Morning dose: allow enough time

Wake up early enough to sip your morning prep slowly without rushing or making yourself nauseated, and finish the dose and all required liquids at least four hours before your procedure. Follow any earlier facility cutoff.

For the three-dose MiraLAX 32/32/32 regimen ONLY: if your bowel movements are completely clear on the procedure morning, Dr. Dainiak allows a minimum of 16 ounces of the correctly mixed morning MiraLAX solution instead of the full 32 ounces. Do not drink less than 16 ounces or skip the morning dose. If output is not completely clear, complete the prescribed 32 ounces. Do not use yesterday’s clear output alone to decide to reduce today’s dose. Keep the first two 32-ounce doses unchanged.

Mix the morning solution exactly as directed: the entire second 8.3-ounce bottle in 64 ounces of clear liquid. This exception changes only how much of that prepared solution you drink, not its concentration. Do not take dry powder or concentrate it into 16 ounces. This exception does not apply to any other prep regimen or remove required hydration.

Even when output looks clear, bile and mucus can accumulate in the colon overnight and obscure polyps. The morning prep helps wash them away. This is for your safety. If you cannot tolerate the required amount or finish before the cutoff, contact the procedure team; do not drink after the cutoff or substitute a few sips.

If the volume makes you feel sick

You do not need to gulp the prep or drink it all at once. Drinking too quickly can stretch your stomach and make you feel nauseated or vomit. Slowing down can make it easier to tolerate, although it cannot guarantee that nausea or vomiting will not occur. The prescribed liquid is important for cleaning the colon and preventing dehydration. This is for your safety.

For Bedford’s prescribed three-dose MiraLAX 32/32/32 prep, you have two days of clear liquids before the procedure. Sip each of the first two 32-ounce portions slowly over its assigned day rather than forcing it down in an hour. If mild nausea develops, slow down and take a break; a break of up to a couple of hours can help during those earlier prep days if you can still finish that day’s portion. Resume slowly as the nausea settles. Keep all three doses on their assigned days, including the essential morning dose.

Between sips, you can vary your permitted clear liquids with clear broth, non-red/purple Jell-O, or dairy-free sorbet without pulp or pieces that melts clear. These are separate clear-liquid choices, not ingredients to add to the prep mixture and not replacements for the prescribed prep volume or any required plain water.

The morning dose and all required liquids must be completed at least four hours before your procedure, or earlier if your facility directs. Do not take a long break that pushes intake past that cutoff. If you cannot finish in time, contact the procedure team rather than rushing, skipping liquid, or drinking after the cutoff.

Other preparations have their own dosing, spacing and water requirements; do not stretch those doses across the day without instructions from the practice. If a shorter preparation has been difficult to tolerate, ask the practice whether the extended three-dose MiraLAX preparation would help. Do not change regimens yourself.

Repeated vomiting, inability to keep fluids down, severe or increasing abdominal pain or swelling, fainting, or markedly reduced urination require prompt medical contact; seek urgent care for severe symptoms. Do not try to push through these symptoms by continuing to drink.

Five days before clear liquids begin

For the five days before you start clear liquids, avoid seeds, nuts, vegetables, granola, trail mix, corn, flaxseed, whole grains and other high-residue foods. These foods can leave material in the colon that is difficult to clean out. Temporarily changing your diet makes the bowel preparation easier and helps the doctor see the colon lining clearly. This is for your safety.

During this low-residue period, you can eat chicken, fish, eggs, meat, potatoes without the skin, white rice instead of brown rice, and white bread instead of whole-grain bread. Examples: eggs and white toast for breakfast; chicken and white rice for lunch; steak and mashed potatoes without skins for dinner.

If you are having trouble having a bowel movement during this low-residue period, one capful of MiraLAX in eight ounces of water daily may help. Talk to your doctor first to make sure this is right for you. This is optional constipation guidance before the clear-liquid phase, not an extra dose to add to your prescribed bowel prep.

When you switch to clear liquids, stop solid foods and follow your assigned clear-liquid and bowel-prep instructions. Do not carry this optional daily MiraLAX dose into the prep phase unless your doctor specifically directs you to do so.

