Colonoscopy 2 DAY MAG CITRATE + MIRALAX - Manhattan Gastroenterology

Colonoscopy is an important and routine screening examination that can save your life. The bowel preparation instructions below are intended to guarantee that little or no stool remains in your intestine before the procedure to ensure its effectiveness. Please follow them carefully and contact your gastroenterologist in case of any concerns.

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2 DAY COLONOSCOPY PREPARATION: MAG CITRATE AND MIRALAX
PLEASE PURCHASE	Over the counter at local pharmacy Dulcolax (bisacodyl) 5 mg pills (need 6 pills total) Magnesium citrate 10 oz bottle Miralax 238 gram bottle Gatorade – two 32 oz bottles (No Red, Purple or Orange Color)
7 DAYS BEFORE	Stop fiber supplements and iron supplements, including multivitamins
4 DAYS BEFORE	Begin a LOW FIBER Diet including: White or sour dough bread White Rice, Pasta Eggs, Chicken, Turkey, Fish Cheese, Yogurt, Milk, Ice Cream, Pudding Canned or cooked fruit/vegetables without skin or peel (carrots, cucumbers, potatoes) Pureed fruits/vegetables (smoothies, strained puree soups) Creamy peanut or almond butter	High Fiber Foods to AVOID: Raw fruits/vegetables with seeds, skin, membranes Cooked/canned fruit/vegetables with skin/seeds/peel Whole wheat or multigrain bread or crackers Nuts, Seeds Popcorn Oatmeal, bran cereal Brown rice, quinoa
3 DAYS BEFORE	Continue LOW FIBER Diet Avoid solid foods after midnight
2 DAYS BEFORE	Begin FULL LIQUID Diet: Smoothies Pureed soups Milk and milk products (yogurt without fruit, pudding, ice cream, sherbet) Clear liquids (see list under “1 day before”) 6PM: Take Dulcolax 3 tablets with sips of water 7PM: Take Magnesium Citrate Drink the 10 oz bottle of magnesium citrate Next drink at least three 8 oz glasses of water or other clear liquid Drink ALL of this liquid within an hour
1 DAY BEFORE	MORNING: Start a CLEAR LIQUID Diet Water Apple, White Grape, White Cranberry Juices without Pulp Clear Soup/Broth Tea or Black coffee (no milk/creamer) Gatorade/Powerade (no red, purple or orange color) Jello (no red, purple, or orange color) Popsicles (no red, purple, or orange color) 6PM: Take Dulcolax 3 tablets with sips of water 7PM: Pour half of the Miralax into one Gatorade bottle and half into the second Gatorade bottle; shake until dissolved Drink one 32 oz bottle, a cup every 15 minutes until completed Put the second 32 oz bottle in the refrigerator Bowel movements should begin 1-2 hours after starting the Miralax/Gatorade mix but the effect can be delayed by up to 4-6 hours

DAY OF COLONOSCOPY
5 HOURS BEFORE	Drink the second 32 oz bottle of Miralax/Gatorade A cup every 15 minutes until completed By the end of the cleanse your stool should be a clear liquid with yellow or green tinge
3 HOURS BEFORE	Stop drinking/eating clear liquids Do not chew gum or mints Take regular medications with a small sip of water the morning of your procedure unless otherwise instructed by your physician
30 MIN BEFORE	Arrive at endoscopy suite 30 MIN PRE PROCEDURE (no later!) Bring list of current medications including doses Bring a Photo ID and Insurance Card Bring any applicable Referrals Please do not bring any valuables

GENERAL INSTRUCTIONS:
URINE PREGNANCY TESTING	If you are a premenopausal woman, you will need to submit a urine sample upon office check in
IF YOU HAVE DIABETES	Contact your primary care doctor or endocrinologist for instructions regarding your medications
IF YOU TAKE MEDICATION TO THIN YOUR BLOOD	Contact your gastroenterologist for further instructions Medications include but are not limited to: Heparin, Lovenox, Warfarin (Coumadin), Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban (Lixiana, Savaysa), Betrixaban (Bevyxxa), Clopidigrel (Plavix), Prasugrel (Effient), Brilinta (Ticagrelor)
IF YOU TAKE WEIGHT LOSS MEDICATIONS	Alert your GI provider to discuss holding your medication(s) prior to your procedure
IF YOU TAKE ASPIRIN OR BLOOD PRESSURE MEDICATIONS	Continue to take these medication(s)
ESCORT	Please ensure that you have an escort (responsible adult over the age of 18) to pick you up at the end of the procedure

Updated on Dec 13, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology