not drink alcoholic beverages for 24 hours after your procedure.
  • Begin eating light foods as soon as you are discharged. Work your way up to your normal diet. If your doctor wants you to limit your diet for a period of time, he or she will tell you.

Call your doctor or nurse if you have:

  • A temperature of 101° F (38.3° C) or higher
  • Severe stomach pain or hardness
  • Bleeding from your rectum that lasts more than 24 hours
  • Bleeding between bowel movements
  • Weakness, faintness, or nausea
  • Heavy bleeding