Bowel Preparation

The goal of preparation is to clean out your bowel before you have your procedure. Please read all the information before you begin. It is very important that you follow these instructions exactly as written to make sure that your procedure can be done, and done safely. Please call 3 West after 2 pm on the afternoon before your procedure at (716) 845-8476. They will let you know when to arrive and where you should go.

Please Note: There are six sets of bowel prep instructions included; each method is numbered. Follow the directions exactly as written for the method (number) that is prescribed for you by your doctor. Do not follow any of the directions from the methods that were NOT prescribed for you by your doctor. For your convenience, we have also included a list of clear fluids on the last page.

Taking Medications During Bowel Prep

  • If you are scheduled for anesthesia during your procedure, you will have an appointment with an anesthesiologist in the Pre-Op Clinic. If you do see an anesthesiologist, follow his or her instructions about taking your medications before your procedure.
  • If you will not need to meet with an anesthesiologist, then follow the general guidelines below. Review the instructions and discuss your medications with your doctor. Be sure you understand when to take your medications and how to prepare yourself for the procedure.

General Guidelines

Medications that affect your blood’s ability to clot or that lower inflammation

These medications need to be stopped at different times before your procedure. Unless your doctor gives you different instructions, follow these instructions to see when you should stop these medications.

7 days beforeyour procedure, stop:

  • Plavix® (clopidogrel)
  • Aspirin
  • Herbal and iron supplements

5 days before your procedure, stop:

  • Coumadin® (warfarin)
  • All nonsteroidal anti-inflammatory medications (NSAIDs):
    • Advil® or Motrin® (ibuprofen)
    • Aleve® or Anaprox® (naproxen)
    • Feldene® (piroxicam)
    • Clinoril ® (sulindac)
    • Ketoprofen

2 days (48 hrs) before your procedure, stop:

  • Fragmin® (dalteparin)
  • Arixtra® (fondaparinux)

1 day (24 hrs) before your procedure, stop:

  • Lovenox® (enoxaparin)

Medications for diabetes or high blood sugar

If you take any medications by mouth because you have diabetes or high blood sugar, you should stop these medications on the same morning that you start the clear liquid diet. If you inject insulin, you will likely be advised to reduce your normal dose when you start the liquid diet.

Medications for high blood pressure and other conditions

If your doctor tells you to take any medication during your bowel prep, take it with water. On the day of your procedure, you can have a small sip of water to take the medications approved by your doctor. You can take them up to 2 hours before the procedure.

After Your Procedure

If you have general anesthesia or if you are sedated during your procedure, you must have a responsible adult available to drive you home after your procedure. Your procedure will be canceled if you do not have a responsible adult to drive you home. Notify a nurse in the clinic if you have problems making arrangements, and the Department of Social Work will try to assist you.

After a short recovery period, your doctor will discharge you into the care of a responsible adult. Your discharge and follow-up instructions will be reviewed with you. If you are confused or have questions, please ask; we are here to help. We will give you a copy of your discharge instructions to take home with you. In some cases, depending on your condition, your discharge may be delayed or you may need to be admitted to the hospital.

Please call us if you have any questions or to report any problems:

Gynecologic Oncology Clinic
(716) 845-5855

Upper GI Clinic
(716) 845-4774

Lower GI Clinic
(716) 845-4660

3 West (Endoscopy Center)
(716) 845-8476

After clinic hours, in the evenings, and on weekends or holidays, please call (716) 845-2300 and ask for your doctor on call.

In an Emergency

Roswell Park does not have an emergency department. If you live in the Buffalo area and have an emergency situation, please go directly to Buffalo General Hospital, which is next to Roswell Park. We have a cooperative relationship with them, and they will take care of you and contact your Roswell Park doctor to coordinate your care.

Please bring your green Roswell Park identification card to Buffalo General so they will know you are a Roswell Park patient.

If you live outside the Buffalo area, please go to the emergency department of the nearest hospital.

Preparation #1 – GoLytely®/NuLytely®

Supplies: Prescription for GoLYTELY®or NuLYTELY®.

  • Metoclopramide (Reglan®) 5mg (optional)
  • Simethicone 125mg (optional)

Take 1 tablet 4 times a day with water one day before your procedure to decrease the risk of nausea (metoclopramide) and/or the formation of foam/gas in your bowels (simethicone).

Instructions for Prep #1

2 Days Before Your Procedure

For best results, follow these instructions to the best of your ability: Stop eating corn, seeds, nuts, beans, popcorn, lettuce, tomatoes, and anything that is red or purple in color. If possible, place your GoLYTELY®/ NuLYTELY® in the refrigerator. It tastes better when chilled.

