Colonoscopy Preparation Instructions

A colonoscopy is a routine, well-tolerated procedure that allows your physician to examine the colon and rectum. Preparation is the most important part of the process: a thorough bowel cleanse helps your doctor see clearly and catch anything important.

Conditions to discuss with our endoscopy scheduling team

Please contact our endoscopy scheduling team if you have not already discussed any of the following with us:

• History of liver, heart, or lung disease
• Kidney disease (including dialysis)
• Diabetes
• Excessive bleeding during previous surgery or dental extraction
• Use of blood thinners
• A pacemaker or internal defibrillator device

Plan ahead for your visit

• Arrange to have a responsible adult drive you to your test and accompany you home afterward.
• If you take public transportation, an adult other than the driver MUST ride with you for your safety.
• Bring a current list of your medicines and doses with you on the day of your procedure.

Need to reschedule?

If you need to reschedule your procedure, please call your endoscopy scheduling team at (682) 400-2153 at least 10 days before your scheduled procedure.

A colonoscopy is an exam of your large intestine, or colon, using a flexible tube placed into the rectum. The tube has a light and camera at the end so your gastroenterologist can check for abnormal growths or other problems. This test helps your doctor diagnose conditions and plan treatment if needed.

We strive to perform the safest, most careful exam for every patient. Because some exams take longer than others, your procedure may not begin at the exact time it was scheduled. We appreciate your patience and ask that you allow 3 to 4 hours from check-in time for your visit.

You will receive a call from the hospital or surgical facility to confirm your appointment and arrival time. This call is important because it determines when you should take the second dose of your bowel preparation.

Diet adjustments

• Avoid eating seeds, corn, popcorn, or fruits and vegetables with many seeds (such as cucumbers, tomatoes, and strawberries). These foods are hard to digest, do not clear out of your colon easily, and can clog the colonoscope.
• Stop using fiber supplements such as Metamucil, Citrucel, or Fiberall.
• Stop taking iron pills, fish oil, vitamin E, and other supplements. You may continue to take Aspirin 81 mg (“baby aspirin”).

Pick up your bowel preparation

• Call your pharmacy before going in person to confirm your prescription is ready. If your bowel prep has not been sent, call your endoscopy scheduling team at (682) 400-2153.
• Do not mix your bowel preparation until the day before your procedure.

Stock up on clear liquids

Purchase a variety of clear liquids that you will consume the day before your procedure (see the clear liquid options listed under The Day Before Your Procedure).

Optional items to have on hand

• One 10-ounce bottle of magnesium citrate (over-the-counter). This can be used the morning of your procedure if your bowel movements are still brown. Do not use magnesium citrate if you have reduced kidney function, kidney disease, a sodium- or magnesium-restricted diet, a diagnosed stomach or intestinal blockage, or a history of seizures.
• Items to minimize anal irritation: petroleum jelly or diaper rash ointment, and alcohol- and fragrance-free baby wipes.

Confirm your ride

Make sure you have a responsible adult arranged to drive you to your procedure and accompany you home afterward.

• Stop taking NSAIDs such as Ibuprofen, Aleve, Naproxen, and Advil.

Clear liquid diet for the entire day

• Do not consume solid food at any point during the day.
• Do not consume alcohol.
• Drink clear liquids only.
• Stay well hydrated throughout the day.
• Avoid all red, blue, or purple drinks or liquids.

Approved clear liquids

• Water
• Chicken, beef, or vegetable broth; consommé
• Sodas (Sprite or other clear sodas)
• Sports drinks such as Gatorade (no red, blue, or purple)
• Juice popsicles (no red, blue, or purple)
• Black coffee (no cream or milk; sugar is okay)
• Tea (no cream or milk)
• Clear Jell-O (no red, blue, or purple)
• Clear, hard candy

Morning: Mix your bowel preparation and refrigerate

• GoLYTELY, GaviLyte-G, Colyte, or PEG 3350 Electrolytes: Add water to the fill line of your container and mix. If a flavor packet was provided, add it now.
• Suprep, Moviprep, or Prepopik (Clenpiq): Mix as directed on the package.

Between 5:00 PM and 9:00 PM: drink the first dose

• GoLYTELY, GaviLyte-G, Colyte, or PEG 3350: Drink one glass every 10–15 minutes until you have consumed ½ gallon. If you feel nauseated, take a 10–15 minute break until the nausea subsides. Refrigerate the rest of the prep for tomorrow.
• Suprep, Moviprep, or Prepopik (Clenpiq): Drink the first dose, then drink the specified amount of additional clear liquids as detailed on the package instructions.

