How To Clean Out Your System With Miralax

This information will help y'all go ready for your colonoscopy using polyethylene glycol (MiraLAX^®).

A colonoscopy is a test that lets your doctor come across inside your colon (large intestine). Your dr. volition utilize a colonoscope (flexible tube with a camera on the cease) to run across the inside of your colon on a video monitor. During your process, your dr. tin:

• Remove a pocket-sized sample of tissue (biopsy) for testing
• Remove a polyp (growth of tissue)
• Take photos of the within of your colon

Before your procedure, you must follow these instructions carefully. You volition need to do a bowel preparation to empty your colon before your procedure. It's very important that your colon is empty for your colonoscopy. If there's stool (poop) inside your colon, your doctor may non exist able to see polyps or other bug inside your colon and you may take to echo the procedure. If you have any questions, contact your medico's office.

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1 Calendar week Before Your Process

Arrange for someone to take y'all domicile

Y'all must have a responsible care partner take y'all dwelling after your procedure. A responsible intendance partner is someone who tin can assist you get habitation safely. They should exist able to contact your care team if they accept whatever concerns. Make sure to plan this before the day of your procedure.

If you don't accept a responsible care partner to take you domicile, call one of the agencies below. They'll transport someone to go abode with you. In that location's oftentimes a charge for this service, and yous'll demand to provide transportation. It'due south OK to use a taxi or car service, just you still need a responsible care partner with you.

Ask virtually your medications

You may need to stop taking some of your medications before your procedure. Talk with your physician about which medications are safe for yous to stop taking. We have included some mutual examples below.

Anticoagulants (claret thinners)

If you take a claret thinner, such as to treat blood clots or to prevent a heart attack or stroke, ask the medico who prescribes it for you when to stop taking it. Examples are listed in the "Mutual anticoagulants (blood thinners)" table. There are others, so check with your physician if you're not sure.

Common anticoagulants (blood thinners)
apixaban (Eliquis®) cilostazol (Pletal®) clopidogrel (Plavix®) dalteparin (Fragmin®)	enoxaparin (Lovenox®) fondaparinux (Arixtra®) heparin	rivaroxaban (Xarelto®) tinzaparin (Innohep®) warfarin (Coumadin®)

Medications for diabetes

If you take insulin or other medications for diabetes, you may need to change the dose. Inquire the doctor who prescribes your diabetes medication what y'all should do the day before and the morning of your procedure. Tell your dr. you will be drinking a sugar-costless clear liquid diet the twenty-four hours before your process.

If you take metformin (such as Glucophage^® or Glumetza^®) or a medication that contains metformin (such as Janumet^®), don't take it the day before or the day of your process.

Tell your doctor if yous accept an AICD

Tell your Memorial Sloan Kettering (MSK) physician if you take an automated implantable cardioverter-defibrillator (AICD).

Get a letter from your doctor, if needed

• If you accept an automatic implantable cardioverter-defibrillator (AICD), y'all will need to go a clearance letter of the alphabet from your cardiologist (heart doctor) before your procedure. A clearance letter of the alphabet is a letter that says yous can safely have the procedure.
• If you've had chest pain, dizziness, problem breathing that's new or worse, or have fainted in the last 6 weeks, you need to be examined by your physician, and go a clearance alphabetic character from your doctor before your procedure.

Your MSK doctor'due south office must have your clearance letter at to the lowest degree 1 day before your process.

Buy supplies

You lot will demand to buy the following supplies for your bowel preparation:

• four (5 mg) tablets of bisacodyl (Dulcolax^®). These are ordinarily sold as a box of 10 tablets.
• 1 (238 gram) bottle of polyethylene glycol (MiraLAX ^®).
• 64 ounces of whatever clear liquid that isn't red, imperial, or orangish. You volition need to mix this with the MiraLAX. Keep it at room temperature.
  • A sports beverage like Gatorade^® or Powerade^® is a good option. Sports drinks volition help replace electrolytes that yous will lose during the bowel training.
  • If yous have diabetes, exist sure to go sugar-free clear liquids.