The Day Before Your Procedure

  • Drink clear liquids (Gatorade®, soda, clear juices, broth, or water).
  • Do not eat solid food or eat/drink any milk products.
  • At 4pm: Begin drinking GoLYTELY®/ NuLYTELY®. Drink 1 cup (8 ounces) every 10-15 minutes until it is gone (1 gallon). This may take only 3 hours, but if you become nauseated, it may take 4 to 5 hours.
  • If you vomit, wait until the nausea subsides and proceed with the prep. A good cleansing is usually achieved even if you vomit, IF the prep is continued.
  • Even if the stool looks clear, do not stop taking the laxatives.
  • Drink at least 4 more 8-ounce cups of clear liquids before midnight.
  • At 12am (midnight): Do not eat or drink anything after midnight. If you need to take medication, take it with a sip of water. No gum or hard candy after midnight.

The Day of Your Procedure

  • Do not eat or drink anything.
  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.

Preparation #2 – Halflytely® and Bisacodyl Tablets Bowel Prep Kit

Supplies: Prescription for a Halflytely® and Bisacodyl Tablets

Bowel Prep Kit(This is only half the volume of regular bowel prep and may be more expensive.)

  • Metoclopramide (Reglan®) 5mg (optional)
  • Simethicone 125mg (optional)

Take 1 tablet 4 times a day with water one day before your procedure to decrease the risk of nausea (metoclopramide) and/or the formation of foam/gas in your bowels (simethicone).

Instructions for Prep #2

2 Days Before Your Procedure

For best results, follow these instructions to the best of your ability. Stop eating corn, seeds, nuts, popcorn, beans, lettuce, tomatoes, or anything that is red or purple in color. If possible, place your Halflytely® in the refrigerator. It tastes better when chilled.

The Day Before Your Procedure

  • Drink clear liquids (Gatorade®, soda, clear juices, broth, or water).
  • Do not eat solid food or eat / drink any milk products.
  • At 12pm (noon): Take 2 tablets of bisacodyl, 5mg each, with 1 cup of water.
  • At 6pm: Wait for a bowel movement (or a maximum of 6 hours). Begin drinking Halflytely®. Drink 1 cup (8 ounces) every 10-15 minutes until the container is empty. This may take only 90 minutes, but if you are full or nauseated, you may take longer to complete the process.
  • If you vomit, wait until the nausea subsides and proceed with the prep. A good cleansing is usually achieved even if you vomit, IF the prep is continued.
  • Even if the stool looks clear as you do the prep, do not stop taking the laxatives.
  • Drink at least 4 more cups (8 ounces each) of clear liquids before midnight.
  • At 12am (midnight): Do not eat or drink anything after midnight. If you need to take any medication, take it with a sip of water. No gum or hard candy after midnight.

The Day of Your Procedure

  • Do not eat or drink anything.
  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.

Preparation #3 – MiraLAX® and Bisacodyl

Supplies

  • MiraLAX® (one 238 gram bottle)
  • Bisacodyl (four 5mg tablets)

You will not need a prescription for MiraLAX® or bisacodyl – both medications are available over the counter. You will likely have to pay
out of pocket for these medications.

Instructions for Prep #3

2 Days Before Your Procedure

For best results, follow these instructions to the best of your ability:  Stop eating corn, seeds, nuts, popcorn, beans, lettuce, tomatoes, and anything that is red or purple in color.

The Day Before Your Procedure

  • Drink clear liquids (Gatorade®, soda, clear juices, broth, or water).
  • Do not eat solid food or eat / drink any milk products.
  • At 12pm (noon): Take 4 tablets, 5mg each, of bisacodyl with 1 cup water.
  • At 4pm: Mix the 238 gram bottle of MiraLAX® with 64 ounces of water, Gatorade®, or any other clear liquid. If you have diabetes, you may use a sugar-free substitute such as Crystal Light®. Drink an 8-ounce glass every 10 minutes until it is finished.
  • If you vomit, wait until the nausea subsides and proceed with the prep. A good cleansing is usually achieved even if you vomit, IF the prep is continued.
  • Even if the stool looks clear as you do the prep, do not stop taking the laxatives.
  • Drink at least 4 more cups (8 ounces each) of clear liquids before midnight.
  • At 12am (midnight): Do not eat or drink anything after midnight. If you need to take any medication, take it with a sip of water. No gum or hard candy after midnight.

The Day of Your Procedure

  • Do not eat or drink anything.
  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.

Extended Preparation #4 – GoLYTELY®, Magnesium Citrate, and Bisacodyl (Recommended for those resistant to traditional bowel preparation)

Supplies: You will need a prescription for GoLYTELY® or NuLYTELY®. You will need to purchase one 300ml bottle of magnesium citrate and four 5mg bisacodyl tablets – both are available without a prescription. You will likely have to pay out of pocket for these two medications.

