About 3 hours later, drink the second bottle of Gatorade. Ideally if you drink it within an hour it’s best, but it shouldn’t take longer than 3 hours to get it down. Then between 10am -12 noon drink the first bottle of Gatorade as fast as possible. On the day before surgery, have a light breakfast (cereal, yogurt, eggs, no meat) in the morning. Mix half of the Miralax in each bottle of Gatorade while it’s room temp, then put in the fridge to chill so they are nice and cold the next day when you drink them. Two days before surgery, get a 8.3oz bottle of Miralax and 2 quart size (32 oz) bottles of Gatorade or Powerade, any flavor. This will make the stool that’s already in the colon easier to get moving, which means the prep will be less uncomfortable. If you tend to be constipated and have hard stools, require straining to pass them, or go less than 2 times a week, we strongly recommend that you start taking Miralax (or the generic equivalent) 3-5 days before your prep starts. Pai and I feel strongly that surgery is easier, safer, and your postop recovery should be less uncomfortable for you if you do a prep. For those of you who read the scientific literature, yes, we are aware of several studies showing no “benefit” to bowel preps as far as perioperative morbidity, however both Dr. Secondly, patients tend to have much less constipation and gas pain after surgery, and finally, if endo is found on the colon or if there is an injury, it allows resection and closure without the need for a diverting colostomy. There are several reasons for the bowel prep- first, it allows the colon to collapse and provides better visualization of the pelvis. This is a kinder, gentler prep that uses Miralax and is much less crampy than older preps such as Go-Lightly. We prefer that most patients do a bowel prep the day before surgery.
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