Ensuring a safe and effective procedure
It’s important that you understand and comply with specific instructions to prepare for your colonoscopy procedure. A thorough prep is the most important step in achieving a successful exam. It allows you to cleanse your colon completely, providing a clear view of the intestinal tract. This ensures that the procedure is safe for you but also reduces the chance of missed findings.
While most patients follow standard preparation steps, please be sure to follow the specific instructions given to you by your provider. If you do not follow the preparation instructions, your colonoscopy may need to be canceled, rescheduled, or repeated.
How to prepare for a colonoscopy
Getting ready for your colonoscopy involves a few key steps to make sure your Penn Medicine care team can provide the most accurate results.
Pre-procedure preparation for a colonoscopy
You’ll want to start preparing for your test up to two weeks prior to the procedure. If you have specific questions about preparing for your colonoscopy at Penn Medicine, please call the gastroenterology practice that is performing your procedure for more information.
Pick up your preparation materials (laxative products) as instructed. For most patients, this will be:
- MiraLAX®: 1 bottle, 238 grams (if your doctor has advised you to use a different prep than MiraLAX, you will need a prescription).
- Dulcolax® (Bisacodyl): 4 pills, 5 mgs each.
- Gatorade or Crystal Light Lemonade: 64 ounces (two 32-ounce bottles). Use yellow, green, or clear colors only.
Please review all of your prep instructions during this time.
You are required to arrange transportation to take you home after the procedure. Arrange for a responsible person to pick you up after your colonoscopy. Tell them that your estimated exam completion time will be two to three hours after your arrival time. You are not allowed to drive or leave the endoscopy center alone.
You may need to stop certain medications prior to your procedure. Check the following medications and supplements section to understand which medications you must stop and when. Contact your physician if needed to determine the timeline.
Eat a low-fiber diet for one week before your exam. Avoid seeds, nuts, popcorn, or other high-fiber foods. 2-3 days before the procedure, also avoid oatmeal, whole grains, beans, peas, corn, and peels of fruits of vegetables. Review the following low-fiber diet section for guidance on how to eat to make your preparation more successful.
Food
- Do not eat any solid food for breakfast, lunch, or dinner.
- You may have clear broth or bouillon, Jell-O®, and ice pops (yellow, green, or clear).
Drink
- Drink plenty of clear fluids, including water (still, sparkling, seltzer), broth, apple juice, white grape juice, or diet or regular ginger ale or Sprite®.
- Do not have any red, blue, or purple foods and drinks.
- Do not drink alcohol.
- You can drink coffee and tea, but no milk or cream.
Smoking
- Avoid smoking tobacco, cigars, cannabis, or vaping products for at least 24 hours before your scheduled procedure to reduce the risk for reactive airway complications.
4:00 pm on the day before your colonoscopy:
- Take 4 Dulcolax® pills.
- Mix the entire MiraLAX® bottle with 64 ounces of Gatorade or Crystal Light lemonade in a large pitcher. Stir and place in the refrigerator.
5:00 to 6:00 pm on the day before your colonoscopy:
- Drink the first half (32 ounces) of MiraLAX solution during this hour. You may not enjoy the taste; try drinking it cold, using a straw, or taking small sips. Use a measuring cup or large drinking glass to measure eight ounces.
- At 5:00 pm: Drink 8 ounces of the MiraLAX solution.
- At 5:15 pm: Drink 8 ounces of the MiraLAX solution.
- At 5:30 pm: Drink 8 ounces of the MiraLAX solution.
- At 5:45 pm: Drink 8 ounces of the MiraLAX solution.
Important medication considerations
You’ll need to stop taking certain medications and supplements in advance of your procedure. Some medications must be stopped at least one week or more before your colonoscopy. Please refer to your preparation instructions for specific medication information.
If you take aspirin, do not stop taking your aspirin. If you take NSAIDs, such as Advil®, Motrin®, Celebrex®, or ibuprofen, you may continue to take them as usual.
If you take prescription medications to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it.
Do not stop these medications without the consent of your physician. Some endoscopic procedures may be performed while on these medications, while others may not.
Some examples of blood thinners are:
- Coumadin® (warfarin)
- Plavix® (clopidogrel)
- Ticlid® (ticlopidine hydrochloride)
- Agrylin® (anagrelide)
- Xarelto® (Rivaroxaban)
- Pradaxa® (Dabigatran)
- Eliquis® (Apixaban)
- Effient® (Prasugrel)
You will need to stop taking any GLP-1 agonists (e.g. Ozempic) and SGLT-2 inhibitors (e.g. Jardiance) before your procedure due to a small risk that you could experience a serious reaction. If you do not stop these medications far enough in advance, your procedure may need to be canceled or rescheduled.
