03116 MiraLAX Colonoscopy Bowel Prep Instructions

Preparing for Your Colonoscopy with UVA Digestive Health

Thank you for choosing us to provide your care. Please follow the following guidelines and preparation instructions to help make for a successful experience.

IMPORTANT: Some medications, such as diabetes medication and blood thinners, could cause complications during your upcoming procedure. If you take any of the following medications, contact the doctor who prescribes them to you two weeks before your procedure date and ask if you need to temporarily stop taking these medications.

• Weight-loss or diabetes medication, including Mounjaro®, Ozempic®, Saxenda®, Victoza®, Wegovy®.
• Blood thinning medication, including Aggrenox®, Coumadin®, Eliquis®, Lovenox®, Persantine®, Plavix®, Pletal®, Pradaxa®, Ticlid®, Warfarin, Xarelto®.

If you take any of these medications, we also recommend that you follow a clear liquid diet for 1 day before this or any endoscopic procedure during which you will be sedated, or “go to sleep,” during the procedure. While following a clear liquid diet, you can drink water, broths, and other sugar-free clear liquids. This will help empty your stomach, which is necessary for these procedures.

If you take a daily Aspirin, continue taking your Aspirin.

• You MUST have a driver on the day of your procedure: As you will receive anesthesia medications on the day of your procedure, you must have a responsible adult 18 years or older who can drive you home. For your safety, UVA Health recommends that this person stay with you for several hours after your procedure. You may not drive for 24 hours after your procedure.
• Visitors: Please find the most up to date visitor information on the UVAHealth website https://uvahealth.com/patients-visitors/visiting-patient, or call us to ask if visitors are allowed at the time of your procedure (434) 243-3090.
• Medication and allergy information: Please bring a complete list of your current medications, their doses, and any allergies you may have.
• Pacemaker or Internal Defibrillator: Please bring your device information card with you.
• Personal belongings: Please leave all jewelry and other valuables at home. Please do not wear contacts the day of your procedure. If you wear glasses, hearing aids, or dentures, please bring a case with you to store these items during your procedure.
• Please note that UVA performs colonoscopies at two locations. Please confirm your location by referring to your appointment reminder letter.

We strive to provide the safest care for all of our patients. As a result, some procedures may take longer for some patients than others. Please arrive 45 minutes prior to your appointment time. We ask for your patience and that you plan to be with us at least 2 to 3 hours.

If you must cancel or reschedule your appointment, please call the UVA Endoscopy scheduling team as soon as possible at (434) 243-3090.

MiraLAX® Bowel Preparation Instructions

Two weeks before your colonoscopy:

• You will need to purchase (at any local pharmacy or grocery store):

                   o  TWO 238 gm/8.3 oz. bottles of MiraLAX® (polyethylene glycol)

                   o  TWO 64 oz. bottles (or four 32 oz. bottles) of Gatorade®, NO red or purple color

• If you take blood thinner medications, diabetes medications (including GLP-1 agonists prescribed for weight loss) contact the prescribing doctor for special instructions about taking this medication before your colonoscopy.

Five days before your colonoscopy:

• Start a low fiber diet – avoid seeds, nuts, popcorn, vegetable skin, and whole grains (see low fiber diet examples below).
• Stop iron, including vitamins/medications that contain iron.
• You may continue taking daily aspirin.
• Arrange to have someone 18 or older drive you to and from your procedure.
• Have plenty of clear liquids available at home (see clear liquid examples below).

One day before your colonoscopy:

• Drink plenty of clear liquids all day (see clear liquid examples below). No milk products or red/purple fluids. Try to drink 8 oz. (8 oz. is equal to one measuring cup) of clear liquid every hour while awake, Gatorade® is preferred.
• In the morning, mix ONE 238 gm bottle of MiraLAX® into 64 oz. of Gatorade®. Repeat this with the SECOND 238 gm bottle of MiraLAX® mixed into the SECOND 64 oz. of Gatorade®. Once dissolved, you may refrigerate the prep. You should not have any MiraLAX® powder left. 
• At 5:00 PM, begin to drink the FIRST 64 oz MiraLAX®/Gatorade® solution.
  Drink SIX 8 oz. glasses of prep solution, one 8 oz. glass every 15-30 minutes.
  • Tip: Use a straw; if you feel cold, drink warm liquids or do not refrigerate the prep.
  • If you experience nausea, vomiting or bloating, take a 30-60 minute break.
• If you have not had a bowel movement by 10 PM, drink TWO more 8 oz. glasses of prep.
• You must drink an additional 16 oz. of clear liquids before bedtime.
• Stay close to a bathroom. Cleaning your colon causes diarrhea.

Day of your colonoscopy:

• Five hours before you leave home for your procedure, drink FOUR 8 oz. glasses of MiraLAX®/ Gatorade® solution, one 8 oz. glass every 15-30 minutes (or more, until bowel movements are clear yellow). You may need to start in the middle of the night for an early morning procedure. Do not skip this part of the prep.
• Drink an additional four glasses (32 oz. total) of clear liquids over the next hour.
• Take your daily medications up to 2 hours before your procedure unless instructed otherwise by your healthcare provider.  
• Two hours before your scheduled procedure time, STOP DRINKING all liquids. If your procedure is at 8 AM, you should stop drinking by 6 AM. 
• Complete all steps on page 1 and bring requested items to your procedure.
• Arrive 45 minutes before your scheduled appointment time with a responsible adult who will be able to accompany you home.

Frequently Asked Questions

Why is it important to get cleaned inside? Your doctor must be able to see in order to complete the colonoscopy exam. If your colon has too much stool on the inside, your doctor may not be able to see important things like polyps or cancer.

Is my prep working? The bowel movement coming out should look like fluids you are drinking – yellow, light, liquid, and clear (like urine) without many particles.

What are the effects of the “bowel prep?” You will have a lot of diarrhea from the bowel prep. This will start anywhere from a few minutes to 3 hours after you start your prep. Many people have bloating, abdominal discomfort, and/or nausea. This is uncomfortable and almost always safe. Some people do not like the taste or smell of the medicine. Please do not let these get in the way of you finishing the medicine as directed.

Rarely, some people throw up while taking the prep. If you throw up, stop taking the prep for 30-60 minutes, then try taking the prep again. If you are unable to finish the bowel prep, your colon may not be clean enough for your exam.

My prep hasn't started working yet - what do I do? Different people respond differently to the bowel prep. If you have waited more than 3 hours without a response, then it may not be working well. Be sure you are drinking enough fluid. If that doesn’t work, drink the second part of your prep and continue to drink fluids. It should work eventually. Call the UVA Endoscopy Unit at (434)243-3090 on the morning of your procedure if the medicine is still not working. 

CLEAR LIQUID DIET

Change to this diet ONE DAY before your Colonoscopy. Stop drinking all liquids two hours before your procedure. You will return to your regular diet after the procedure.

Start this diet FIVE DAYS before your Colonoscopy. You will return to your regular diet after the procedure.