Some people may need other supplies. To see if you demand whatsoever other supplies, answer the questions below:

• Do you tend to be constipated (accept fewer bowel movements than what's normal for you) or accept fewer than 3 bowel movements per week?
• Do you have narcotic (opioid) medications such as fentanyl (Duragesic^®, Subsys^®) morphine (DepoDur^®, Duramorph^®), hydrocodone (Vicodin^®) or oxycodone (Oxycontin^®, Percocet^®)? If you're non certain, ask your healthcare provider.
• Have you had a colonoscopy with a poor prep in the past? This means that during your colonoscopy, your healthcare provider still saw stool in your colon.

If you answered yes to any of the questions, you must too buy the post-obit supplies:

• 3 (17 gram) doses of MiraLAX (for a total of 51 grams).
  • You can buy 1 boosted small bottle (119 grams) or the packets.
• More liquids for a full liquid diet.
  • Examples of what you tin can drink are listed in the section called "two Days Before Your Procedure."

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5 Days Before Your Process

Stop taking fe supplements

If you take an iron supplement, you'll need to stop taking it 5 days before your process. Iron supplements tin can cause color changes in your stool, which can get in harder for your doctor to see your colon clearly.

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3 Days Before Your Process

Avert sure foods

Yous should follow a low-fiber nutrition starting iii days before your colonoscopy. During this fourth dimension, practise not consume:

• Raw (fresh) fruits and vegetables
• Whole kernel corn, including canned corn
• Whole grains (such as oatmeal, brown rice, quinoa, or wheat bread)
• Seeds (such as poppy or sesame)
• Nuts

Talk with your endoscopy nurse

A few days before your procedure, y'all'll become a call from an endoscopy nurse. They will review the instructions in this guide with y'all and inquire you questions about your medical history. The nurse will likewise review your medications and tell you which to take the morn of your procedure.

Utilize the space below to write them downward.

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2 Days Earlier Your Process

Don't start your articulate liquid diet until the twenty-four hours before your process if you lot:

• Aren't unremarkably constipated
• Don't take narcotic (opioid) medications
• Oasis't had a colonoscopy with poor prep in the past

Avoid raw fruits and vegetables, whole kernel corn, grains, seeds, and nuts. Skip to the adjacent section "The Day Before Your Procedure."

If y'all're usually constipated, take narcotic medications, or accept had a colonoscopy with a poor prep in the past:

• Take ane capful (17 grams) of MiraLAX mixed with 8 ounces of liquid at breakfast, dejeuner, and dinner.
• Follow a full liquid diet. On a full liquid diet, you may consume and drinkable the following:
  • Yogurt (without any pieces of fruit)
  • Fruit juices without pulp
  • Soda
  • Broth or cream soups that take been strained then there are no vegetable pieces
  • Nutritional supplements
  • Ice cream and fruit ices (without any pieces of fruit)

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The Twenty-four hours Before Your Procedure

Prepare your MiraLAX bowel grooming

On the morning time of the mean solar day earlier your procedure, mix all 238 grams of the MiraLAX pulverisation with 64 ounces of a room temperature clear liquid until the MiraLAX powder dissolves.

Once the MiraLAX is dissolved, you lot tin can put the mixture in the refrigerator. Many people notice it tastes ameliorate when information technology's chilled.

Don't mix the MiraLAX earlier than the morning time of the day before your procedure.

Follow a clear liquid diet

You will need to follow a articulate liquid diet the twenty-four hour period before your procedure. Examples of clear liquids are listed in the table in this section.

• Don't swallow whatever solid foods.
• Don't drink annihilation red, purple, or orange.
• Make sure to potable enough of liquids other than simply water, coffee, and tea. This helps to brand sure that you become enough calories and is an important part of your colonoscopy preparation. Try to beverage at least ane (8-ounce) drinking glass of liquid every 60 minutes while you lot're awake.
• If you have diabetes, you should drink only sugar-free clear liquids and check your blood sugar level often. If y'all have whatsoever questions, talk with your healthcare provider.

Articulate Liquid Diet
	Drink	Do Not Drink
Soups	Articulate goop, bouillon, or consommé	Whatsoever products with particles of dried nutrient or seasoning
Sweets	Gelatin, such every bit Jell-O® Flavored ices Hard candies, such as Life Savers®	Anything red, majestic, or orange
Drinks	Clear fruit juices, such as apple, white cranberry, lemonade, or white grape Soda, such as 7-Up®, Sprite®, ginger ale, or seltzer Gatorade® Black coffee Tea Water	Juices with pulp Nectars Milk or cream Alcoholic beverages Anything red, regal, or orange

Annotation the time of your procedure

A staff fellow member will call you after noon the day before your procedure. The staff fellow member volition tell you what time yous should arrive for your process. If you're scheduled for your procedure on a Monday, you will be called on the Friday before. If you don't receive a call, call your physician's office.