What to expect during the prep

• Bowel movements often begin about 1 hour after the first glass and may continue for 1 to 4 hours after you finish the last glass.
• Bloating, nausea, abdominal cramps, or chills are common and temporary. They should ease as the prep progresses.
• Consider using baby wipes and/or ointment to minimize anal irritation.
• If nausea becomes severe, pause for 30 minutes and then resume drinking the prep slowly.

Upon waking

• Continue the clear liquid diet: absolutely no solid foods.
• If applicable, take your blood pressure and heart medications with a small sip of water at least 30 minutes before drinking the second dose of prep.

Timing the second dose

Use your scheduled appointment time (not check-in time) to determine when to take the second dose:

• 5 hours before your appointment time: begin drinking the remaining half of your bowel preparation, and finish within the hour.
• 4 hours before your appointment time: stop drinking all fluids.

If your bowel movements are still brown

Your colon is well-prepared when your bowel movements are clear or clear-yellow. If they are still brown on the morning of your procedure, and you do not have any of the conditions that prevent its use (reduced kidney function, kidney disease, a sodium- or magnesium-restricted diet, a diagnosed stomach or intestinal blockage, or a history of seizures), you may drink a 10-ounce bottle of magnesium citrate, finishing no later than 3 hours before your appointment time. If you cannot take magnesium citrate, call (682) 400-2153. Your procedure may need to be rescheduled if your colon is not well-prepared. Please discuss this with the nurse first.

To improve the taste

• Chill the prep before drinking it.
• Add a citrus-flavored powdered drink packet if one was provided by the pharmacy.
• Lick a lemon or lime wedge dipped in sugar, or eat hard candy, between sips.
• Use a straw.

To prevent dehydration

Drink plenty of fluids during the clear-liquid day and after your test is complete. Your body can lose a significant amount of fluid during the bowel preparation.

Common symptoms during the prep

Bloating, nausea, abdominal cramps, and chills are common and should decrease as the preparation progresses.

• Wear loose, comfortable clothing.
• Leave valuables at home.
• Plan to spend approximately 2–3 hours at the unit; allow 3 to 4 hours from check-in.
• The procedure itself usually takes 30–60 minutes.

You will meet your endoscopy nurse

Your nurse will ask questions to confirm you understand the test and are properly prepared. Your gastroenterologist will also review the procedure with you before it begins.

An IV will be started

You will receive medications through your intravenous (IV) line. Unless your procedure is scheduled with anesthesia, you will be receiving moderate sedation: a sedative to help you relax and a narcotic to help with discomfort. Your vital signs (blood pressure, heart rate, oxygen level) will be monitored closely before, during, and after the test.

Rest for the remainder of the day

• You will stay in a recovery area until the effects of the sedation begin to wear off.
• Do not drive for the remainder of the day.
• Do not participate in any activities that require coordination or judgement, and do not sign legal documents.
• You should not drink alcohol until the following day.
• You must have a responsible adult pick you up. You cannot drive yourself home.
• You may resume normal activities the day after your procedure.

If you plan to travel by air

Please inform your physician if you plan to travel by air after your procedure. There is a small risk of bleeding for up to two weeks after a polyp is removed during a colonoscopy. We discourage booking an international flight within two weeks after your colonoscopy for your safety.

What is normal after the procedure

Mild bloating, gas, or cramping is normal after a colonoscopy and should diminish on its own within a few hours.

General medications

Most medications should be continued as usual, but some may interfere with the procedure. Medications may be taken with small sips of water unless otherwise instructed.

Diabetes medications and insulin

If you take medicines for diabetes, please call the doctor who manages your diabetes to discuss how to manage them around your procedure.

• Do not take your oral diabetes medication on the day of your procedure unless otherwise instructed.
• If you take injectable insulin, we recommend that you hold your morning dose.
• If you have an insulin pump, you will need instructions on the settings of your device during the procedure, as well as your prescribed off-pump instructions.
• On your clear-liquid day, help prevent low blood sugar by consuming chicken, beef, or vegetable broth.
• Keep glucose tablets on hand for any sudden drops in blood sugar (available over-the-counter at any pharmacy).

Blood thinners

Do not stop aspirin unless instructed by your physician. If you take any other blood thinner, you will need additional instructions from the doctor who manages that medication. Examples include:

• Warfarin (Coumadin)
• Plavix
• Xarelto
• Effient
• Pletal
• Eliquis
• Fragmin
• Pradaxa
• Brilinta
• Innohep
• Savaysa
• Lovenox
• Heparin
• Any other blood thinner not listed here

Pacemaker or internal defibrillator

If you have a pacemaker or internal defibrillator, your endoscopy scheduler will obtain information about your device from your doctor's office. Please bring your device card with you on the day of your procedure.

Weight loss medications / diet pills

Follow specific stopping instructions for any weight loss medications or diet pills. For medications such as Ozempic and Mounjaro, stop them 1 week before the procedure unless otherwise instructed by your physician.