Preparing for Your Colonoscopy

Please read the following instructions now.

A thorough colon cleansing is key to its success. 

Insurance Information

Please check with your health insurance provider to ensure your "Endoscopic exam with MAC Anesthesia" is covered by your insurance plan. Please check Middleton Family Medicine webpage for additional information.

  • Dr. Ollington (NPI- 1821258195)

  • Dr. Demarkles (NPI-1376578534)

  • Orthopedic Surgical Center of The North Shore (NPI: 1285746263)

    • If biopsy is needed, tissue is taken to Beverly Hospital Pathology Department.

    • Beverly Hospital (NPI: 1316917941)

  • Colonoscopy (CPT Code 45380)

  • Ask if Anesthesia is covered.

    • Name: Propofol (Code: J2704 For 10mg IV)

 

Introduction

It is important to follow all the instructions in this guide.

If you do not, your procedure will be delayed or rescheduled for another time. If you have questions after you read this or are not sure how to prepare for your colonoscopy, please contact your health care provider. 

What to Know Before Your Visit

 

Medication Instructions

5 days prior to your colonoscopy you should hold: 

  • Fish oil 

  • Iron medication

  • Vitamin E

  • Ibuprofen

  • Fiber supplements

 

If you have diabetes: Hold oral diabetic medications the evening prior and morning of the procedure. If you take a daily long acting insulin, continue your current dose. If you take short acting insulin, take 1/2 of your usual dose or dose the insulin per carbohydrate, When you are limited to clear liquids. Monitor your blood sugars throughout the day, especially if having unexplained weakness, sweating, etc. Consume plenty of water and electrolytes throughout the colon preparation. 

 

If you take blood-thinning medications: Blood-thinning medications affect clotting and bleeding. Both the health care provider who manages these medications and the provider doing your procedure will need to decide if your medications need to change.

 

Some examples of generic and brand name medications that affect blood thinning are: 

  • Warfarin (Coumadin, Jantoven)

  • Clopidogrel (Plavix)

  • Prasugrel (Effient)

  • Ticagrelor (Brilinta)

  • Ticlopidine (Ticlid)

  • Cangrelor (Kengreal)

  • Cilostazol (Pletal)

  • Dabigatran (Pradaxa)

  • Rivaroxaban (Xarelto)

  • Apixaban (Eliquis)

  • Edoxaban (Savaysa)

  • Heparin

  • Enoxaparin (Lovenox)

  • Dalteparin (Fragmin)

  • Fondaparinux (Arixtra)

  • Aggrenox

  • Vorapaxar (Zontivity)

  • Fish oil Curcumin 

 

Aspirin 81 mg per day should NOT be stopped IF you have had a heart attack, angina, TIA, or stroke. 

Contact the health care provider who manages your anticoagulation and ask them about when, and for how long, you can stop taking them (usually 3-7 days before the exam depending on the half life of the drug). Following the procedure, you will be informed when to restart your anticoagulation. 

 

Diuretics should be taken up to the day before the exam. You should not take your diuretic on the morning of the procedure but should resume it that evening. You should take your blood pressure medications the morning of the exam.

 

Eating & Drinking Instructions

Eating and drinking instructions are the same for all colon-cleansing preparations.

 

About ALL Colon-Cleansing Preparations

All preparations work best when you take them as a split-dose. This means you take the first dose the evening before your procedure. You take the second dose the day of your procedure.

 

It is very important to drink all of the preparation solution. 

  • Colon-cleansing preparations cause frequent, liquid stools.

  • You may have your first bowel movement about one hour after you start to drink the solution.

  • You may continue to pass liquid stools up to 3 hours after you finish the solution.

  • In patients with a history of constipation it may take longer to have the first bowel movement after starting the prep. 

TIPS

Find it hard to tolerate the taste of the solution?

  • Refrigerate the solution and drink it cold. Do not add ice or flavorings. 

  • Suck on ice or a lemon or lime wedge. 

  • Chew gum right before you drink each glass of solution. 

  • Drink the solution through a straw. 

Side Effects from the preparations may include bloating, stomach cramps, nausea and vomiting. You also may have chills, headache and irritation of your anal area. If you have severe cramps, nausea or vomiting, drink the solution more slowly until your symptoms improve.

 

If you develop a skin rash or itching, stop drinking the solution. Call your health care provider right away. These may be signs of a serious allergic reaction. 

 

Plan ahead for your second dose

  • Note how your body reacts to the evening dose of the preparation solution.

  • Give yourself plenty of time the next day to finish your morning dose and travel to your appointment. 

 

Specific Colon-Cleansing Preparation Instructions

There are a number of different colon cleansing preparations. The prep recommended for you is based on factors such as your medical condition and insurance coverage. 

Click on the colon-cleansing preparation you've been instructed to use to view information.

Miralax

SGoLYTELY
PEG-3350
Colyte
TriLyte

NuLYTELY

GaviLyte-Cports

Suprep

 

Miralax

Purchase the following over the counter:

  1. Miralax 8.3 ounce bottle

  2. 96 fluid ounce of non-red Gatorade/Powerade

  3. 4 Senna tabs/caps 8.6 mg

  4. 2 Simethicone (gas-x) 125 mg

 

PLEASE NOTE: 

The directions on the MiraLAX box may differ from the directions in this section.

Read and follow the instructions in this section. 

MiraLAX comes in an 8.3-ounce (238 gram) bottle. 

