Preparing for your colonoscopy with polyethylene glycol 3350/miralax and bisacodyl/dulcolax | veterans affairs

* DO NOT DRINK milk or dairy products, alcohol, beer, or any clear liquid or Jell-O that is red, orange, or purple in color. These dyes are difficult for the doctor to see through. * AT 3

P.M., swallow FOUR Dulcolax/bisacodyl tablets with at least 16 ounces of a clear liquid. * AT 5 P.M., mix 1/2 (one half) of the bottle of PEG 3350/MiraLAX (about 119 grams) in one of the

bottles of Gatorade. Shake it well to dissolve. * You may use warm, cold or room-temperature Gatorade. Some patients find drinking the prep through a straw helpful. * Finish this solution

WITHIN 1 HOUR by drinking an 8-ounce glass every 10 to 15 minutes until you finish the bottle. * PEG 3350/MiraLAX is a laxative. It empties your colon, so the doctor will be able to see its

walls and spot any abnormal growths (polyps). * PEG 3350/MiraLAX will give you diarrhea! This is normal. * You may drink other clear liquids after you finish the PEG 3350/MiraLAX and

Gatorade, up until midnight. * After midnight DON’T drink anything except what we instruct you to further in these instructions! TIP: You may want to buy flushable baby wipes and Vaseline to

use during your prep due to skin irritation. THE DAY OF YOUR COLONOSCOPY * Do not eat any solid food today, and drink clear liquids only as instructed below! * FIVE HOURS BEFORE LEAVING for

your colonoscopy, mix the other 1/2 (one half) of the bottle of PEG 3350/MiraLAX (about 119 grams) in the other bottle of Gatorade and shake it well to dissolve. * Drink an 8-ounce glass of

the solution every 10 to 15 minutes until you finish it. * Take any morning medications you need at least FOUR HOURS BEFORE your colonoscopy, with a few sips of water to swallow any pills,

tablets or capsules. * During the FOUR HOURS BEFORE your colonoscopy, for your own safety, there should be NOTHING IN YOUR MOUTH, not even chewing gum. * If you have ANYTHING in those four

hours, even WATER, your colonoscopy will be delayed or canceled. * Your stool should be clear and yellow, with no solid particles in it. * Come to your appointment 60 minutes beforehand! The

GI Lab is on the 3rd floor of building D, Mount Harvard. Take elevator number 1 to the 3rd floor, and our waiting room will be on the east side of the building. DO YOU HAVE DIABETES? OR

TAKE ANY WEIGHT LOSS/DIET MEDICATION? TAKE SPECIAL CARE WHILE ONLY DRINKING CLEAR LIQUIDS! * Monitor your blood sugar every 4 hours during your prep time before your colonoscopy. * If you

have an insulin pump: Maintain pump as usual and bring all pump equipment and supplies as well as continuous glucose monitor on the day of the procedure. ORAL DIABETIC MEDICATIONS: Please

hold all oral diabetic agents the morning of the procedure. METFORMIN: Hold the night before and the day of the procedure. GSLT2I: (Canagliflozin,Dapagliflozin,Empagliflozin): hold 3 days

prior to the procedure. GLP1R: agonists (Ozempic, Wegovy): Hold oral dose the morning of surgery. Hold weekly injections 1 week(7 days) prior to the procedure. INSULIN: Hold all short acting

insulin when on the liquid diet (1- or 2-day colon prep). Decrease the long-acting Insulin 50% the days you are doing the prep/liquid diet. Take 50% of the normal long-acting dose of

insulin on the day of the procedure IF YOU TAKE A MORNING DOSE. Do Not Take short acting insulin on the days of prepping/liquid diet or day of the procedure. Taking any of the following

GLP-1 medications for DIABETES, WEIGHT LOSS, OR ANY OTHER REASON? If taking once daily, stop taking 2 days before procedure. If taking once weekly, stop at least 7 days before procedure:

Dulaglutide, Exenatide, Liraglutide, Lixisenatide, Semaglutide, Tirzepatide. Stop taking Phentermine 7 days before procedure. Please consult your PCP or Endocrinologist if you think your

diabetic or weight loss adjustment may be an issue for you. WHY IS FOLLOWING THE DIRECTIONS SO IMPORTANT? GOOD PREP: POLYPS ARE EASIER TO SEE