Bowel Preparation Instructions
These instructions are for patients WITHOUT severe kidney and heart disease. If you have severe kidney or heart disease, please call our office for alternative instructions: 303-604-5000
This bowel preparation requires a little organization but is an extremely important part of your colonoscopy to ensure you have the highest quality exam. Bowel preparation starts days prior to your procedure, as you need to stop taking certain medications or supplements and change your diet. If you do not follow these directions, your colonoscopy may be cancelled. Please note, it is your responsibility to contact your insurance company about coverage and cost for your upcoming colonoscopy procedure. Sometimes, colonoscopies result in a cost to the patient. You will need to tell your insurance company when your last colonoscopy was and if you are performing the colonoscopy because you have symptoms, a personal history or family history of colon cancer or polyps.
DO NOT EAT any solid food the ENTIRE DAY before your colonoscopy. Drink only clear fluids.
Bring a list of all your MEDICATIONS (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.
DO NOT bring unnecessary belongings. We are not responsible for lost or misplaced items.
Stop all clear liquids two hours before your procedure arrival time.
Your colon must be COMPLETELY EMPTY so that your doctor can clearly view your colon.
Follow all instructions in this handout EXACTLY as they are written. If you have completed your prep, and your stools are not clear or yellow, please contact our office at 303-604-5000, even if after hours.
Transportation on the day of your procedure:
A responsible adult MUST BE PRESENT (18 years or older) with you at check-in before your procedure and MUST BE ABLE to pick you up IMMEDIATELY when you are discharged. You are NOT ALLOWED to drive, take a taxi or bus, or leave the Endoscopy Center alone. If you do not have a responsible driver with you to take you home, your procedure WILL BE CANCELLED.
Because of the sedation, you are NOT ALLOWED to use a bus, taxi, Uber/Lyft, Access-a-Ride, walk home, etc. alone.
Blood thinners: including Coumadin (warfarin), Plavix (clopidrogel), Ticlid (ticlopidine hydrochloride), Brilinta (ticagrelor), Aggrastat (tirofiban), Agrylin (anagrelide), Xarelto (rivaroxaban), Pradaxa (dabigatran), Eliquis (apixaban), Lovenox (low molecular weight heparin), Innohep (heparin) or Effient (Prasugrel), You must follow the instructions provided by our nurses.
Diabetes medication: See instructions below.
All other medications: Including aspirin, should be taken the day of the exam with a sip of water.
Procedure Cancellation Notice Requirements:
Procedure cancellations must be made three (3) business days prior to your appointment.
Failure to provide the required advance notice will result in a $150 Total Cancellation Fee.
($50 Physician cancellation fee from Gastroenterology of the Rockies + $100 Facility cancellation fee from the endoscopy center).
If you have diabetes, follow these instructions:
Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Do not take any long-acting basal insulins the day before or the day of your procedure.
Rapid-Acting and Regular Short-Acting Insulin (ex. Lispro, Humalog, Admelog, Regular Insulin): If your blood sugar is high and you need to take a correction, take ½ or 50% of your usual correction. This applies to the day before and the day of your procedure.
Insulin Pump: Decrease basal rate by ½ the day before and the day of your procedure. Do not administer bolus doses.
Other Diabetic Oral & Injectable Medications (ex. Metformin, Glipizide, Sulfonylureas, Tradjenta, Dipeptidyl Peptidase IV (DPP IV) Inhibitors, Januvia, Janumet, Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors): Do not take the day before or the day of your procedure.
Check your blood sugar at same intervals as usual, and additionally, if needed: If your blood sugar is less than 60, please take glucose tablets at any time before your procedure with a sip of water.
Checklist to Ensure Proper Bowel Preparation
To ensure the proper completion of your colonoscopy preparation, we strongly suggest that you PRINT OUT this document and check off each of the instructions as you complete them. This will greatly help you in following the detailed instructions and help ensure you receive a proper colonoscopy.
GROCERY STORE LIST: Purchase your bowel preparation items below at least five days before your procedure:
☐ 4 - Dulcolax laxative tablets containing 5 mg of bisacodyl each (NOT Dulcolax stool softener).
☐ 2 - 8.3 oz bottle of MiraLAX (238 grams) or generic equivalent.
