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A better tasting prep?

tommycat's picture
tommycat
Posts: 790
Joined: Aug 2011

Ask almost anyone after their first colonoscopy, and they’ll tell you, “The procedure was nothing, but the prep was awful.”

Now patients are reporting that combining MiraLAX®, an over-the-counter laxative, with 2 quarts of Gatorade tastes better and is easier to take than the standard 4-quart Golytely colonoscopy preparation. In a randomized clinical trial , almost 100 percent said they would repeat it again, compared to 1 out of 4 who wouldn’t take GoLYTELY® in the future.

In addition, doctors found no differences in how thoroughly the two preps clean the colon.

Splitting the dose between the night before the colonoscopy and the morning of the procedure did improve colon cleansing. But there was no difference in cleansing between split-dose GoLYTELY and split-dose MiraLAX with Gatorade.

Although the combination of MiraLAX and Gatorade is being used to clean the colon before colonoscopy by community gastroenterologists, there hasn’t been evidence that it was safe and effective. Gastroenterologists at the VA Healthcare System in Long Beach, California and at the University of California Irvine developed a randomized clinical trial to compare the MiraLAX prep with traditional GoLYTELY.

They also compared bowel cleansing quality between giving all of the dose the night before colonoscopy to splitting the dose between the evening before and the morning of the exam.

Results:

There was no difference in bowel cleansing between the GoLYTELY and the MiraLAX/Gatorade preps.
There was a significant difference in bowel cleansing when either prep was given in a split dose. Split doses were better.
On a questionnaire, patients reported better taste and tolerability for the MiraLAX prep.
96.8 percent of patients said they would be willing to repeat the MiraLAX prep compared to 75 percent of the GoLYTELY patients.
There were no significant changes in electrolytes before and after the prep between MiraLAX and GoLYTELY or in single-dose or split doses.

GoLYTELY is a powdered form of polyethylene glycol (PEG-ES) and electrolytes. It is combined with about a gallon of water to draw fluid into the colon to flush out feces.

MiraLAX is also powdered PEG, but doesn’t contain electrolytes. It needs to be combined with two quarts of Gatorade to replace the electrolytes lost in watery diarrhea during the prep process.

Jason B Samarasena MD and his colleagues concluded,

Split-dosed MiraLAX/Gatorade was an effective, safe, and tolerable option for bowel preparation before colonoscopy in the low-risk patients in this study. MiraLAX/Gatorade appears to be more tolerable than Golytely as a bowel cleansing regimen and was the preferred agent by the patients in this study.

What This Means for Patients

Ask your gastroenterologist about combining MiraLAX with Gatorade as a preparation for colonoscopy.

Splitting the prep in two doses: one the evening before your test and the other half the morning before the exam will improve colon cleansing. A clean colon is critical to an accurate exam.

Source: Samarasena et al, The American Journal of Gastroenterology, advance online publication May 8, 2012.

Annabelle41415's picture
Annabelle41415
Posts: 4265
Joined: Feb 2009

I've been doing the miralax prep for the last two felx sigs and last two colonoscopies but never have done the split. Just drank all 64 oz in about a 2 hour period and I'm not a big gatorade fan so I'll use Propel water and 4 dulcolox pills. Just had a colonoscopy last week and doctor didn't mention anything about it not being cleaned out enough but what was left on the bed was kind of disgusting but I'm sure that is where they spray the water to see all the areas. Interesting though.

Kim

danker
Posts: 742
Joined: Apr 2012

I found mixing lemon gatorade with the golytely was easy to take. Mix it a few days ahead and cool it Two quarts at night- only needed one quart in morning.

coloCan
Posts: 1850
Joined: Oct 2009

you do 6 ounces of the liquid mixed with ten ounces of water and then two sixteen ounce glasses of water, once the night before and then again about four hours prior to colonoscopy...

The Jan, 2012 on-line issue of www.gastroendonews.com had an interesting article tho i don't know if its still available(I had printed it at the time):"Bowel Preperation for Colonoscopy:Eschewing the One-Prep-Fits-All Approach"

Aud's picture
Aud
Posts: 476
Joined: Oct 2009

I have used Miralax with Gatorade also, never the Golytely and no split dose with Miralax. I have used Moviprep (sounds like something fun, doesn't it? like you're going to the movies...not!) with split dose. I like the Moviprep better because after awhile the taste of Gatorade makes me sick. And I think there was less to drink with the Moviprep. But I had trouble with the split dose since the second dose was about 4-5 hours before the test, that means getting up in the middle of the night and going to the bathroom through the night rather than being done by midnight. I was thinking for next time to ask my doctor if I can start the prep earlier to be done with it all by midnight. I don't see why not.

