Colonoscopy preparation with MiraLAX - TidalHealth Gastroenterology in Ocean Pines

Instructions for colonoscopy preparation with MiraLAX for patients of TidalHealth Gastroenterology in Ocean Pines

Your procedure will be performed at TidalHealth Delmarva Endoscopy Center located at 11103 Cathage Road, Berlin, MD 21811, near the north gate of Ocean Pines. This office can be reached at 410-677-6654.

Turn right into the second parking lot for building 4, drive around the building and stop underneath the canopy, which is one way.

Patients who develop COVID symptoms, travel internationally or are exposed to COVID between the time of scheduling their appointment and the date of the procedure, must contact our office.

Please note:

• You will be sedated. You must have a responsible adult over 18 to drive you home after the procedure. This person must pick you up from the endoscopy center and plan to stay with you.
• Do not plan on returning to work that day, making any important decisions, operating heavy machinery, no driving or drinking alcoholic beverages for the next 12 hours.
• You may not take a taxi, bus, Uber, Lyft or medical transportation, etc. home unless accompanied by a responsible adult over 18.
• If you do not have a responsible adult to drive or accompany you home, your procedure will be rescheduled.

We need 48 hours prior notice if you are going to cancel or reschedule this appointment. Please call our office at 410-912-6021 or 410-677-6654.

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7 days before the procedure

You will need to purchase:

• One (1) Bottle of MirLAX powder (238 grams or 8.3 ounces)
• Four (4) Dulcolax (bisacodyl) 5 mg laxative tablets (not the stool softener tablets)
• One (1) 64 oz. bottle of Gatorade (not red or purple)  If you have diabetes, you may purchase a no- or low-calorie drink such as Crystal Light instead. Do NOT purchase a carbonated drink.
• One (1) bottle of magnesium citrate (any flavor)

Seven (7) days prior to your procedure you must STOP the following medications:

• Advil
• Aleve
• Celebrex (celecoxib)
• Daypro (oxaprozin)
• Indocin (indomethacin)
• Iron
• Mobic (meloxicam)
• Motrin
• Naprosyn (naproxen)
• Voltaren (diclofenac)

We will contact your prescribing physician for permission to hold blood thinners. Please follow up with your prescriber to confirm they have given permission to hold the medication and for how long.

If you are a diabetic and take pills, injections or insulin, please contact your medical provider who prescribed this medication for instructions as these may lower blood sugar too much before the procedure.

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3 days before your procedure

Three (3) days prior:

Please purchase Dulcolax Laxative 5 mg tablets at the pharmacy.

You will take Dulcolax 5 mg tablets daily at bedtime for 3 days prior to your clear liquids prep day.

For example, if your procedure is scheduled on a Monday, you will take one (1) 5mg Dulcolax tablet on Thursday, Friday and Saturday. Sunday will be your Clear Liquids day.

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The day before your procedure

Upon awakening, you may only have clear liquids. You may not have any solid foods including breakfast. Please follow the clear liquid diet below.

Do not consume:

• Red or purple colored liquids or products.
• Milk, cream or non-dairy substitutes (such as artificial creamer, soy or nut milks)
• Juices containing pulp (I.e. orange, grapefruit, pineapple, tomato & V-8 juice) or frozen juice products containing pulp
• Alcoholic beverages
• Solid foods

Do not follow the instructions on the MiraLAX box. Follow the below instructions.

6 pm - first dose

Drink only clear liquids for breakfast, lunch and dinner. NO solid foods or dairy products allowed. Please refer to the clear liquid diet included in your colonoscopy instructions provided.

• In the morning, mix the 238-gram bottle of MiraLAX with 64 oz. of Gatorade. Shake until the MiraLAX has dissolved. Refrigerate
• At 6 pm, take (4) Dulcolax/bisacodyl tablets with an 8 oz. glass of clear liquid.
• At 8 pm, begin drinking an 8 oz. glass of the Gatorade solution every 10-15 minutes until 32 oz. has been consumed (half of the total volume mixed).

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The day of your procedure

6 hours before your procedure time - second dose

• Begin the second dose of your prep at the time indicated below.
• Drink an 8 ounce glass of the MiraLAX/Gatorade mixture every 10-15 minutes until finished.
• Nothing 4 hours prior to your procedure including hard candy, chewing gum, prep, etc.

Take your medications such as aspirin, blood pressure, Parkinson's, seizure, or asthma medications. Please take these medications four (4) or more hours prior to the procedure start time with only a small sip of water.

If a physician has prescribed for you an inhaler for asthma, bring it with you to the procedure.

Additional instructions:

• Bring your photo ID, insurance cards and co-payment, if required.
• Wear comfortable clothing. Do not wear jewelry or bring valuables.
• Do not wear perfume or lotions, deodorant is allowed
• If you use a CPAP or BIPAP please bring your device the day of the procedure.

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What to expect

• Expect to have frequent bowel movements and diarrhea within 1-4 hours. Be patient and try walking around to stimulate bowel motility. Remain near a restroom. During this time, continue your preparation.
• Expect to pass clear or yellow fluid at the completion of your preparation.
• You must complete all doses of your preparation even if you are passing clear or yellow fluid early in the process.
• Patients should continue drinking clear liquids up to four (4) hours before the procedure. During the four (4) hours before your procedure, consume nothing by mouth, not even water, chewing gum or candy.
• Your procedure may be cancelled under the following circumstances: failure to fully complete the preparation or inadequate preparation (not passing clear or yellow fluid); consuming anything (including liquids) by mouth within four (4) hours of the procedure.

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What to do to make preparation easier

• Use Desitin, Anusol, Tucks pads or Vaseline to coat the rectal area to avoid irritation during the preparation.
• Drink the preparation solution with a straw or hold your nose when drinking.
• Slow down between doses if feeling nauseous.
• If you vomit the preparation, take a break and then continue drinking the preparation slowly once vomiting passes.