Shopping list

• Your prescription SUTAB kit (two bottles of 12 tablets).
• Four 80 mg simethicone tablets OR two 250 mg Phazyme tablets.

It is essential to drink all of the liquid. Not doing so could result in dehydration and kidney problems. This is for your safety.

Complete every water step below, including the water after the tablets.

The day before: first dose

Between 3 PM and 6 PM, take two 80 mg simethicone tablets OR one 250 mg Phazyme tablet.

1. Fill the SUTAB container with water to the fill line. Swallow one tablet every 1–2 minutes until you finish the first bottle of 12 tablets. Finish the tablets and all the water within 30 minutes.
2. One hour after finishing the tablets, refill the container to the fill line and drink all the water within 30 minutes.
3. Twenty minutes after finishing the second container of water, refill it to the fill line and drink all the water within 30 minutes.

It is essential to drink all of the liquid. Not doing so could result in dehydration and kidney problems. This is for your safety.

Procedure morning: second dose

5–6 hours before your arrival time, take two 80 mg simethicone tablets OR one 250 mg Phazyme tablet.

Then repeat steps 1–3 above with the second bottle of 12 SUTAB tablets and three containers of water filled to the fill line.

It is essential to drink all of the liquid. Not doing so could result in dehydration and kidney problems. This is for your safety.

Stop all liquids at least four hours before your procedure, including water and prep liquids. Do not chew gum or tobacco or suck hard candies during that period. Do not smoke anything that morning.

Clear liquids and the morning dose

Clear liquids only during your clear-liquid phase. All Bedford colonoscopy preparations use clear liquids for the entire day before, including breakfast. Some start earlier; use the days listed for your regimen.

Choose water, ginger ale, plain black coffee or tea, pulp-free apple or white grape juice, clear chicken, beef or vegetable broth, and non-red/purple sports drinks. Jell-O, popsicles, Italian ice, and dairy-free sorbet are allowed when they contain no pulp or fruit pieces and melt to a clear liquid.

No red or purple coloring, milk, cream, almond/oat milk, creamers, ice cream, sherbet, alcohol, or solid food. Red coloring can resemble blood during the examination. Low-residue foods allowed earlier are not allowed during this phase.

Do not skip the morning dose even if you looked clear the evening before. Follow the morning-dose instructions below, including the specific exception for three-dose MiraLAX when output is completely clear that morning. Bile, mucus and other intestinal secretions can accumulate overnight and coat the colon, making polyps harder to see.

This is for your safety. Bedford fasting rule: no solid food for at least 24 hours before your procedure. Have clear liquids only until four hours before the procedure, then nothing by mouth. Follow any longer clear-liquid period in your assigned regimen.

Finish the entire morning prep and all required water at least four hours before the PROCEDURE. Then do not eat or drink anything—not even water—until your care team says you may. Do not drink until arrival or until your IV is placed. Do not chew gum or tobacco or suck on hard candies during the fasting period. If your facility gives an earlier stop time, follow it. Arrival time is not procedure time. If you only know your arrival time, ask the facility for your procedure time; do not guess. Do not shorten dose intervals or omit required water to meet the cutoff; have the practice resolve a conflicting schedule before starting.

Why this matters: during sedation, fluid or food in the stomach can travel back up the esophagus and enter the lungs. This is called aspiration. It can cause lung inflammation (aspiration pneumonitis) or a lung infection (aspiration pneumonia), sometimes requiring antibiotics or hospitalization. Fasting reduces this risk; it does not guarantee an empty stomach or eliminate all risk.

If you have already eaten or drunk within the four-hour window, stop and tell the procedure team what you had, how much, and when. The team will decide whether the procedure needs to be delayed. Do not assume a small sip is safe. Take oral medicines during this fasting window only if the procedure/anesthesia team specifically directs you to do so.

Severe pain, repeated vomiting, inability to keep liquids down, fainting, or markedly reduced urination need prompt medical help. Do not force the prep through these symptoms.