Union Health 

Patient Information Sheet 



Phone appointment with Pre-Anesthesia Testing nurse:    
Please be sure to answer this call. If you miss the call, please call the PAT clinic at 812-238-7474. All of your medications will be discussed and instructions will be given by the pre-anesthesia testing nurse during this phone appointment. 

Procedure Date:  


Place of Service:  

Please make transportation arrangements, you will not be able to drive yourself home. 


Procedure Time: The PAT clinic will call you the day prior to your procedure to give your arrival time.   

You will need to pick up the following at the pharmacy:  
A 238 gram bottle of Miralax 
A box of Dulcolax Laxative tablets. 
We strongly recommend purchasing 64oz of Gatorade or Powerade to mix with the Miralax. This will help keep you hydrated during your prep. If you are diabetic, we recommend Propel Fitness water, Gatorade Zero or any no sugar alternative. If you do not wish to use Gatorade you may mix with another liquid that follows your clear liquid diet. 

Important things to note:  

- Do not take any anti-inflammatories (Ibuprofen, Advil, Aleve, Motrin, Nuprin, Medipren or fish oil) for 5 days prior to your procedure. You may take Tylenol. 

Do not eat popcorn or chia seeds 5 days prior to your procedure 

- If you are currently taking any prescribed blood thinners:   
Plavix, EffientBrilinta, Warfarin/Coumadin - needs to be stopped 5 days prior to your procedure. 
Pradaxa, Eliquis – needs to be stopped 2 days prior to your procedure 
Xarelto – needs to be stopped 1 day prior to your procedure 
Aspirin – 81 mg once a day does not need to be stopped, you may take as normal.  


      GI office will contact your prescribing physician to request clearance for you to stop these prior to the procedure. Plan on stopping them the number of days listed unless you are contacted and told otherwise. If your doctor does not grant clearance you will be contacted and advised to continue taking your medications as normal. If you have any concerns about this you may contact your prescribing physician. 

2 days prior to your colonoscopy:  
Soft diet all day.   

5pm:  Take 2 Dulcolax tablets with 8oz glass of water.    


Coco, coffee, tea, carbonated beverages, synthetic fruit-flavored drinks (no red food coloring), cooked refined cereals (cream of wheat, oatmeal), gelatin, sherbet, ice cream, ice, pudding, custard, cream, butter, margarine in cereal or soup, pureed meats, very thin cream soup or broth, baby food, strained cream soups, broth or bouillon, vegetables pureed in milk or very thin cream soups or broth, salt, honey, sugar, plain syrups, hard candy, marshmallows, flavorings except anything with red, purple or orange food coloring, soft chocolate, plain cream candies, eggs chopped finely. 

Start your colonoscopy bowel prep 1 day before procedure:  
Your clear liquid diet begins when you wake up this morning, this means absolutely no solid foods.  If you consume solid foods at any point during this day you will need to contact our office and your procedure may have to be rescheduled.  
Things you may have 
- Any water, sodas, clear fruit juices, sports drinks, drink mixes such as crystal light, etc. Please do not drink anything red or blue.  
- Coffee and tea's, you may add sugar or sweeteners but no milk or milk products and no powdered creamer products.
- Soup broths, Consomme, bullion - make sure there are no food pieces.  
- You may also have popsicles and jello, make sure there is no added fruit/fruit pieces. Please nothing red or blue. 
- You may have gum and dissolvable mints, do not swallow gum. No gum or mints after midnight please. 


No cigarette's, chewing tobacco, or vaping of any kind the day of your prep. 
Bowel prep instructions: 


4pm: Take 4 Dulcolax Laxative Tablets 

5pm: Mix 238 grams of Miralax with 64 ounces of Gatorade and drink ½ of this preparation (32 oz).  You have 2 hours to drink, this half needs to be completed by 7pm. 
You can continue your clear liquid diet up until midnight. Nothing to eat or drink after midnight, except the second dose of the bowel prep.  


Second dose: You will drink your second dose 6 hours prior to your arrival time. You will be given your arrival time closer to the date of the procedure. When given your arrival time you will count 6 hours before, this is when you will drink the remaining Miralax mixture. You will have 2 hours to complete this. No more liquids once this prep is finished. 


If you have any questions please feel free to contact your doctors office. 

Reference: Union Health.