Order online on MNGI website https://www.mngi.com/your-visit/procedure-prep

• Pick up at one of MNGI’s endoscopy centers.

• Purchase at a drug store (Walgreens, CVS, Cub, Target, Walmart, etc..)

Please check the patient portal for prep instructions. If you do not have access to the patient portal and have not received instructions in the mail, please call 612-871-1145 to speak with a MNGI representative. If you know what prep you have been assigned, you can find most of the MNGI prep instructions on our website. Click here to view MNGI prep instructions

No alterations to prep instructions will be approved. Only prep instructions provided by MNGI will be approved, completing an alternative prep could lead to cancellation.

No, it is important to use one of the pre-approved electrolyte drinks while prepping, to help stay hydrated.

• MNGI recommends Gatorade, Powerade, Pedialyte, Liquid IV or Propel for bowel prep.

• Other electrolyte drinks, such as Nuun or LMNT, can contain higher levels of magnesium and/or sodium which may present a risk to the patient if consumed in large amounts. Coconut water and kombucha should not be used.

• NO RED colors.

No.

Please call 612-871-1145 to speak with MNGI staff about prep sensitivity.

• Please know alternative preps can be expensive due to insurance not covering the whole price. It is important to check with your insurance to see if they will cover alternative preps. The alternative preps are prescriptions that must be sent to the pharmacy, they are not available over the counter, unlike Miralax.

Our goal is for you to finish your prep early enough to ensure you are cleaned out enough to get some sleep the night before your procedure. You may start your prep earlier in the day, but we don’t advise in starting the prep later then 6pm and want the prep completed by 8pm. If you have difficulty with nausea and vomiting while prepping, you can start your prep earlier in the day and take longer breaks. If you want to start the Miralax – Gatorade/Powerade mixture earlier, please also move up the Dulcolax tablets, so that there is 4 hours in between the Dulcolax pills and the Miralax – Gatorade/Powerade mixture.

A clear liquid diet consists of liquids you can see through (NO red). You can have up to one 8 fl. oz. cup of dark soda, black coffee, or tea (no milk, cream, or honey) each day.

• For more details on following a clear liquid diet, please see https://www.mngi.com/conditions/clear-liquid-diet.

We do not recommend consuming kombucha or coconut water during colonoscopy preparation. Please avoid fluid you cannot see through as this can result in a cancelled procedure due to safety concerns with anesthesia.

There is not a specific prep for diabetic patients, although you can choose to mix zero sugar electrolyte drinks with your Miralax powder. It is important to contact your monitoring provider of your diabetes for questions relating to your diabetes and a clear liquid diet.

If you take daily medication, you may do so up until 3 hours before your procedure time.

• This includes heart and blood pressure medications, blood thinners (if you have not been told to stop these by our office), methadone, and anti-seizure medications.

• DO NOT take any chewable vitamins or supplements.

Please contact your monitoring provider of your diabetes for information regarding your diabetic medications. We will check your blood sugar before the start of the procedure. Medications must be taken at least 3 hours before your procedure as you must not take anything by mouth after.

Please refer to the Colon Emptying Tips (above). If you continue to experience symptoms, please contact 612-871-1145 for advice with the prep process.

Please do not consume more then 10-15 grams of fiber per day.

• For additionally low fiber information please visit: www.mngi.com/conditions/low-fiberdiet.

Iron can turn stool dark and tarry, which can impair visualization during the procedure. We want you to have the most effective prep results. If you forgot to stop your iron supplement 7 days prior to your procedure, please call 612-871-1145.

No, you may not complete a double prep in one day. You will need to reschedule and complete the colonoscopy prep as outlined in MNGI double prep instructions. Please call 612- 871-1145 and choose the option for scheduling.

It is important to drink the additional prep outlined in your prep instructions the day of your procedure because it is normal to have more cloudiness/sediment in stools in the morning. We want to ensure your colon is properly cleaned out so our providers are able to give you a proper exam.

Magnesium Citrate is a laxative product that helps to ensure the colon is entirely cleansed prior to a colonoscopy. If you are unable to obtain Magnesium Citrate from MNGI, please contact us at 612-871-1145 for an alternative prep option. If you do not complete approved prep prior to your colonoscopy, your procedure may be cancelled or rescheduled. Please be aware that the Magnesium Citrate should be clear in color and to avoid any nonclear, milky, or chalky product as this poses a clinical risk for anesthesia.

• To ensure you have all the appropriate supplies, we encourage you to purchase your prep kit through MNGI. Click here to purchase prep kit.

Yes, it is important to finish all of the prep to ensure a proper clean out of your colon. You may begin prep two hours early or end two hours late if additional time is needed to consume prep. It is okay to take breaks.

When you are finished with your prep you should not have any solid stool, only clear liquid stool. You should be able to see to the bottom of the toilet bowl. If you are unsure whether your colon is cleaned out, please call our office at 612-871-1145 before you leave for your appointment.

It is requested that your responsible party stay on site and have their phone on.

