Frequently Asked Questions as You Prepare for Your Colonoscopy or Upper Endoscopy

What should I do if a prescription for laxative wasn’t included in my bowel preparation packet?

Some bowel preparations require prescription laxative. If your bowel preparation instructions say that you will need to take prescription laxative, your prescription will be sent electronically to your pharmacy. Many pharmacies place these prescriptions on hold, so contact your pharmacy and ask to have it filled.

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What should I do if my pharmacy hasn’t received the prescription for laxative yet?

Please call your pharmacy first. If your pharmacy does not have the prescription for laxative, please call your gastroenterology doctor’s office for a prescription. If your procedure is more than 1 week away, you may also send a Patient Gateway message to request a prescription at patientgateway.massgeneralbrigham.org

I was given PEG laxative. Is it the same as GoLYTELY?

Yes, PEG and GoLYTELY laxatives are the same. The generic name is PEG-3350 with Electrolytes (polyethylene glycol electrolyte solution). Brand names include GoLYTELY, NuLYTELY, Colyte, Trilyte, or GaviLyte.

What if a prior authorization is needed for my prep/laxative?

Please check with your insurance upon scheduling to understand if your prep requires a prior authorization (insurance coverage). It is important to you notify the office as soon as possible to avoid scheduling issues.

I took magnesium citrate as a laxative the last time. Can I have that this time?

We no longer recommend magnesium citrate as a laxative for our patients. Magnesium citrate doesn’t work as well and can have more risks and side effects than other laxatives.

My friend had a laxative that was easier to drink. Can I have a different laxative?

We strongly recommend that you use the laxative prescribed for you. Other laxatives may not work as well, may not be covered by your insurance, and can be more expensive.

Do I need to drink half of the laxative the night before my procedure and half the morning of my procedure?

Yes, it is important to drink half of the laxative the night before your procedure and half the morning of your procedure. Make sure you follow the schedule in your bowel preparation packet carefully. Following this schedule will clean your bowels completely and allow your gastroenterology doctor to see inside your colon better.

If your bowels are not clean, your procedure may get postponed, cancelled, or need to be repeated. You may also be given a different bowel preparation to clean your bowels better.

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Please follow our instructions and disregard the bottle which may tell you to take the laxative all at once.

Do I need to wake up in the middle of the night to finish drinking the laxative?

It is very important that you finish the laxative 4 hours before your scheduled arrival time as instructed in your bowel preparation packet. This may require you to wake up in the middle of the night to finish drinking the laxative. The correct timing of drinking the laxative is important in cleaning your bowels completely and allowing your gastroenterology doctor to see inside your colon better.

We understand early appointments and travel time may be difficult however please make every effort to follow the prep instructions, it is to your benefit to avoid having to re-schedule your procedure for poor prep.

You may drink a small amount of clear liquids up until 2 hours before your procedure.

If your bowels are not clean, your procedure may get postponed, cancelled, or need to be repeated.

Can I drink all the laxative the night before my procedure?

No. It is important to follow the schedule in your bowel preparation packet. Drinking the last half of the laxative closer to your procedure time will give better results and a cleaner colon for your procedure.

If your bowels are not clean, your procedure may get postponed, cancelled, or need to be repeated. You may also be given a different bowel preparation to clean your bowels better.

What should I do if I have a long travel time to MGH for my procedure?

If you have a long travel time to MGH for your procedure, we recommend that you drink the last half of the laxative earlier. For example, we generally recommend drinking the last half of the laxative 4-5 hours before your scheduled arrival time. However, if it will take you 2 hours to get to MGH, you may want to drink the last half of the laxative 6-7 hours before your scheduled arrival time instead. This will allow the laxative to work before you leave for your procedure.

What are some tips for drinking the laxative if I feel sick to my stomach?

It is common to feel nauseous or sick to your stomach during your bowel preparation. Here are some tips you can try to help you drink the laxative:

• Rest for 30 minutes then continue to drink the laxative every 20-30 minutes as tolerated.
• Use a straw to drink the laxative.
• Chill the laxative in the fridge and drink it cold.
• Add some fruit juice, Crystal Light, or ice to the laxative to help make it taste better. Don’t use any red, purple or orange colored fruit juice or Crystal Light.
• Chew gum or suck on lemon or hard candy in between drinks to help with the taste.

These tips can also be found in your bowel preparation packet.

What if the amount of laxative will be too much for me to drink?

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If you think the amount of laxative will be too much for you to drink, talk with your gastroenterologist about your options.

What should I do if I already drank the first half of the laxative, but haven’t had a bowel movement yet?

If you haven’t had a bowel movement after the first half of the laxative, continue to drink the laxative until you have a bowel movement then stop. In the morning, finish drinking the rest of the laxative as instructed in your bowel preparation packet.

Be sure to drink plenty of clear liquids to keep yourself hydrated.

What should I do if I have severe constipation or gastroesophageal reflux disease?

If you have a history of severe constipation, GERD (gastroesophageal reflux disease), or any other problems with digestion, contact your gastroenterology doctor at least 2 weeks before your procedure to discuss the right laxative and diet plan for you.

What should I do if I don’t think the laxative prescribed for me will clean out my bowels completely?

If you don’t think the laxative prescribed for you will clean out your bowels completely, contact your gastroenterology doctor at least 2 weeks before your procedure to discuss the right laxative and diet plan for you.

How can I tell if my bowels are clean before my procedure?

After finishing your laxative, your stool should be watery. The color of your stool should also be clear or yellow.

If your stool is thick, brown, or has particles in it, call your gastroenterology doctor to discuss if your procedure should be canceled.

What do you recommend if I did not tolerate the prep for my last colonoscopy?

Please discuss prep options with your endoscopist and or primary care provider when the procedure is booked. It is important to have the best prep possible to ensure a thorough examination of your colon.

If I have constipation, what can I do improve this?

If you move your bowels 2 times a week or less or if you use a laxative more than 2 times a month, at bedtime, take 4 tablespoons of milk of magnesia.

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