You have been scheduled for a colonoscopy at Duke Gastroenterology of Raleigh. This procedure is performed by passing a thin flexible tube through your large intestine to examine its lining. For this procedure you will receive intravenous moderate sedation.

Duke University Medical Center is following the recommendation of the American College of Gastroenterology (ACG), which now recommends splitting the dose of colonoscopy bowel preps.

The first dose to be taken the night before the colonoscopy, and the second dose to be taken the day of the procedure. This literature has shown to have a better prep quality, tolerance, and a decrease in missed cancers.

MiraLAX is a prep that does not require a prescription and has been shown to be equivalent to other GI preparations. If your physician has prescribed you a different colonoscopy prep, please follow his or her orders. It is very important you do not take two colonoscopy preps.

Preparation for Your Procedure

• Please fill your preparation prescription at least one week prior to your procedure date at your pharmacy of choice and read through these instructions thoroughly.

• Daily prescription medications: Please take your morning medications the day of your procedure with a sip of water except any medications for diabetes. Please hold your morning dose of diabetes medications. If you take insulin, take half of your usual dose the day before your procedure and hold your insulin the day of your procedure.

• Please do not drink anything except your prep, three hours before your procedure.

• You must have a driver over the age of 18 years old (with a valid driver’s license) to accompany you and drive you to and from your procedure. Your driver must remain on site until your procedure is completed and until you are discharged.

• If you are having your procedure at Duke Raleigh Hospital, you are required to have the person accompanying you to your procedure remain with you at home for the rest of the day.

• If you are taking medications that thin your blood -- lovenox, coumadin, or plavix -- please ask the physician performing your procedure if you should hold these medications. You do not need to hold aspirin products.

• Please bring a list of your current medications to your procedure.

• Please bring your insurance card, picture identification, and copayment.

• If you do not have a driver or you do not complete your preparation, your procedure will be canceled.

If you are scheduled for your procedure at our office, a nurse from our staff will call you prior to your procedure to review your health history, medication use and preparation instructions.

If your procedure is scheduled at Duke Raleigh Hospital, you may be required to speak with a hospital staff nurse or have a pretesting appointment.

If you are required to have a pretesting appointment, based on a review of your medical history and you do not follow up with the pretesting department at Duke Raleigh Hospital, your procedure may be canceled.

If you miss our call, please contact us promptly and ask to speak to a nurse concerning your procedure.

MiraLAX Colonoscopy Preparation

You will need to drink a laxative solution to clean your colon prior to your colonoscopy. You must drink the entire solution to ensure the most effective cleansing.

Read through these instructions completely before beginning the prep. If you have any questions,or if you have kidney disease or are on dialysis. A nurse will call you to review the instructions at least one week prior to your procedure.

Five Days Before Your Colonoscopy

• Begin a restricted residue diet
• Do not eat nuts, seeds, popcorn, corn, etc.
• Discontinue fiber supplements such as Metamucil, Citrucel, Fiberall, etc.

Two Days Before Your Colonoscopy

• Take two tablespoons of milk of magnesia at 8:00 p.m.

One Day Before Your Colonoscopy

• No solid food
• Drink clear liquids only for breakfast, lunch, and dinner (see list below)
• In the morning, put the bottle of Gatorade (G2) in the refrigerator to chill
• At 3:00 p.m. take two Dulcolax tablets with a clear beverage of your choice
• At 5:00 p.m. pour the 238-gram bottle of MiraLAX powder into the 64-ounce bottle of Gatorade (G2)
• Shake the solution until the MiraLAX is completely dissolved
• Drink one eight-ounce glass every 10 to 15 minutes until the solution is three quarters gone
• Refrigerate remaining prep for the morning. It is important to continue drinking clear liquids until bedtime.

If you experience nausea, slow down the pace of drinking or take a short break, then resume drinking.

Day of Your Colonoscopy

• Four hours before you leave for your procedure, drink one eight-ounce glass of the MiraLAX solution every 10 to 15 minutes until solution is gone.
• You may have clear liquids up to two hours prior to your procedure.
• You should not have anything by mouth after that time. Follow the recommendations on the colonoscopy prep instruction sheet regarding your medications.

Clear Liquid Diet List

Drinking clear liquids will help with your preparation.

Beverages

• Soft drinks: orange, ginger ale, cola, Sprite, 7-Up, Gatorade, Kool-Aid (not red or purple)
• Strained fruit juices without pulp: apple, white grape, orange, lemonade
• Water
• Do not drink anything with red or purple coloration

Soups

• Chicken or beef broth

Desserts

• Hard candies
• Jell-O gelatin (lemon, lime or orange; no fruit or toppings)
• Popsicles (no sherbet or fruit bars)

Contact Information

Please call our GI Scheduling Hub at 919-684-6437 if you have questions, or visit Duke Gastroenterology for additional information.

E-mail: DGIR@mc.duke.edu