If y'all demand to cancel your process, call the doctor who scheduled it for you.

Start your bowel training

Step 1: At 4:00 p.thousand. on the day before your procedure, take ii bisacodyl (5mg) tablets by mouth with a drinking glass of water.

Step 2: At 4:15 p.m., start drinking the MiraLAX mixture.

1. At 4:15 p.m. , drink 1 (eight-ounce) glass of the mixture.
2. At 4:thirty p.k. , drink 1 (eight-ounce) glass of the mixture.
3. At four:45 p.m. , potable 1 (8-ounce) glass of the mixture.
4. At five:00 p.g. , drinkable i (eight-ounce) glass of the mixture.

You will drink four glasses of the mixture in total.

• When you're finished, one-half of the MiraLAX mixture will be left. Salvage the balance of it in the fridge for the second half of your preparation.
• Bowel movements usually begin inside one hour of drinking the first dose, just information technology may have longer for some people.
  • Don't worry if you don't start having bowel movements after drinking the first one-half of the MiraLAX. Go along to drinkable liquids and start the second half of the MiraLAX equally instructed.
• Put petroleum jelly (Vaseline^®) or A & D^® ointment on the pare effectually your anus after every bowel motion. This helps forbid irritation.
• Keep to drink articulate liquids to stay hydrated and affluent out your colon.

Step three (If yous were told to go far for your process before xi:00 am):

If yous were told to arrive for your procedure before xi:00 a.k., follow these instructions the night earlier your procedure:

At 11:00 p.one thousand. , take 2 bisacodyl tablets past mouth with a glass of water. Then, start drinking the second one-half of the MiraLAX mixture.

1. At xi:15 p.m. , drink ane (viii-ounce) glass of the mixture.
2. At eleven:30 p.k. , drink ane (8-ounce) glass of the mixture.
3. At 11:45 p.one thousand. , drink one (8-ounce) glass of the mixture.
4. At 12:00 a.g. (midnight), drink i (viii-ounce) glass of the mixture.

Exist sure to finish the unabridged MiraLAX mixture.

• You tin continue to drink clear liquids until 4 hours before your scheduled arrival time.
• Don't eat anything until afterwards your procedure.

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The 24-hour interval of Your Procedure

Footstep 3 (If yous were told to make it for your procedure at 11:00 a.m. or later):

If y'all were told to make it for your procedure at 11:00 a.chiliad. or later on, follow these instructions the morning of your procedure:

At 6:00 a.1000. , take 2 bisacodyl tablets by mouth with a glass of water. Then, start drinking the 2nd half of the MiraLAX mixture.

1. At 6:15 a.1000. , drink 1 (8-ounce) glass of the mixture.
2. At vi:30 a.yard. , drinkable i (8-ounce) drinking glass of the mixture.
3. At 6:45 a.k. , drinkable 1 (8-ounce) glass of the mixture.
4. At 7:00 a.m. , drinkable 1 (eight-ounce) glass of the mixture.

Be certain to end the entire MiraLAX mixture.

• You lot tin continue to drink clear liquids until 4 hours before your scheduled arrival time.
• Don't consume anything until afterwards your process.

Things to remember

• Take only the medications you were instructed to take the morning of your procedure. Take them with a few sips of water.
• Don't utilize whatsoever lotions, creams, or powder to your chest or arms.
• Remove any jewelry, including body piercings.
• Get out all valuables, such equally credit cards and jewelry, at home. We don't accept lockers to shop your valuables in.
• If you lot wear contacts, wear your spectacles instead.

