Scheduled for a colonoscopy?
Watch our video to learn how to prepare
Download the guide or review the instructions below:
Review preparation instructions for the location or type of colonoscopy:
What is a Colonoscopy?
A colonoscopy is an examination of the lining of the rectum and colon (the large intestine) through a flexible tube called a colonoscope. This allows a specially trained doctor to directly view this area and identify, biopsy, or remove any abnormalities such as polyps. Removal of polyps helps to prevent colon cancer.
Any stool that is left in the colon can hide polyps and small cancers and result in the need to repeat the colonoscopy. Therefore, it is critical that you follow your physician's instructions as directed. To make sure your colon is as clean as possible before your test, it is very important to follow the colonoscopy preparation instructions.
You will be given sedation for the procedure. For your safety, you must arrange for a responsible adult to escort you home after the procedure. If you are planning to take a bus, taxi or paratransit home from your procedure, you must have someone with you other than the driver. If you do not have an escort at the time of your procedure, your procedure will be canceled.
Colonoscopy Preparation Guide
The following information will help you prepare and know what to expect for your colonoscopy at Penn Medicine Radnor, Pennsylvania Hospital, Penn Presbyterian and the Perelman Center.
Please read this entire page. Preparation begins one to two weeks before your colonoscopy.
It is very important to follow these colonoscopy prep instructions to make sure your colon is as clean as possible and to get the highest quality procedure. Your colonoscopy may need to be canceled if instructions are not followed.
One to Two Weeks Before
Preparation for a colonoscopy begins a few weeks before the actual procedure to address medication interactions, preparation materials and dietary changes.
If you take prescription medications regularly — including blood thinners and diabetes medications — ask the doctor who prescribed them if and when you should stop taking them before your colonoscopy. Do not stop taking any of your regular medications without direction from your doctor.
Please check with your prescribing physician if you currently take any of the following medications:
- 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)
- Ertugliflozin (Steglatro™)
- Ertugliflozin/metformin (Segluromet™)
- Ertugliflozin/sitagliptin (Steglujan™)
You will need to pause taking the medications listed above for at least three days before your colonoscopy. Please discuss pausing your medications with the doctor who prescribed them. Do not stop taking medications without reviewing your plan with your doctor’s office. If you do not pause taking these medications for at least three days before your colonoscopy, the exam may need to be delayed or cancelled.
If you take any other medications regularly — including blood thinners — ask the doctor who prescribed them when you should stop taking them. Do not stop taking any of your regular medications without directions from your prescribing doctor.
Stop taking iron supplements seven days (one week) before your colonoscopy.
Purchase these preparation materials:
- MiraLAX®: 1 bottle, 238 grams
- Dulcolax® (Bisacodyl): 4 pills, 5 mgs each
- Gatorade or Crystal Light Lemonade: 64 ounces (two 32 ounce bottles), yellow, green, or clear only
Try to eat a low-fiber diet for one week before your colonoscopy. Avoid seeds, nuts, popcorn or other high-fiber foods.
Arrange for a responsible person to pick you up after your exam is completed. Inform 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.
One Day Before
Food:
- Do not eat any solid foods the day before your colonoscopy. This includes breakfast, lunch and dinner.
- You may have clear broth or bouillon, Jell-O® and ice pops (yellow, green or clear).
Drink:
- Drink plenty of clear fluids such as: water, broth, apple juice, white grape juice, and diet/regular Ginger Ale or Sprite®.
- Do not have any red, blue or purple foods and drinks.
- Do not drink alcohol.
- Coffee and tea are OK, no milk or cream.
4 pm on the Day Before the Exam
- Take four 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 to 6 pm on the Day Before the Exam
Drink the first half (32 ounces) of MiraLAX solution – 8 ounces at a time - during this hour. You may not enjoy the taste; try drinking it cold, use a straw, or take small sips. Use a measuring cup to make sure you are drinking the right amount.
- 5:00 pm: Drink 8 ounces of the MiraLAX solution
- 5:15 pm: Drink 8 ounces of the MiraLAX solution
- 5:30 pm: Drink 8 ounces of the MiraLAX solution
- 5:45 pm: Drink 8 ounces of the MiraLAX solution
Six Hours Before Arrival Time
You may need to set an alarm to meet this time requirement.
Drink the remaining half (32 ounces) of MiraLAX solution – 8 ounces at a time - starting six hours before your ARRIVAL time. It is important to finish drinking all of the solution before the colonoscopy procedure.
