December 7th, 2009
Gatorade and Miralax: A Better Bowel Prep?
Only about half of U.S. adults have undergone colonoscopy screening for colorectal neoplasia. To reach our goal of screening 100% of the adult population, we must find ways not only to make the procedure more accessible and affordable for patients, but also more tolerable, especially in terms of bowel preparation.
Intolerance of the gold-standard bowel prep, which is now 4 liters of a PEG-based electrolyte solution (since Fleet’s Phospho Soda was removed from the market), has been blamed on both the unpleasant taste of the solution and the large volume that must be swallowed. Since split dosing has come into vogue, volume seems to be less of a problem, but the taste issue remains.
To help make the taste of the solution more bearable, one of my colleagues began giving patients the option of drinking split doses of a Miralax/Gatorade combination. I was surprised by how well-tolerated and effective he said the prep has been. Now, we routinely offer patients split doses of either a PEG-based or Miralax/Gatorade bowel prep. As a result, patients do not seem to complain as much about the prep when they come in for their exams. More important, a greater portion of patients complete the whole prep, and almost all of the prep results are excellent or good.
What preps do you offer patients who undergo colonoscopy, and what is your experience with Miralax/Gatorade?
6 Responses to “Gatorade and Miralax: A Better Bowel Prep?”
M. Brian Fennerty, MD
Editor-in-Chief
NEJM Journal Watch Gastroenterology
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how much miralax do you give for each of the split doses? 17 grams? also, what volume of gatorade do they drink?
this sounds as a much needed answer to the resistance of many patients, the amount of fluid and the taste.
We have been struggling with preps ever since Fleet’s went away as a viable option for the masses. Our experience with Gatorade/Miralax is good. Question for others using this: is anyone concerned about a bowel prep containing lots of simple sugars (as Gatorade contains)?
Like Dr. Dreznick, I am also interested in the amount of miralax and gatorade.
What is meant by split dose? How is it taken?
Is there any contraindication to using Miralax and Gatorade in patients with chronic CHF or chronic renal failure? Do you use Golytely for those patients exclusively?