Stop seven days before your procedure:
- Dulaglutide (Trulicity®)
- Exenatide (Byetta®, Bydureon®)
- Lixisenatide (Adlyxin®)
- Liraglutide (Saxenda®, Victoza®)
- Orforglipron (Foundayo®)
- Semaglutide (Ozempic®, Wegovy®, Rybelsus®)
- Tirzepatide (Mounjaro®, Zepbound®)
Stop four days before your procedure:
- Ertugliflozin (Steglatro™)
- Ertugliflozin/metformin (Segluromet™)
- Ertugliflozin/sitagliptin (Steglujan™)
Stop three days before your procedure:
- Bexagliflozin (Brenzavvy®)
- Canagliflozin (Invokana®)
- Canagliflozin/metformin (Invokamet®)
- Canagliflozin/metformin XR (Invokamet® XR)
- Dapagliflozin (Farxiga®)
- Dapagliflozin/metformin XR (Xigduo®)
- Dapagliflozin/metformin XR (Xigduo® XR)
- Dapagliflozin/saxaglipitin (Qtern®)
- Dapagliflozin/saxaglipitin/metformin (Qternmet® XR)
- Empagliflozin (Jardiance®)
- Empagliflozin/metformin (Synjardy®)
- Empagliflozin/metformin XR (Synjardy® XR)
- Empagliflozin/linagliptin (Glyxambi®)
- Empagliflozin/linagliptin/metformin XR (Trijardy® XR)
Low-fiber diet guidelines
Starting one week before your colonoscopy, try to eat a low-fiber diet to make your preparation more successful. Avoid seeds, nuts, popcorn, or other high-fiber foods.
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Vegetables (Well-Cooked Only)
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Dairy
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Fruits (Low-Fiber Only)
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Snacks & Sweets
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Proteins
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Grains & Carbs
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Drinks
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| Number of Days Before Procedure | Sample Low-Fiber Meal Plan |
|---|---|
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Day 7 |
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Day 6 |
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Day 5 |
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Day 4 |
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Day 3 |
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Day 2 |
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Day 1 Before Your Procedure (Prep Day) |
You may only consume clear liquids from when you wake up until your procedure is completed tomorrow. Please refer to your prep instructions. |
Day of colonoscopy procedure
This section provides essential instructions for the day of your colonoscopy procedure. Following these guidelines will help ensure a smooth and successful examination.
- Do not eat or drink anything the morning of the procedure.
- You can take medications with small sips of water.
- Do NOT drink any liquids later than three hours before your arrival time.
- You can brush your teeth.
- Pack lightly and wear loose, comfortable clothing. Leave your money and all other valuables, including jewelry, at home.
Drink the remaining half (32 ounces) of the MiraLAX solution starting six hours before your arrival time. It’s important to finish drinking all the solution. You may need to set an alarm to meet this time requirement.
- Six hours before arrival: Drink 8 ounces of the MiraLAX solution.
- Five hours and 45 minutes before arrival: Drink 8 ounces of the MiraLAX solution.
- Five hours and 30 minutes before arrival: Drink 8 ounces of the MiraLAX solution.
- Five hours and 15 minutes before arrival: Drink 8 ounces of the MiraLAX solution.
The exact times can be found using the following table, based on your arrival time:
| Scheduled arrival time | START drinking your remaining prep at | Complete drinking entire prep by |
|---|---|---|
| 7 am | 1 am | 2 am |
| 8 am | 2 am | 3 am |
| 9 am | 3 am | 4 am |
| 10 am | 4 am | 5 am |
| 11 am | 5 am | 6 am |
| 12 pm | 6 am | 7 am |
| 1 pm | 7 am | 8 am |
| 2 pm | 8 am | 9 am |
| 3 pm | 9 am | 10 am |
| 4 pm | 10 am | 11 am |
Post-procedure colonoscopy care
After the colonoscopy procedure, it’s important to follow specific guidelines for a smooth recovery. This section provides essential information on what to expect from day-of colonoscopy recovery at Penn Medicine and how to care for yourself during this time.
- After the colonoscopy, you will go to a recovery area where a nurse will watch you until most of the effects of the relaxing medicine have worn off.
- You may have some cramping or bloating because air is placed into your intestine during the test. This should go away after several hours.
- The nurse will provide information about how to take care of yourself at home.
- A copy of your exam results will be sent to your referring doctor.
- We will contact you with the test results. If you do not hear from us within one week, please call the number listed for your test location.
- You should NOT do any of the following until the day after your exam: drive a car, operate machinery or power tools, drink alcoholic beverages, or make any important decisions.
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Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.