- 6 hours before arrival: Drink 8 ounces of the MiraLAX solution
- 5 hours and 45 minutes before arrival: Drink 8 ounces of the MiraLAX solution
- 5 hours and 30 minutes before arrival: Drink 8 ounces of the MiraLAX solution
- 5 hours and 15 minutes before arrival: Drink 8 ounces of the MiraLAX solution
Based on your arrival time, the exact times you should drink the solution can be found using the Solution Schedule table below.
Do not drink or eat anything within three hours of your colonoscopy procedure.
Solution Schedule
Based on your arrival time, please refer to the chart below for the second part of your colonoscopy preparation.
Stop drinking all liquids at least three hours before arrival time.
| Drink 8 oz. |
Drink 8 oz. |
Drink 8 oz. |
Drink 8 oz. |
Arrival |
| 1:00 am |
1:15 am |
1:30 am |
1:45 am |
7:00 am |
| 1:30 am |
1:45 am |
2:00 am |
2:15 am |
7:30 am |
| 2:00 am |
2:15 am |
2:30 am |
2:45 am |
8:00 am |
| 2:30 am |
2:45 am |
3:00 am |
3:15 am |
8:30 am |
| 3:00 am |
3:15 am |
3:30 am |
3:45 am |
9:00 am |
| 3:30 am |
3:45 am |
4:00 am |
4:15 am |
9:30 am |
| 4:00 am |
4:15 am |
4:30 am |
4:45 am |
10:00 am |
| 4:30 am |
4:45 am |
5:00 am |
5:15 am |
10:30 am |
| 5:00 am |
5:15 am |
5:30 am |
5:45 am |
11:00 am |
| 5:30 am |
5:45 am |
6:00 am |
6:15 am |
11:30 am |
| 6:00 am |
6:15 am |
6:30 am |
6:45 am |
12:00 pm |
| 6:30 am |
6:45 am |
7:00 am |
7:15 am |
12:30 pm |
| 7:00 am |
7:15 am |
7:30 am |
7:45 am |
1:00 pm |
| 7:30 am |
7:45 am |
8:00 am |
8:15 am |
1:30 pm |
| 8:00 am |
8:15 am |
8:30 am |
8:45 am |
2:00 pm |
| 8:30 am |
8:45 am |
9:00 am |
9:15 am |
2:30 pm |
| 9:00 am |
9:15 am |
9:30 am |
9:45 am |
3:00 pm |
| 9:30 am |
9:45 am |
10:00 am |
10:15 am |
3:30 pm |
| 10:00 am |
10:15 am |
10:30 am |
10:45 am |
4:00 pm |
What to Expect During the Colonoscopy
The primary goal of a colonoscopy is to screen patients for gastrointestinal issues, like polyps or cancer. During a colonoscopy, your gastroenterologist or colorectal surgeon – the providers that typically perform colonoscopies – will look for abnormalities using the small, illuminated camera attached to the end of the colonoscope.
On the day of your test, pack lightly and wear loose, comfortable clothing. Leave your money and all other valuables, including jewelry, at home. Despite restrictions with eating and drinking, you can brush your teeth.
The test takes about 30 to 60 minutes, but plan to spend two to three hours at the unit to allow time for your preparation, your test, and your recovery. We give each patient the attention needed for his or her test; however, unexpected delays may occur.
Before the test, a nurse will greet you and help you change into a hospital gown. The nurse will place a catheter in your arm. You will receive relaxing medicines through the catheter during the test.
A colonoscopy procedure follows these steps:
- A thin, flexible tube called a colonoscope is inserted by the healthcare provider into the anus.
- The colonoscope is then slowly moved forward through to the end of the colon until it reaches the small intestine.
- As the tube advances, air is pumped to inflate the colon. The colonoscope’s camera captures video of the interior of the colon during this time, displaying the video on a nearby monitor visible to the healthcare provider. They will observe the video for any abnormal findings.
- Once they reach the end of your colon, the provider will pull the colonoscope back through the same route in the opposite direction while re-examining the video.
What Happens After a Colonoscopy?
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, whilea copy of your exam results will be sent to your referring doctor.
We will contact you with the test results. If you have not heard from us in seven days, 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
- Make any important decisions
*Note: Please follow the instructions as listed for all colonoscopy testing locations. The polyethylene glycol (PEG) solution instructions should be followed only if your doctor tells you to.
Contact Us
If you have specific questions about preparing for your colonoscopy at Penn Medicine, please call your testing location.