Microsoft word - miralax prepnov_10.doc

Miralax Colon Prep
Colonoscopy is a procedure to examine the colon. A small flexible tube with light and
miniature camera is inserted into your rectum. Medication is given by I. V. to keep you
comfortable during your exam. The risks include but are not limited to pain, bleeding,
infection, medication reactions (irregular heart rhythm or breathing difficulties), bowel
perforation, need for blood transfusion, surgery or repeat colonoscopy, ICU stay and
even rarely death.
Some procedures are scheduled directly. However, if you wish to first have a
consultation with the doctor in the office, to discuss the procedure, sedation, risks and
complications, alternatives etcetera, please notify our office and schedule a clinic visit
instead.

Purchase:
Miralax or generic (238 gm) – over the counter, ½ ( half) gallon
drinking water, Bisacodyl 5 mg (generic for dulcolax) 4 tablets.

Preparation
1. You will need to stop aspirin and Anti-inflammatories for seven (7) days before
your exam. These medications include Advil, Alka-Seltzer, Anacin, aleve, BC powder, Bufferin, Ecotrin, Excedrin, Ibuprofen, Feldene, Midol, Motrin, and Naprosyn. Check with your doctor if you have any questions about medications. 2. You will need to stop iron or ferrous sulfate, herbal medications, metamucil for
3. Stop taking Coumadin (Warfarin) for five (5) days before your exam. Please get
an okay from your primary care doctor to stop coumadin for the test (may need lovenox). If you have an artificial heart valve, please notify Dr. Mahajan’s office. 4. Stop taking Plavix (Clopidogrel) for five (5) days before your exam. Please get
an okay from your cardiologist/neurologist. 5. Medications allowed the morning of your procedure with a small sip or water or 7-
■ Blood Pressure medication.
■ Heart medication.
■ Breathing medication, anxiety, depression medications.
6. Medications to avoid: Insulin or diabetic medication on the morning of your
exam(check with primary physician).

FAILURE TO HAVE A DRIVER WILL RESULT IN CANCELLATION OF EXAM.
If colon is not totally cleaned out, the procedure will have to be repeated.
5 Executive Drive, Suite B-1 | Lafayette, IN 47905 | PH: 765.807.0531 | www.lafayettegastro.com
Take 2 tablets dulcolax (bisacodyl) on _____________ at 9 PM (2 days before procedure) You can take the tablets as early as 9 AM, if you are not planning to go out. - Pour entire Miralax 238 gm in 1/2 (half) gallon jug of water. Refrigerate it. Clear Liquid Diet ______________
No Solid Food or Milk Products all day
7-Up or Sprite type Chicken Broth or Beef Bouil on (No noodle soups) Clear Gatorade Plain coffee or tea (no cream or milk or Coffemate)
Jel -O (White grape or Lemon), with no fruits in them
Apple or White grape juice
Kool-Aid, popsicles, strained fruit juices (no pulp)
AVOID ALL RED, PURPLE, OR ORANGE COLORING
Start drinking miralax at 5:00 p.m. and complete entire jug in 2
hours. (You may start as early as 10 am). If you develop nausea
and vomiting, please stop drinking miralax prep for 1 hour. Then,
resume the prep to complete it. After completion of miralax, wait 1
hour. Then take 2 tablets of dulcolax (bisacodyl).
 May have clear liquids after miralax jug is completed.
Day of Procedure ______________________

You can have clear liquids only, until 4 hours prior to procedure. Take
the al owed medications with sip of water (see other side of this page).
You are required to have a responsible adult to accompany you to and
from the hospital. You wil not be al owed to drive home after
discharge. Please register at ________ a.m.
Do not take diabetic meds in the morning.

( ) Unity Surgical Center ( ) St. Elizabeth EAST(ON CREASY)
1411 South Creasy Lane
CALL 423-6443 TODAY TO
PRE-REGISTER
Suite # 200) (go to North Entrance) Tel: 765-446-5000
PLEASE CANCEL PROCEDURE 3 DAYS IN ADVANCE (807-0531) TO AVOID
CHARGE of $50. If any biopsies are taken/blood test done, results will be mailed
in 2 weeks.
5 Executive Drive, Suite B-1 | Lafayette, IN 47905 | PH: 765.807.0531 | www.lafayettegastro.com

Source: http://www.lafayettegastro.com/sites/lafayettegastro.com/files/LG_MiralaxPrepNOV_10.pdf