A responsible person needs to be with you at check in, go with you after discharge, drive you home after your procedure and help you with follow up care. This takes about 2 hours from check-in to discharge. You will not be able to drive a car, use machinery, or go to work until the next day. Failure to bring a responsible person will result in your appointment being rescheduled. You may only take an Uber/Lyft or Non-medical taxi if you have a responsible person with you. If you do not have a responsible person with you and need a ride home, you must take a certified medical taxi. This needs to be arranged before your procedure. You do NOT need to call MNGI and confirm you have driver. If the patient is under 18 or has a legal guardian, the legal guardian must be with the patient for check-in. If the legal guardian is not able to be with the patient at check in, they will need to be available by phone during the procedure and discharge.

You cannot ingest CBD oil while on a clear liquid diet. Doing so will result in procedure cancellation. Other forms of CBD are acceptable so long as NPO guidelines are followed which are outlined in MNGI prep instructions.

No. To avoid cancellation, do not use or consume any form of marijuana/THC the day of your procedure.

Renal patients on fluid restrictions can safely take Nulytely. There should be minimal fluid shift with Nulytely. Nulytely does not count towards fluid restrictions and patient should still consume their recommended fluids. *This does not include cardiac pts on fluid restrictions*

The day of the procedure you will be assessed by the Anesthesiologist, who will listen to your heart and your lungs and determine if you are safe to proceed in our settings. If you are having flu-like symptoms (such as fever, cough, shortness of breath) within 14 days of your appointment, please call to reschedule. If you develop COVID-19, are exposed to COVID-19 or have COVID-19 like symptoms at any point after you schedule this appointment, please call our office to determine if it is okay to proceed with your visit. COVID-19 guidelines for health care facilities may differ from community guidelines.

Please call us at 612-871-1145 at least 72 hours prior to your appointment if:

• You develop COVID-19, are exposed to COVID-19 or have COVID-19 like symptoms.

• You have flu-like symptoms within 14 days of your appointment.

• You recently had significant weight gain, started a blood thinner, or have a new condition like diverticulitis, heart problems or breathing problems.

It is advised that you do not smoke on the day of the exam to prevent an irritable airway.

A MNGI RN will be determining if you need to hold your blood thinning medication and will work with your monitoring provider if needed (Ex: Coumadin/Warfarin, Xarelto, Eliquis, Plavix, etc.) before your procedure. A MNGI RN will be reaching out to you to inform you whether you need to hold this medication or not. If you have not heard from us 14 days before your procedure, please call: 612-871-1145.

Please arrive at least 45 minutes prior to your procedure time.

You will sign informed consent after speaking with the anesthesia and GI providers. You will be brought back to the procedure room where you will position yourself on your left side for the procedure. Your vital signs will be taken after positioning. After your care team has completed a safety time out, the anesthesia provider will administer the medication to keep you comfortable. The colonoscopy will take around 30 minutes and then you will be brought back to the recovery room for the next 30 minutes. Your driver will be notified once you have arrived at the recovery room. If you would like your driver to accompany you in recovery room and hear the results from the GI provider, please notify a member of your care team. Some patients may experience temporary memory loss after the procedure due to use of monitored anesthesia care. You may wish to have a responsible person present during your discharge to take notes on your behalf and ask questions related to your follow up care.

Although serious complications are rare, any medical procedure has the potential for risks. Risks from the procedure include perforation, or a tear through the lining of the colon, bleeding from a biopsy site, reaction to medications, heart and lung problems, and dental or eye injuries.

You may feel cramping and gas-like pain. You will be given IV medication to keep you comfortable and make you fall asleep during the procedure.

Small pieces of tissue (biopsy or polyps) may have been removed and sent to the pathology department for review. Bleeding from your polyp removal may occur up to two weeks after your procedure. Any tissue samples or polyps removed during the procedure will be sent to a lab for evaluation. It may take 10-14 working days for you to be notified of the results by mail or through the Patient Portal. Your referring provider will receive a copy of the pathology results. If you have not been notified after 14 business days please call MNGI at 612- 871-1145.

You will not be able to drive a car, operate machinery, or go to work until the following day. Please avoid air travel for at least 24 hours post procedure.

Your stool may not return to normal for 3-5 days.

Some patients may experience temporary memory loss after the procedure due to use of monitored anesthesia care. You may wish to have a responsible person present during your discharge to take notes on your behalf and ask questions related to your follow up care.

Post procedure you may feel short-term cramping or gas-like pain.

Biopsy results may take up to 10-14 days, you will receive a result letter to the patient portal or in the mail if you do not have a MNGI patient portal.

If you experience a temperature above 101 degrees, please call your doctor.

• Seek medical attention if you have trouble breathing, wheezing, new persistent cough, or shortness of breath.

• If you have redness or swelling where the medications were given, place a warm, wet washcloth over the affected area for 20 minutes, 3 times a day until the redness subsides. If the symptoms continue or are severe for more than 1 day, call your physician.

• Notify your physician immediately if you experience more than a small amount of bleeding.

• Notify your physician immediately if you develop severe abdominal pain.

• You are advised to avoid air travel for 24 hours following your procedure.