Colonoscopy Prep Instructions
NE Gastroenterology
Orchard Surgical Center is a state-of-the-art surgical facility located in Salem, NH. We are committed to providing quality and affordable care to our patients. We know that our patients often have questions about their procedures. We will be communicating through text and email with preparatory items throughout this week.
Most of our patients utilize the following prep, known as the MiraLAX split prep. If you need a different prep, please contact NE Gastroenterology at (603) 898-5082.
Before you come in
Prior to Your Procedure
Surgical patients will receive communication to register via text and/or email. We request that you complete your online health history as soon as possible by clicking Pre-Register It is important that the surgeon and the anesthesiologist know your general state of health to better prepare to care for you. Please call (603) 898-5082 if you are unable to complete your pre-registration online.
steps you need to take
The Day Before Your Procedure
- You will receive a text message or phone call in the afternoon to confirm the time you should arrive at the surgical center. Your arrival time is subject to change.
- Please make arrangements with a responsible adult to drive you home after your procedure.
- Do not eat anything after midnight. We now encourage you to drink clear liquids up until 4 hours prior to your scheduled arrival time unless instructed otherwise.
- Do not drink any alcohol or use recreational drugs (including marijuana) for 24 hours prior to your procedure.
- Follow the specific preparation and cleansing instructions given to you by your physician’s office if applicable.
- If you develop a cold, persistent cough, fever, or flu please notify your surgeon. He/She may want to postpone your surgery.
what you need to bring
On The Day of Your Procedure
- You will need to bring your insurance card, your Photo I.D., and a form of payment (if applicable).
- Please arrive at the time confirmed by the surgical center.
- Remove all body piercings. Do not wear contact lenses. Bring your glasses if you need them to read and sign paperwork.
- Leave your valuables and jewelry at home.
- If possible, wear loose-fitting clothing that is easy to remove.
- You may bring your cellphone with you.
When you return home
While at Home
- It is not unusual to feel sleepy or dizzy after receiving sedation. Therefore, it is important that you go straight home, rest and follow your written instructions. Do not drink alcohol or take any medication other than what is prescribed by your doctor(s).
- Please call (603) 685-4346 Monday - Friday between 8:30 AM - 4:30 PM if you have questions.
Checking in call
Follow Up
- A nurse from Orchard Surgical Center will call you the next business day following your procedure. Your physician’s office will provide medical follow-up as needed.
Colonoscopy Prep (MiraLAX Split Prep)
*Over-the-Counter*
steps you need to take
Shopping List
- 238-gram (8.3 oz) bottle of MiraLAX powder
- Bisacodyl/Dulcolax 5mg pills x 4
- Simethicone/Gas-X tabs x 2
- Gatorade/Powerade 64 oz.
- Baby wipes and diaper cream
Prep Procedure
- Two (2) days before your procedure: Take four (4) tablespoons of Milk of Magnesia ONLY if you have chronic constipation or move your bowels infrequently.
- One (1) day before your procedure: All day follow a CLEAR LIQUID diet ONLY. AVOID orange, red, and purple beverages.
- 4PM: Take 4 Dulcolax tabs. Prepare the MiraLAX prep solution by combining the 238-gram bottle of MiraLAX powder with 64 ounces of a Gatorade/Powerade or other clear liquid. Separate into 2 separate containers and place in the refrigerator.
- 6PM: Start to drink the first 32 oz of the MiraLAX prep solution. Drink 8 oz every 10-15 minutes over the next 2 hours.
- 10PM: Take 2 Simethicone tabs.
- Day of your procedure, SIX (6) hours before your scheduled arrival time: Drink the second 32 oz bottle of the prep solution. Drink 8 oz every 10 minutes until gone. You must drink ALL the laxative by FOUR (4) hours before your arrival time.
- FOUR (4) hours before you time of arrival STOP drinking all liquids!
Helpful Tips
- Please refer to the Home Medication Instructions found on the NE Gasto website for information regarding diabetic, heart, blood pressure, blood thinners and certain weight-loss medications.
- Remember that on the day before your procedure you should avoid solid foods, all dairy products and alcohol.
- Stay hydrated! Drink at least 6-8 tall glasses of clear liquids in addition to the prep solution.
- Recommended clear liquids include broths, teas, black coffee, Jello, popsicles, water, and sports drinks. AVOID orange, red, and purple beverages.
- You may not start to move your bowels until 2-3 hours after you drink the prep solution. Stay close to the bathroom.
- Drink the laxative through a straw or put on ice to reduce nausea.
- If you feel nauseous, try chewing gum, drinking peppermint tea, or sucking on a lemon.
- For hemorrhoids, you may use Tucks pads or hemorrhoid cream.
Home Medication Instructions
(for ALL colonoscopy patients)
Patients on Diabetic Medications:
- Take HALF of your long-acting insulin dose the night before.
- DO NOT TAKE your regular insulin dose the morning of your procedure.
- Insulin pumps should be reduced to HALF (1/2) the basal rate two (2) hours prior to your arrival.
- Do not take any diabetic medications by mouth on the morning of your procedure!
- Please refer to the directions below for injectable GLP-1 Agonists.
Patients on Weekly Injectable GLP-1 Agonist
Medications for any reason:
- Such as semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro), exanatide ER (Bydureon), albiglutide (Tanzeum) and dulaglutide (Trulicity).
- STOP at least one week (7 days) prior to your procedure.
Patients on Blood Thinners:
- Aspirin: Continue to take as prescribed.
- Eliquis(apixaban) or Xarelto(rivaroxaban): Must be stopped 48 hours prior to your procedure.
- Coumadin (warfarin) and Plavix (clopidogrel): Must be stopped for 5 days prior to your procedure. CALL your prescriber for instructions, as you may need a "Lovenox bridge".
- Recent stroke/heart attack: CALL your prescriber. It may not be safe for you to discontinue your blood thinner. Your colonoscopy may be postponed until it is safe to do so.
- All other blood thinners: Call NE Gastro (603) 898-5082 to discuss at least one week prior to your procedure.
Patients on medications for your heart and/or blood pressure:
- You should take these medications (Common meds include, but not limited to: Metoprolol, amlodipine, lisinopril, atenolol, diltiazem) the morning of your procedure with a sip of water.
- Wait to take diuretics (such as Hydrochlorothiazide, Furosemide, Spironolactone, and Bumex) until you get home.