Portland Gastroenterology Center

161 Marginal Way • Portland, Maine 04101 • 207-773-7964
Extended MiraLAX prep
Please read through the instructions at least one week before your procedure.

If you have any questions, please call 207-773-7964.

Download these Prep Instructions for Printing

About Your Appointment

A responsible adult will need to drive you home. Taxis, Ubers, buses, medical ride services, or walking are not options unless a responsible adult accompanies you. You will not be able to drive for the rest of the day.

Plan on being at our facility for about 1 1⁄2 hours from arrival to departure (although this may vary depending on the day/procedure/location – ex. approx. 2.5 hrs for MMC)

For appointments with a scheduled arrival time of 4:00 pm or later, have your ride plan to be at the facility no later than 5:30 pm.

If you are unable to keep your appointment, please call at least 3 business days prior to your procedure to reschedule. We reserve the right to charge a penalty fee for patients who “no show” or cancel without adequate notice.

Medication Instructions

  • Aside from the medications below, we recommend you take all home medications as usual with a small amount of water, at least 3 hours before your arrival time.
  • If you take blood thinners (Eliquis®, Plavix®, warfarin, Xarelto®, etc.) and haven’t been given directions to stop them by our office or your prescribing physician’s office, please call us to clarify. It is ok to continue your Aspirin.
  • Take 1⁄2 your morning insulin dose. Bring the other 1⁄2 with you.

Stop the following medications until after your procedure as directed below

7 days before your procedure

  • Iron supplements
  • Fiber supplements (e.g. Citrucel®, Metamucil®)
  • Weekly dosed GLP-1 agonists:
    • Adipex-P®/Lomaira® (Phentermine)
    • Bydureon® BCise®(Exenatide ER)
    • Mounjaro®/Zepbound® (Tirzepatide)
    • Ozempic®/Wegovy®(Semaglutide)
    • Qsymia® (Phentermine/Topiramate)
    • Trulicity®(Dulaglutide)

The day before your procedure

  • Anti-diarrheal medications:
    • Colestid® (colestipol)
    • Lomotil®
    • Imodium® (loperamide)
    • Questran® (cholestyramine)

The day of your procedure

  • Daily dosed GLP-1 agonists:
    • Adlyxin® (Lixisenatide)
    • Byetta® (Exenatide IR)
    • Rybelsus® (Semaglutide)
    • Saxenda®/Victoza® (Liraglutide)
  • Morning dose of oral diabetic medication (Bring it with you)

Step-by-Step Preparation Instructions

1 Week Prior to Colonoscopy

  • Stop eating seeds, nuts, popcorn, tomatoes, corn, berries, granola with dried fruit, raisins
  • Purchase the following items:
    • 1 box Simethicone or Gas-X® tablets (125mg or 180mg)
    • 2 – 8.3 oz. containers of MiraLAX® or GaviLAX powder
    • 128 ounces of Gatorade® (orange green, or yellow), Propel Water®, Vitamin Water®, coconut water or smartwater®
    • 2 – 10 oz. bottles of liquid magnesium citrate
  • Hydrate. Avoid/manage constipation. Consider adding a daily dose of MiraLax®.
  • Call the office if you are pregnant, have an internal cardiac defibrillator, have had a recent cardiac procedure, or have a new cardiac health concern.
  • Review the Medication Instructions above.

2 Days Before Colonoscopy

Before 1:00 pm

Eat a light meal from the following list of foods:

  • Boiled or poached egg
  • Applesauce
  • Yogurt (no granola or fruit chunks in it)
  • Skinless chicken, turkey, or fish
  • Cottage cheese
  • White bread or white toast without butter
  • Plain tofu

At 1:00 pm

  • Do not eat any more solid foods until your procedure is completed.
  • Drink 8oz of clear liquids every hour while awake (TIP: hydrating helps the prep work!)
  • Mix 1st 8.3 oz MiraLAX® in the 64 oz of liquid (e.g. Gatorade®, Propel®, smartwater®, etc.) and refrigerate. (TIP: it is best tolerated cold!)

Starting at 5:00 pm

  • Drink 8oz of the MiraLAX® mixture every 10 – 20 minutes until you have finished 1/2 of the mixture (32oz)

The Day Before Your Colonoscopy (All Colonoscopies)

In the Morning

  • Drink a 10oz bottle of magnesium citrate. (TIP: it is best tolerated cold!)
  • Drink 8oz of MiraLAX® mixture every 10 – 20 minutes until you finish the second 1/2 of the mixture you prepared the evening before. (32oz)
  • Mix 2nd 8.3oz MiraLAX® in the 2nd 64oz of liquid (e.g. Gatorade®, Propel®, smartwater®, etc.) and refrigerate. (TIP: it is best tolerated cold!)

For Colonoscopies scheduled before 10 am

At 5:00 pm

  • Drink 8 ounces of the MiraLAX® mixture every 10 to 20 minutes until you have finished the entire 64 ounces.
  • Drink a 10oz bottle of magnesium citrate. (TIP: it is best tolerated cold!)
  • Take two simethicone (Gas-X®) anti-gas tablets.
  • Continue to drink 8oz water per hour while awake up to 3 hours prior to your procedure. (TIP: it is important to HYDRATE!)
  • Review Colonoscopy preparation tips below to determine if you are ready for your colonoscopy.

The Day Of Your Colonoscopy

For Colonoscopies scheduled later than 10:00 am

4 to 5 hours prior to your Procedure

  • Drink 8 ounces of the MiraLAX® mixture every 10 to 20 minutes until you have finished the entire 64 ounces.
  • Drink a 10-oz bottle of magnesium citrate. (TIP: it is best tolerated cold!)
  • Take two simethicone (Gas-X®) anti-gas tablets.
  • Continue to drink 8oz of water per hour up to 3 hours prior to your procedure. (TIP: it is important to HYDRATE!)
  • Review Colonoscopy preparation tips below to determine if you are ready for your colonoscopy.

Please review the following prior to starting your prep

Examples of clear liquids

  • Popsicles, EXCEPT for red, purple, or blue
  • Coconut water (NOT coconut milk)
  • Gatorade®
  • Kool-Aid®
  • Strained fruit juice (apple or white grape)
  • Jell-O®
  • Coffee and tea (without dairy products/creamer)
  • Soft drinks

 

Tips

If you start to feel nauseous while prepping, try:

  • Pause drinking the prep until the feeling improves, then resume
  • Decrease the amount you drink at a time
  • Take more time between drinks
  • Refrigerate the prep mixture
  • Use a straw

Prep goal: your stool should be clear and yellow. This chart will help you judge your progress!

Your prep is one of the most important parts of your colonoscopy. Without a good prep—your bowel empty and clean—your gastroenterologist will not be able to see your colon clearly. This could lead to missing a polyp or having to reschedule your colonoscopy.

Here are photos that show the difference between a good prep and a bad prep so you can see why it’s essential.

 

What are the risks of a colonoscopy?

Colonoscopy is a standard medical procedure. Although rare, colonoscopies like all procedures have some risks.

  • The instrument may tear the wall of the colon which may require surgery to repair.
  • There may be adverse drug reactions or heart/breathing complications.
  • Bleeding may occur and is more often a risk when tissue or polyps are removed.
  • There may be discomfort during and after the procedure.