Lori R. Swenson, MD
Please read ALL instructions carefully. The exam cannot be performed if your colon is not properly cleaned out. If you have severe allergies to Soy Beans and Eggs, please contact us immediately. If you have any questions after reading these instructions, please contact our office. ONE DAY BEFORE PROCEDURE: You may have a light breakfast as long as it is before 9:00 a.m. Drink only CLEAR LIQUIDS the rest of the day (i.e. water, black coffee, tea, Gatorade®, etc.). NOTHING RED OR PURPLE. NO SOLID FOODS OR MILK PRODUCTS. One of the most important aspects to a successful prep is to consume PLENTY of clear fluids the day before the procedure. THE PREP REQUIRES 3 INGREDIENTS: 1. Four DULCOLAX LAXATIVE tablets–must be the LAXATIVE pills (over the counter). 2. MIRALAX POWDER 238 Gram bottle (over the counter). 3. 64 ounces of Gatorade® or Powerade®. Diabetics may use low calorie Gatorade® or similar liquid. Mix the
entire 238 Gram bottle of Miralax® with 64 ounces of Gatorade® in a large pitcher. THE NIGHT BEFORE YOUR PROCEDURE: At 3:00PM take all four Dulcolax tablets. It will probably take about 2-3 hours for this to take full effect. If you are a frequent laxative user. Please start with double your usual Dulcolax dose. At 4:00PM start drinking HALF of the Miralax “cocktail.” You should pace yourself to drink about FOUR 8-ounce glasses (for a total of 32 ounces) over a one-hour period, one glass every 15 minutes, until you’ve finished the 32 ounces. At 7:00PMfinish drinking the Miralax: “cocktail.” You should pace yourself to drink about FOUR 8-ounce glasses (for a total of 32 ounces) over a one-hour period, one glass every 15 minutes, until you’ve finished the 32 ounces.
• Expect to use the restroom multiple times, as well as some cramping. • Continue drinking clear fluids until midnight. • Please do NOT eat or drink anything after midnight. • You will be sedated and you will NEED SOMEONE TO DRIVE YOU HOME. PATIENTS ON BLOOD THINNERS If you are taking blood-thinning medication such as Coumadin (Warfarin) or Plavix, CALL YOUR PRIMARY CARE DOCTOR AND ask whether you can STOP taking it 3 day prior to your procedure. If a polyp is found during your colonoscopy and you HAVE NOT discontinued it for 3 days prior, you may have to repeat the colonoscopy. REMEMBER – OBTAIN APPROVAL FROM YOUR PRIMARY CARE DOCTOR BEFORE DISCONTINUING BLOOD THINNERS. PROCEDURE Your procedure will be at the following facility: Pioneer Valley Hospital: 3460 South Pioneer Parkway WVC, UT 84120 YOU MUST ARRIVE 30 MINUTES PRIOR TO YOUR EXAM TIME!
EXAM DATE: _______________________________ EXAM TIME: ______________________________________
Please give at least 24-48 hours notice of cancellation or you may be charged. 801-964-3855 3336 South 4155 West, Suite 306 West Valley City, UT 84210 Where Healthy Relationships Begin SM
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