Bowel Prep Instructions

Please follow these important bowel prep instructions as requested by Dr. Deirdre Hart.

A endoscopy nurse will call you about one week prior with additional instructions.

One Week Prior to Procedure

No vitamins, iron, vitamin E, aspirin, or blood thinners 

Important Bowel Prep Instructions

Please purchase the following items:

  • 4 Dulcolax laxative (or generic Bisacodyl) 5 mg tablets
  • ​238 gram bottle of Miralax (powdered laxative)
  • ​1 bottle of Magnesium Citrate, 10 oz liquid
  • ​64 oz bottle of POWERADE, Gatorade, or Crystal Light (any flavor/color). May use water instead.

Diabetic patients only: Take only half a dose of your diabetic medication the day before your procedure and NO diabetic medication the day of your procedure.

1 Day Prior: Clear Liquid Diet All Day, NO SOLID FOOD

Clear liquids may include water, apple juice, tea, white grape juice, Crystal Light, Sprite, 7UP, ginger ale, lemon-lime, lemonade, chicken broth, Jell-O (any flavor/color).

  • 1:00 pm - Drink the bottle of Magnesium Citrate.
  • 3:00 pm - Take 2 Dulcolax tablets.
  • 5:00 pm - Take 2 Dulcolax tablets. Mix bottle of Miralax with the 64 oz drink you picked up (may use water instead if you prefer). Drink an 8 oz glass every 15-20 minutes until GONE. Do not drink all at once, may cause some cramping.
  • Midnight/12:00 am - Nothing by mouth (NO food or drink) after midnight.

Day of Procedure

On the day of the procedure, if you are still passing any stool, take a plain Fleet Enema and repeat if necessary.

Check List Before Leaving for Procedure

  • Bring a DRIVER, photo ID, and insurance card.
  • ***If you have an ostomy, please bring extra ostomy appliance supplies with you.***

Should you have any questions regarding the PREP instructions, please call our office at 618.277.7400.


Screening Colonoscopy Versus Diagnostic Colonoscopy

Screening Colonoscopy

Patient is over 45 and asymptomatic with no GI issues to report.

  • No pathology found to report. IF screening colonoscopy is a benefit, insurance should consider it as a covered benefit.
  • If pathology is found and reported, a modifier is added to the claim to demonstrate it was a screening procedure which changed to a diagnostic one, which changes patient responsibility for payment.

Diagnostic Colonoscopy

Patient of any age with any GI symptoms or a positive Cologuard or fecal occult test.

  • GI symptoms disqualify any colonoscopy from being a “screening” procedure, even if it is the first procedure a patient has had or they are due for repeat. Examples include diverticulitis, rectal bleeding, abdominal pain, abnormal imaging, etc.
  • Most insurance companies consider Cologuard to be the primary colon cancer screening test if done first. If test result is positive, colonoscopy can only be diagnostic.
  • Colonoscopy may be a covered benefit, but diagnostic colonoscopy is not considered “screening” or preventative care.