☐ 2 - 28 oz or 32 oz bottles of Gatorade (NOT Red or Purple). Patients with diabetes should use Gatorade G2 (low sugar version-
not red or purple). See clear liquid list on page 3.
☐ 4 - Gas-X tablets (simethicone) containing 125 mg of simethicone each.
☐ 1 - Easily measurable 8-ounce glass/cup: You will be drinking multiple quantities of 8 oz liquids.
5 days before your colonoscopy:
☐ Make sure you have purchased your bowel preparation items! (listed above!)
☐ DO NOT take medications that stop diarrhea such as Imodium (loperamide), Pepto-Bismol (bismuth subsalicylate) or Lomotil
☐ DO NOT take fiber supplements such as Metamucil, Citrucel, Psyllium or Benefiber.
☐ DO NOT take products that contain iron such as multi-vitamins or iron supplements.
☐ Take one heaping teaspoon of MiraLAX® mixed with 8 oz. of a beverage twice daily until the day before your procedure when you will
follow your general prep instructions. MiraLAX® can be mixed into any beverage, hot or cold. Some examples include coffee, tea, water, orange juice, iced coffee, ice water, coconut water, smoothie, iced tea and seltzer.
3 days before your colonoscopy:
☐ Discontinue high-fiber foods such as popcorn, beans, seeds (flax, chia, quinoa, sunflower),
multigrain breads, nuts, vegetables, salads, fresh fruit, or dried fruits until after your procedure.
Checklist: One Day Before Your Colonoscopy
☐ No marijuana on the day of your procedure.
☐ If you have diabetes, please see Diabetes instructions above.
☐ Only drink clear liquids the ENTIRE DAY before your procedure. NO solid foods.
☐ Drink at least 8-ounces of clear liquids EVERY HOUR after waking up. The charts below have examples of what you can & cannot drink:
CLEAR LIQUIDS - YOU CAN DRINK:
Gatorade, Pedialyte, Powerade, Kool-Aid
Gatorade G2, Propel, Crystal Light
Jell-o, Juice without Pulp (ex. Apple Juice)
Clear Sodas (ex. Sprite, Ginger Ale)
DO NOT DRINK:
NO red or purple liquids
NO Milk or non-dairy creamers
NO Noodles or vegetables in soup
NO Juice with Pulp (ex. pineapple juice)
NO Liquid you cannot see through
NO Apple Sauce
4:00 pm - the evening before your procedure, prepare the MiraLAX bowel preparation solution:
☐ Mix ½ of MiraLAX bottle (4.2 oz) into each of the two 28 oz or 32 oz Gatorade bottles, until dissolved.
You may have to drink a little or pour some of the Gatorade out, to make room for the MiraLAX.
Keep both Gatorade bottles cool in the refrigerator. DO NOT add ice.
5:00 pm - the evening before your procedure:
☐ 5:00 pm: Take four Dulcolax tablets and two tablets of simethicone/Gas X
6:00 pm - the evening before your procedure:
You will need to drink one of the 28 oz or 32 oz Gatorade bottles:
☐ 6:00 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 6:15 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 6:30 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 6:45 pm: Drink the rest of the MiraLAX Gatorade bottle.
☐ 7:00 pm: Drink an 8-ounce glass of a clear liquid. (see chart above)
☐ 7:15 pm: Drink an 8-ounce glass of a clear liquid.
☐ Before going to sleep: Take two additional simethicone tablets.
☐ Set your alarm! Make sure to wake up at least 4 hours before your procedure check-in time.
4 hours - before your procedure check-in time - this may be in the middle of the night or early AM:
You will need to drink the remaining 28 oz or 32 oz Gatorade bottle:
☐ 4 hours before procedure check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 3 hours & 45 min before check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 3 hours & 30 min before check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 3 hours & 15 min before check-in: Drink the rest of the MiraLAX Gatorade bottle. You should have finished the entire bottle.
☐ 3 hours before check-in: Drink an 8-ounce glass of a clear liquid. (see chart above)
☐ 2 hours & 45 min before check-in: Drink an 8-ounce glass of a clear liquid.
2 hours - before your procedure check-in time
☐ Discontinue mints, gum, hard candy, and chewing tobacco.
☐ 2 hours before check-in: STOP DRINKING ALL LIQUIDS!
Congratulations, you have completed your prep!