Henry C. Ho, M.D.

A colonoscopy is an internal exam used to detect colon polyps. Colorectal cancer can occur from these polyps. When detected early, the polyps can be removed, preventing them from becoming colorectal cancer. Most colon cancers have no symptoms which is why screenings are so important.

Patients with a personal history of polyps, a strong family history of colorectal cancer, inherited forms of colorectal polyps or cancers, or predisposing chronic digestive conditions such as inflammatory bowel disease, Crohn’s Disease or ulcerative colitis should schedule a colonoscopy by the age of 45.

A rise in colon cancer diagnoses in people younger than 50 led the U. S. Preventative Services Task Force to establish a new guideline siting age 45 for colonoscopy. When detected early, the polyps can be removed, preventing them from becoming colorectal cancer.

From 2012 to 2016, colon cancer cases increased every year by 2 percent in people younger than 50, according to cancer.org.

According to mdanderson.org, if the current trend continues, by 2030 colon cancer cases are projected to increase by 90 percent in patients 35 and younger.

Please read entire instruction sheet carefully.

You must purchase the following:
– 6 Bisacodyl (Dulcolax) Laxative tablets
– 1 Miralax 238-gram bottle
– 64 ounces of Gatorade (or similar beverage)

The Day Before Your Procedure

• Mix Miralax powder with 64 ounces of Gatorade (or similar beverage). Shake well and refrigerate.
• YOU MUST BE ON A CLEAR LIQUID DIET ALL DAY.
• No red or purple dyes
• Clear tea, soft drinks, Gatorade, coffee no cream, Jell-O, popsicles, clear bouillon, apple juice, Kool-Aid, water, water ice
• NO solid food
• At 12 p.m., take 3 Bisacodyl (Dulcolax) tablets with 8 ounces of clear liquid.
• At 1 p.m., drink ½ the Miralax solution. Drink one 8-ounce glass every 15-30 minutes. If you are full or have nausea, stop or slow your intake for 30 minutes, then start again.
• At 5 p.m., take the remaining 3 Bisacodyl (Dulcolax) tablets with 8 ounces of clear liquid.
• At 6 p.m., drink the remaining ½ of the Miralax solution until completed (8 ounces every 15-30 minutes).
• Do not drink or eat anything after the prep is complete except for medications you are required to take (i.e. blood pressure medications) with a small sip of water.
• You must take ALL of the prep solution to clean your bowel adequately. Even if you are passing clear liquid, you must continue to take the entire dose of the prep.

The Day of Your Procedure

• NO solid food. Stop all liquids 4 hours before your arrival time. No gum or breath mints.
• You MUST take your morning heart, blood pressure, asthma, and/or seizure medications with a small sip of water.

Notes and Reminders

• Be sure to bring someone with you who can remain during the procedure and drive you home.
• Please consult your prescribing provider at least 1 week prior to your scheduled procedure regarding any diabetic or anti-coagulant medication (Plavix, Coumadin, Xarelto, etc). Speak to your primary care provider or endocrinologist regarding your diabetes medications prior to your procedure. If you take blood thinners, we prefer that these are held prior to the procedure. Please call your prescribing provider to determine if it is safe to hold these medications and for how many days prior to your procedure.
• For 1 week prior to the procedure, avoid iron tablets or vitamins with iron supplements, oil-based vitamins or herbals, and fiber supplements. Also avoid salads or high fiber foods including seeds, corn, quinoa, or nuts.
• Wear comfortable, loose-fitting clothing. Do not wear body piercings, jewelry, or valuables. Do not wear eye make-up or contact lenses.
• You will not be able to drive, operate machinery, or return to work for the rest of the day. You may resume normal activities the next day unless the doctor states otherwise.

Please read entire instruction sheet carefully.

The Day Before Your Procedure

• Mix all of the PEG 3350 with water or any clear liquid of your choice then refrigerate.
• YOU MUST BE ON A CLEAR LIQUID DIET ALL DAY — No red or purple dyes. Clear tea, soft drinks, Gatorade, coffee no cream, Jell-o, popsicles, clear bouillon, apple juice, Kool-Aid, water, water ice are permitted.
• NO solid food.
• Start drinking PEG 3350 mixture at 6 p.m. the day prior to your procedure. You may flavor with Crystal Light. Drink one 8-ounce glass every 15-30 minutes until you have consumed ½ the container. If you are full or have nausea, stop or slow your intake for 30 minutes, and then start again.
• Resume drinking the second ½ of the container at 8 p.m. until completed. (8 ounces every 15-30 minutes).
• Do not drink or eat anything after the prep is complete except for medications you are required to take (i.e. blood pressure medications) with a small sip of water.
• You must take ALL of the prep solution to clean your bowel adequately. Even if you are passing clear liquid, you must continue to take the entire dose of the prep.

The Day of Your Procedure

• NO solid food. Stop all liquids four hours before your arrival time. No gum or breath mints.
• You MUST take your morning heart, blood pressure, asthma, and/or seizure medications with a small sip of water.

Notes and Reminders

• Be sure to bring someone with you who can remain during the procedure and drive you home.
• Please consult your prescribing provider at least 1 week prior to your scheduled procedure regarding any diabetic or anti-coagulant medication (Plavix, Coumadin, Xarelto, etc). Speak to your primary care provider or endocrinologist regarding your diabetes medications prior to your procedure. If you take blood thinners, we prefer that these are held prior to the procedure. Please call your prescribing provider to determine if it is safe to hold these medications and for how many days prior to your procedure.
• For 1 week prior to the procedure, avoid iron tablets or vitamins with iron supplements, oil-based vitamins or herbals, and fiber supplements. Also avoid salads or high fiber foods including seeds, corn, quinoa, or nuts.
• Wear comfortable, loose-fitting clothing. Do not wear body piercings, jewelry, or valuables. Do not wear eye make-up or contact lenses.
• You will not be able to drive, operate machinery, or return to work for the rest of the day. You may resume normal activities the next day unless the doctor states otherwise.

Please read entire instruction sheet carefully.

The Day of Your Procedure

• DO NOT eat or drink anything after midnight. No gum or breath mints.
• You MUST take your morning heart, blood pressure, asthma, and/or seizure medications with a small sip of water.

Notes and Reminders

• Be sure to bring someone with you who can remain during the procedure and drive you home.
• Please consult your prescribing provider at least 1 week prior to your scheduled procedure regarding any diabetic or anti-coagulant medication (Plavix, Coumadin, Xarelto, etc). Speak to your primary care provider or endocrinologist regarding your diabetes medications prior to your procedure. If you take blood thinner, we prefer that these are held prior to the procedure. Please call your prescribing provider to determine if it is safe to hold these medications and for how many days prior to your procedure.
• For 1 week prior to the procedure, avoid NSAIDS such as Naprosyn, Aleve, Ibuprofen, Advil, or Motrin, if possible.
• Wear comfortable, loose-fitting clothing. Do not wear body piercings, jewelry, or valuables. Do not wear eye make-up or contact lenses.
• You will not be able to drive, operate machinery, or return to work for the rest of the day. You may resume normal activities the next day unless the doctor states otherwise.