 

Prepare the solution: 

  • Mix 96 ounces of room temperature “non-red” colored Gatorade or Powerade with the entire 238 grams of MiraLAX powder. 

  • Refrigerate the prepared solution. Consuming a large volume of chilled liquid might cause you to develop chills.

 

The evening before your procedure: 

  1. At 5 pm:

    1. Take 4 Senna (8.6 mg) pills with water 

  2. At 6 pm:

    1. Drink 64 ounces total after mixing.

    2. Drink 32 ounces of miralax solution.

    3. Take 1 tablet/capsules 125mg dose of simethicone and finish the remaining 32 fluid ounces of miralax solution you do not need to take a break in between.

    4. Drink 8 ounces every 15-20 minutes

    5. If you become nauseated then stop for 30 minutes and then resume the prep. 

 

 

The day of your procedure: 

 

Between 2 am and 3:30 am take the 2nd dose of the prep.

  1. You should take 1 tablet/capsule 125 mg dose of simethicone and consume the remaining 32 ounces of the Miralax solution.

  2. You should not consume any liquids after you finish the remainder of the prep.

  3. If you take daily medication(s), you may do so up until 2 hours before your scheduled report time with water or other clear liquid.

 

GoLYTELY, PEG-3350, Colyte, TriLyte, NuLYTELY or GaviLyte-C

Purchase the following over the counter:

  • GoLytely, PEG-3350, Colyte, TriLyte, NuLytely, and GaviLyte

    • (All equivalents)- see Pharmacist.

  • 4 x Senna tabs/caps 8.6 mg- Over the counter

  • 2x Simethicone (gas-x) 125 mg- Over the counter

 

PLEASE NOTE: 

The directions on the cleansing preparation box may differ from the directions in this section. Read and follow the instructions in this section.

 

Prepare the solution: 

  1. All of these colon cleansing preparations come as a powder in a jug.

    • Dissolve the powder in water before you drink the solution. 

  2. Fill the jug about halfway with lukewarm water.

    • Warm water dissolves the powder better than cold water. 

  3. Shake the jug well to dissolve the powder. 

  4. Add cold water to the fill mark on the jug. Again, shake the jug well. The full jug contains sixteen 8- ounce cups of solution. 

  5. Do not add ice or any flavorings to the solution. 

  6. Keep the jug away from heat and direct light. 

  7. You may refrigerate the jug or keep it on ice until you drink all the solution. 

  8. Use the solution within 24 hours after you mix it.

 

The evening before your procedure: 

  1. At 5 pm:

    1. Take four 8.6 mg senna pills with 8 ounces of water. 

  2. At 6 pm:

    1. Shake the jug of mixed solution well. 

    2. Drink one 8-ounce cup (240 milliters) of the solution. Drink it quickly. The solution will not work as well if you sip small amounts. 

    3. Every 10 to 15 minutes, quickly drink another cup of solution.

      • Do this until you drink 8 cups of the solution. This will take about two hours. 

        After consuming 8 cups take 1 125 mg dose of Simethicone (gas-x) with next 4 cups of the solution you should drink 12 cups of the prep total and will take 3 hours to complete the night before.

    4. Keep the rest of the solution to drink on the day of your procedure. Keep the jug away from heat and direct light. You may refrigerate the jug or keep it on ice. 

 

 

The day of your procedure: 

 

Between 2 am and 3:30 am take the 2nd dose of the prep.

  1. Shake the jug of mixed solution well and take one 125 mg of simethicone (gas X) with a sip of water.

  2. Quickly drink one 8-ounce cup of the solution. 

  3. Every 10 to 15 minutes, quickly drink another cup of solution. 

  4. Do this until you drink the rest of the solution. 

  5. You should not consume any liquids after you finish the remainder of the prep.

  6. If you take daily medication(s), you may do so up until 2 hours before your scheduled report time with water or other clear liquid.
     

 
 

Suprep

Purchase the following over the counter:

  • Suprep- see pharmacist.

  • 4 x Senna tabs/caps 8.6 mg- Over the counter

  • 2 x Simethicone (gas-x) 125 mg- Over the counter

 

PLEASE NOTE: 

The directions on the Suprep box may differ from the directions in this section. Read and follow the instructions in this section. 


Suprep comes with two 6-ounce bottles of solution and a 16-ounce mixing container. 

 

The evening before your procedure: 

  1. At 5 pm:

    1. Take 4 senna 8.6 mg pills with water. 

  2. At 6 pm:

    1. Pour one bottle of solution into the mixing container. 

    2. Add cold water to the 16-ounce (480 milliliter) line on the container and mix.

      • Do not drink Suprep without adding water. 

    3. Drink all the mixed solution in the container. 

    4. Over the next hour, drink two 16-ounce containers of water and take one 125 mg dose of simethicone (makes colon less bubbly). This step is important. It keeps you hydrated and helps the solution cleanse your colon better. 

 

 

The day of your procedure: 

 

Between 2 am and 3:30 am take the 2nd dose of the prep.

  1. Pour the second bottle of solution into the mixing container. 

  2. Add cold water to the 16-ounce (480 milliliter) line on the container and mix. 

  3. Drink all the mixed solution in the container. 

  4. Take one dose of simethicone 125 mg and drink two 16-ounce containers of water 

  5. You should not consume any liquids after you finish the remainder of the prep.

  6. If you take daily medication(s), you may do so up until 2 hours before your scheduled report time with water or other clear liquid.