  • Metoclopramide (Reglan®) 5mg (optional)
  • Simethicone 125mg (optional)

Take 1 tablet 4 times a day with water one day before your procedure to decrease the risk of nausea (metoclopramide) and/or the formation of foam/gas in your bowels (simethicone).

Instructions for Prep #4

3 Days Before Your Procedure

For best results, follow these instructions to the best of your ability: Stop eating corn, tomatoes, seeds, nuts, popcorn, beans, lettuce, and anything that is red or purple in color.

2 Days Before Your Procedure

  • Drink clear liquids (i.e., Gatorade®, soda, clear juices, broth, or water). Do not eat solid food or eat / drink any milk products.
  • If possible, place your GoLYTELY®/NuLYTELY® in the refrigerator. It tastes better when chilled.
  • At 12pm (noon): Take two tablets, 5mg each, of bisacodyl with 1 cup of water
  • At 8 pm: Drink one 300ml bottle of magnesium citrate.

The Day Before Your Procedure

  • Continue to drink clear liquids (Gatorade®, soda, clear juices, broth, anything. or water). Do not eat solid food or eat / drink any milk products.
  • At 12pm (noon): Take two tablets, 5 mg each, of bisacodyl with 1 cup of water.
  • At 4pm: Begin drinking GoLYTELY®/ NuLYTELY®. Drink 1 cup (8 ounces) every 10-15 minutes until the container is completely emptied (total of one gallon). This may take only 3 hours, but if you are full or nauseated, it may take 4 to 5 hours.
  • If you vomit, wait until the nausea subsides and proceed with the prep. A good cleansing is usually achieved even if you vomit, IF the prep is continued.
  • Even if the stool looks clear as you do the prep, do not stop taking the laxatives.
  • Drink at least 4 more cups (8 ounces each) of clear liquids before midnight.
  • At 12am (midnight): Do not eat or drink anything after midnight. If you need to take any medication, take it with a sip of water. No gum or hard candy after midnight.

The Day of Your Procedure

  • Do not eat or drink anything.
  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.

Preparation #5 – Magnesium Citrate (Not recommended for non-GYN procedures that require full bowel prep.)

Supplies: You will need to purchase two 300ml bottles of magnesium citrate, which is available without a prescription. You will likely have to pay out of pocket for this medication.

  • Metoclopramide (Reglan®) 5mg (optional)
  • Simethicone 125mg (optional)

Take 1 tablet 4 times a day with water one day before your procedure to decrease the risk of nausea (metoclopramide) and/or the formation of foam/gas in your bowels (simethicone).

Instructions for Prep #5

2 Days Before Your Procedure

For best results, follow these instructions to the best of your ability: Stop eating corn, tomatoes, seeds, nuts, popcorn, beans, lettuce, and anything that is red or purple in color.

The Day Before Your Procedure

  • Drink clear liquids (Gatorade®, soda, clear juices, broth, or water).
  • Do not eat solid food or eat / drink any milk products.
  • At 4pm: Drink one full bottle of magnesium citrate.
  • At 8pm: Drink a second full bottle of magnesium citrate. Drink at least 4 more cups (8 ounces each) of clear liquids before midnight.
  • Even if the stool looks clear as you do the prep, do not stop taking the laxatives.
  • 12am (midnight): Do not eat or drink anything. If you need to take medication, take it with a sip of water. No gum or hard candy after midnight.

The Day of Your Procedure

  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.
  • Do not eat or drink anything.

Preparation #6 – Clear Liquid Diet Only

Instructions for Prep #6

The Day Before Your Procedure

  • Starting at dinner time, drink clear liquids only (e.g., Gatorade®, soda, clear juices, broth, or water). Do not eat solid food or eat/drink any milk products.
  • Additional clear liquids are encouraged to avoid dehydration. Drink plenty of clear liquids until midnight.
  • At 12am (midnight): Do not eat or drink anything after midnight. If you need to take medication, take it with a sip of water.

The Day of Your Procedure

  • Do not eat or drink anything.
  • If you need to take any medication, you may take it with a sip of water, up to 2 hours before your procedure.

Suggestions for a Clear Liquid Diet

Beverages

  • Soft drinks (ginger ale, cola, lemon/lime, etc. – not red or purple)
  • Gatorade® or Kool-Aid® (not red or purple)
  • Strained fruit juice without pulp (apple, etc.)
  • Water or flavored waters
  • Tea or coffee (may add sugar, but not milk or creamers)

Soups

  • Chicken broth or bouillon
  • Beef broth or bouillon
  • No added meats, noodles, or vegetables

Desserts

  • Hard candy
  • Jell-O® (not red or purple, and no fruit toppings or whipped cream)
  • Popsicles or lemon ice (not red or purple, and no sherbets or fruit bars)

Restrictions

  • No reds or purples (for example, no grape juice, cherry Jell-O® or strawberry Jell-O®)