We prefer that most patients do a bowel prep the day before surgery. This is a kinder, gentler prep that uses Miralax and is much less crampy than older preps such as Go-Lightly. There are several reasons for the bowel prep- first, it allows the colon to collapse and provides better visualization of the pelvis. 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. 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. 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.
Detailed Bowel Prep Instructions:
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. This will make the stool that’s already in the colon easier to get moving, which means the prep will be less uncomfortable.
Two days before surgery, get a 8.3oz bottle of Miralax and 2 quart size (32 oz) bottles of Gatorade or Powerade, any flavor. 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. On the day before surgery, have a light breakfast (cereal, yogurt, eggs, no meat) in the morning. Then between 10am -12 noon drink the first bottle of Gatorade as fast as possible. Ideally if you drink it within an hour it’s best, but it shouldn’t take longer than 3 hours to get it down. About 3 hours later, drink the second bottle of Gatorade. You should start feeling rumblings and perhaps feel the need to have a bowel movement. The beauty of this prep is that people usually don’t have a lot of cramping, but feel a normal sensation of needing to go, even though what comes out is liquid. If things go smoothly, you should be done going by 10 pm or so. After you start the prep you should drink plenty of clear liquids until midnight, then nothing thereafter unless your surgery is scheduled for the afternoon and you are specifically instructed.
Nothing by mouth after midnight the day before surgery.
Clear liquid diet examples include: coffee & tea (no cream or sugar), apple or white grape juice, sports drinks, popsicles, JELL-O, broths etc.