danker
Posts: 742
Joined: Apr 2012

It all depends on when the colonoscopy is going to be done,

ketziah35
Posts: 1150
Joined: Jun 2010

I took 4 or 5 duclolax. An hour later I mixed 258 mg (?) Of miralax in 64 ounces of light colored gatorade and drank 8 onzs every 15 minutes. I was still running to and from the bathroom$ best thing about the colonscopy was the propyfl (sp). I have cchronic insomnia and would never abuse it, but ahhhh I had fond memories of that sedative. Best nap I ever had.

Luckygirl2
Posts: 308
Joined: Mar 2012

I did the same dosage on miralax and gatorade and 4 ducolax starting at two with the ducolax and at 5pm with the miralax. I couldn't go the last glass I think I would have thrown up! I was first up that morning so I was in the room across from the scope room, I get my IV and as I'm being wheeled in, I ask them "you haven't forgotten the good stuff, right". I get all situated, and the nurse starts my IV and all I remember is saying, Oh that burns a little...I remember nothing else which is exactly how I like it...and I rested so good the rest of the day...I'm with you between the port in my left shoulder and not being able to lay for long on my right side still, sleep is allusive.. I sure enjoyed that day though.

JohnsIsland
Posts: 9
Joined: Mar 2012

Hope raising this from the dead won't upset anyone, but I thought I would add my penny in case there is another person like me, who reads the old posts.

I was prescribed Gavilyte-N and didn't mind the taste. Was told to split the dose, afternoon, early morning for a early morning appointment.

Gavilyte-N was a generic for Nulytely. GaviLyte-N is PEG3350, with sodium chloride, sodium bicarbonate and potassium chloride.

I use Fred Meyer as my pharmacy. I understand they just started stocking this generic.

Jeff

scared99
Posts: 73
Joined: Jun 2012

Eck, I go for my first Colonoscopy on Sept 25th. Does the prep make you feel sick ? Or is it pretty much like drinking to much apple cider ? LOL sorry I did not know what to compare it to.

Maxiecat's picture
Maxiecat
Posts: 524
Joined: Jul 2012

I did fine on the sureprep but the golytley was horrible. I developed a really strong gag reflex from it and wound up throwing up much of the second half of the prep. I will definately request the miralax approach the next time.

Alex

JohnsIsland
Posts: 9
Joined: Mar 2012

On you, your taste buds and most of all (IMNERHO) which prep your doctor prescribed. What did your doctor prescribe for your prep?

Going on a liquid diet for a day or two was tough for me.

Different subject (slightly,)did you discuss medication during the procedure?

Jeff

scared99
Posts: 73
Joined: Jun 2012

I just found the prescription. He prescribed Halflytely.

Doc_Hawk's picture
Doc_Hawk
Posts: 685
Joined: Jan 2012

My last colonoscopy I did the Gatorade/MiraLAX prep and it was a lot more tolerable. The instructions said to not use anything red or orange, so I went with a blue flavor and the results were great.

ron50's picture
ron50
Posts: 1288
Joined: Nov 2001

Numerous scopes over the past 14 years. I had trouble with the standard prep when they gave it to me half way through my year of chemo. (my firsf scope could not get passed the cancer),. I had fleet preps for years after that ,then they decided that they were causing kidney problems with dehydration. I did two lots of the tablets with lots of water (colocaps,epsom salts).they did not clean me out at all. last two scopes they did in hospital,they made me drink nearly eight litres of the prep. I was cleaned out well and truly.My GI was very impressed ,i was far from impressed.Ron.

marbleotis's picture
marbleotis
Posts: 491
Joined: Mar 2012

I first used the "gallon sized prep". Most of it was thrown up. The second colonoscopy (pre-surg) I didi a two day prep with Suprep and it was a million times better. I will use that for all my future colonoscopies.

ketziah35
Posts: 1150
Joined: Jun 2010

I usedd Miralax and Gatorade. Easy peasy!

thxmiker's picture
thxmiker
Posts: 1225
Joined: Oct 2010

I did the Myralax prep for my last PT. It was much better and much less stressful on my body. The Fleet was nearly violent poops. (We named Fleet Colon Blow.) I was so tired the day after using the fleet.

Best Always, mike

scared99
Posts: 73
Joined: Jun 2012

Can't wait to get this scope over with lol!!!

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