Gastroenterology Procedure Prep

Please follow the below instructions the day prior to and morning of your procedure

• On the day of your procedure, someone must accompany you to and from the hospital and assist you during the first 24 hrs. of recovery. Do not drive for 24 hours after the procedure. (See post-procedure home care guide)
• If you have a colostomy please bring an extra stoma bag. 
• If you develop any flu like symptoms 2 weeks prior to your procedure, please call us immediately.

If you are diabetic, please check with your physician regarding insulin and oral diabetic medication regimen.

• Metformin - hold for 48 hours. 
• Jardiance - hold for 3 days

If you take a GLP-1 medication for diabetes or weight loss please hold for 7 days

• Liraglutide (Victoza)
• Dulaglutide (Trulicity)
• Semaglutide (Ozempic, Wegovy)
• Tirzepatide (Zepbound, Mounjaro)

Supplements: Hold for 7 days 

Blood thinners: Please consult with your cardiologist

• Aspirin 81mg - Hold day of procedure 
• Plavix, Brilinta, Pradaxa - Hold for 5 days
• Eliquis and  Xarelto - Hold for 2 days
• Warfarin – Please consult with your cardiologist

NSAIDS: Please hold all NSAIDS (Ibuprofen/ Motrin, Naproxen/ Aleve etc.) for 7 days.

• Tylenol is OK

If you take the following medication, please hold on the day of your procedure.

• Losartan (Cozaar), Valsartan (Diovan), Telmisartan (Micardis), Irbesartan (Avapro), Olmesartan (Benicar), Candesartan (Atacand),  Lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril),  quinapril (Accupril), ramipril (Altace)

Do not drink anything that is red, orange, blue or purple dye

• Ginger Ale
• Sprite
• 7 Up
• Gatorade
• Kool Aid
• Apple Juice
• White Cranberry Juice
• White Grape Juice
• Tea (No Milk or No Dairy Creamer)
• Coffee (No Milk or Non Dairy Creamer)
• Water

• Fat free, low sodium chicken or beef broth or bouillon

No sherberts or fruit bars

• Hard Candy
• Jell-O
• Italian Ice
• Popsicles

• No solid foods after midnight. Begin a clear liquid diet and maintain it throughout the day.
• You may consume clear liquids up until four (4) hours prior to your arrival time.
• Nothing by mouth for at least four (4) hours before your procedure. This includes ice, water, gum, hard candy, and mints.

Morning:

• Begin a clear liquid diet and continue throughout the day. (Refer to the attached list of approved clear liquids.) Avoid all solid foods.
• Prepare the solution: Mix the entire bottle of Miralax with 64oz of Gatorade, shake well, and refrigerate.

Afternoon:

• 3:00 PM: Take two (2) Dulcolax tablets with water.
• 5:00 PM: Begin drinking the Miralax/Gatorade solution as follows:
• Consume four 8-ounce glasses (half the solution).
• Drink one glass every 10–15 minutes. Try to drink quickly. Using ice and a straw may help.
• Return the remaining solution to the refrigerator.

Evening:

• Maintain a clear liquid diet until bedtime.
• 7:00 PM: Take two (2) Dulcolax tablets and drink at least three additional glasses of clear liquids before bedtime.
   

Six hours before your scheduled procedure:

• Drink the remaining Miralax/Gatorade solution (four 8-ounce glasses), consuming one glass every 10–15 minutes until finished.
• After finishing your first two glasses, take two simethicone (Gas-X) soft gels (total of 250 mg). Then continue drinking the remaining two glasses of Miralax solution.

Four hours before your scheduled procedure:

• After this time, do not consume anything by mouth, including water, ice, gum, hard candy, or mints.
   

Morning:

Begin a clear liquid diet and continue throughout the day. (Refer to the attached list of approved clear liquids.) Avoid all solid foods.

Prepare the solution: Mix the solution the evening before your colonoscopy and refrigerate before drinking. You may add the flavor pack that came with the bowel preparation. Do NOT add ice, sugar or any other flavorings to the solution.

Evening:

4:00 PM: Take four (4) Dulcolax tablets with water.

6:00 PM: Begin drinking the solution as follows:

• Consume four 8-ounce glasses (half the solution). Drink one glass every 10–15 minutes.
• Return the remaining solution to the refrigerator and maintain a clear liquid diet until bedtime.
   

Six hours before your scheduled procedure:

• Drink the second half gallon of the solution (1 glass every 15 minutes).
• You must complete all of the Golytely solution even if your stool looks watery.
• After finishing your first two glasses, take two simethicone (Gas-X) soft gels (total of 250 mg). Then continue drinking the remaining two glasses of Miralax solution.
• Maintain a clear liquid diet until 4 hours prior to your procedure.

Four hours before your scheduled procedure:

• After this time, do not consume anything by mouth, including water, ice, gum, hard candy, or mints.

Morning:

Begin a clear liquid diet and continue throughout the day. (Refer to the attached list of approved clear liquids.) Avoid all solid foods.

Evening:

3:00 PM: Take two (2) Dulcolax tablets with water.

5:00 PM: Mix and begin drinking the solution as follows:

• Pour ONE (1) 6-ounce bottle of SUPREP liquid into
• Add cool drinking water (10oz) to the 16-ounce line on the container and mix.
• Drink ALL the liquid in the container. 
• You must drink two (2) more 16-ounce containers of water (32oz) over the next 1 hour. 

8:00 PM: Take two (2) Dulcolax tablets with water.

Maintain a clear liquid diet until bedtime.

Six hours before your scheduled procedure:

Mix and begin drinking the solution as follows:

• Pour ONE (1) 6-ounce bottle of SUPREP liquid into the mixing container
• Add cool drinking water (10oz) to the 16-ounce line on the container and mix.
• Drink ALL the liquid in the container. 
• You must drink two (2) more 16-ounce containers of water (32oz total) over the next 1 hour.
• After finishing your first 16oz glass, take two simethicone (Gas-X) soft gels (total of 250 mg). 

Four hours before your scheduled procedure:

• After this time, do not consume anything by mouth, including water, ice, gum, hard candy, or mints.