What to bring

• A listing of the medications you take at dwelling house
• If yous have an implanted pacemaker or cardioverter-defibrillator (AICD), bring your wallet bill of fare with y'all.
• Your rescue inhaler (such as albuterol (Proventil^®, Ventolin^®) for asthma), if y'all accept i
• A case for your glasses
• Your Health Intendance Proxy course, if y'all have completed 1

Where to go

Your procedure will take place at one of these locations:

• Endoscopy Suite at Memorial Hospital (MSK'southward principal hospital)
  1275 York Artery (betwixt Eastward 67^th and Due east 68^th Streets)
  New York, NY 10065
  Take the 1000 elevator to the 2^nd Flooring. Enter the Endoscopy Suite through the glass doors.
• MSK Monmouth
  480 Cherry Loma Road
  Middletown, NJ 07748

What to expect

One time you arrive, you will be asked to state and spell your name and date of nativity many times. This is for your safety. People with the same or similar names may exist having procedures on the same mean solar day.

When it's time to change for your procedure, you will get a hospital gown, robe, and nonskid socks to wear.

You volition meet with your doctor earlier your procedure. They will explain the process to y'all and answer any questions you may accept.

You volition meet with your anesthesiologist. They will review your medical history with you and talk with you about the kind of anesthesia (medication to brand you sleep) you lot volition receive.

One time information technology's fourth dimension for your procedure, y'all will be brought into the procedure room and helped onto the exam table. You will lie on your left side with your knees bent.

Your anesthesiologist will place an intravenous (4) line into a vein, usually in your arm or hand. You will get anesthesia through your Four, which will make yous fall asleep. Once you're asleep, your doc will begin the process.

Your doctor volition identify a colonoscope into your rectum. The colonoscope is connected to a video monitor. This lets your md to come across the inside of your colon. Your doctor will utilize air and fluid to move the colonoscope through your colon while looking for anything unusual on the video monitor.

The procedure ordinarily takes less than lx minutes (1 hour).

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Frequently Asked Questions (FAQs)

I'thousand taking the prep and started having loose, watery stool earlier I finished it. Do I withal need to have the balance of the prep?

Yes. You must drinkable all the prep to fully make clean out your colon for a safe and consummate colonoscopy.

I feel like throwing up (nausea) or did throw upwardly (vomit) later taking the bowel prep. What should I exercise?

Many people may feel nauseous while drinking the bowel prep. To assistance with this, try mixing the MiraLAX powder with clear liquids you like drinking.

If y'all feel like airsickness, you lot should potable slowly, and take a break. This means y'all should stop drinking the liquid for 30 to 45 minutes to permit your stomach empty. While you take a intermission, put your prep liquid in the fridge. After your break, effort to slowly drink the prep over again. Use a straw if you take one.

If you lot do vomit, take a 30 to 45 infinitesimal break. If y'all have anti-nausea medication at abode, you can take 1 dose before starting the prep again. You can drink any clear liquids you like to beverage to stay hydrated. It'due south of import that you drink all the prep liquid to fully clean out your colon for a safe and consummate colonoscopy.

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After Your Procedure

Your nurse volition continue to monitor your heart, breathing, and blood pressure. Many people feel swollen and have stomach cramps after a colonoscopy. This is normal and goes away past passing gas.

Once you're fully awake, your nurse will remove your IV. If you take someone waiting with you, your nurse volition explicate your belch instructions to both of yous before you lot go home.

At habitation

• You may begin eating light foods as shortly every bit you're discharged. Avoid spicy, greasy, and fried foods at showtime. Work your way up to your normal nutrition. If your dr. wants you lot to limit your nutrition for a period of time, they will tell you lot.
• Yous can go dorsum to doing your usual activities 24 hours after your procedure.
• Don't drink alcoholic beverages for 24 hours afterward your procedure.

If you had a biopsy, it's normal to have a minor corporeality of bleeding from your rectum. At that place should be no more than a few drops of blood, and the haemorrhage should stop within 24 hours afterwards your procedure.

Subsequently a colonoscopy, it's normal for your bowel movements to exist irregular or different from your usual habits. This may final for upwards to a calendar week afterward your process.

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When to Call Your Healthcare Provider

Telephone call your healthcare provider if you have whatever of the following:

• A fever of 101° F (38.3° C) or college
• Serious stomach pain or bloating
• Bleeding from your rectum that lasts more than 24 hours
• Bleeding betwixt bowel movements
• Weakness, faintness, or nausea
• Heavy bleeding from your rectum

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Source: https://www.mskcc.org/cancer-care/patient-education/how-prepare-your-colonoscopy-using-miralax#:~:text=Prepare%20your%20MiraLAX%20bowel%20preparation,the%20mixture%20in%20the%20refrigerator.

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