Small Bowel (Ileoscopy Prep)

Small Bowel (Ileoscopy Prep) Explained

This preparation is used before colonoscopy to improve visualization of the end of the small intestine (terminal ileum). It uses dietary restrictions and bowel cleansing to ensure the area can be safely reached and carefully examined during the procedure.

Important Things to Know

Important: Do not eat breakfast the day prior to your procedure

If you do not have regular, daily bowel movements, or are on a GLP1 medication let us know. You will need different instructions to have a successful exam.
Continue all aspirin and anti-inflammatory medications including ibuprofen, Motrin, Aleve, naproxen, Naprosyn, sulindac, piroxicam, Feldene, indomethacin, diclofenac, and Voltaren. Tylenol (acetaminophen) is also safe to continue.
If you take a prescribed blood thinner you will need holding instructions from our office.
Arrange to have a driver take you home after the procedure. You will not be allowed to drive after receiving sedation.
If you have diabetes or are taking medications for weight loss, use the following instructions:
- Fasting (going without food) is required for this procedure, monitor your blood sugar and follow these directions
- GLP-1 - STOP 7 days prior to your procedure. (ex: Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity, Semaglutide, Tirzepatide)
- SGLT2 - Stop 3 days prior to procedure (ex: Jardiance, Farxiga, Invokana, Steglatro, Brenzavvy, Glyxambi, Synjardy, Xigduo, Qtern)
- Other oral diabetic medication: do not take the morning of your procedure.
- Insulin Pump: Leave on, if you have questions refer to your endocrinologist.
- Long-acting Insulin: half dose the evening before procedure. Do not take the morning of your procedure.
- Short-acting insulin: dose as necessary with blood sugar monitoring.
- If you are concerned about your blood sugar dropping, consider purchasing glucose tablets.

Timing & Schedule

Preparation follows a structured timeline that begins several days before your procedure and continues through the day of your exam. You’ll make diet and supplement adjustments in advance, follow a clear-liquid diet the day before, and complete the bowel prep as scheduled. Exact instructions and timing details are provided below.

Instructions:

Step 1.

7 Days Before Your Procedure

If applicable,

STOP ALL GLP-1 medications 7 days prior to procedure.

Step 2.

5 Days Before Your Procedure

No nuts or seeds.
Stop all fiber supplements including Metamucil, Citrucel, Benefiber, FiberChoice and flax seeds. If you are taking these to treat constipation, take 17g of MiraLAX daily starting five days prior to your procedure in place of the fiber. (This will require you to purchase MiraLAX in addition to bowel preparation stated above).
Stop all oil-based vitamins and supplements to include Vitamin A, D, E, Fish Oil, Etc.

Step 3.

3 Days Before Your Procedure

If applicable,

STOP SGLT2 medications 3 days prior to procedure.

Step 4.

Day Before Your Procedure - Step 1

From the moment you wake up, start a clear liquid diet. Do not eat breakfast. Avoid red beverages.
Clear liquids only by mouth. This includes clear juices (apple, grape, strained orange, strained lemonade), tea, coffee (no milk or creamer), soft drinks, sports drinks (Gatorade, Powerade), clear broth or bouillon, Jell-O, and Popsicles.
Avoid red drinks, red Jell-O, and dairy products.
Consume large amounts of clear fluids to increase success of the bowel flush, help avoid hunger and avoid dehydration.

Step 5.

Day Before Your Procedure - Step 2

At 5:00 pm, mix the full bottle of MiraLAX (119 g) into 32 ounces of the sports drink of your choice. Shake until completely dissolved.
- To decrease the chance of nausea, you may take one Zofran tablet 30-60 minutes prior to drinking your prep. If you become nauseated or vomit, you may repeat Zofran x1.
- Drink one 8 - ounce glass every 10-15 minutes until you have finished the 32 ounces. It is necessary to drink the ENTIRE bottle, even if your bowels appear clear.
If no stools occur within 2 hours of completion, repeat this step. This will require you to purchase more MiraLAX and sports drink.
If you experience nausea while taking your prep, stop drinking and allow the nausea to settle. You may take a second Zofran tablet to help ease your nausea. When you resume drinking, drink slower or through a straw to help avoid nausea. If vomiting occurs, please call us at 208-343-6458.
Continue drinking clear liquids. This helps your prep be more successful.

Step 6.

Day of Your Procedure

Please continue consuming clear liquids after prep completion to avoid dehydration up until 4 hours prior to your scheduled procedure.
4 hours prior to your procedure STOP drinking fluid. You may take small sips of water only to take your prescribed medications – this is very important. Drinking within 4 hours of your procedure may result in delay or cancellation.
Bring a list of your current medications and correct dosages to your appointment.

Step 7.

Después de la intervención

NO DRIVING –you cannot drive for the remainder of the day if you are sedated. You need to have a responsible driver to take you home after your procedure. If your driver wishes to discuss the results of your procedure with the doctor, please have them accompany you to your procedure and remain on site.
We do not recommend Uber, Lyft, or taking a taxi – these are not acceptable forms of transportation.
You will be sedated for your procedure. Please avoid alcohol and making legal decisions for the remainder of the day after your procedure.

Take Aways

Additional Details

Medication:

STOP GLP-1 medications 7 days prior to your procedure.
STOP SGLT2 medications 3 days prior to procedure.
Clear liquids only the day before and on the day of your exam. Do NOT drink any fluids 4 hours prior to your exam.
You must complete your entire bowel prep. We often see poor bowel preparations because patients stop drinking.
If you have trouble drinking the prep, try sucking on ice or a lemon wedge, brush your teeth, chew gum, or rinse your mouth.
If you finish the whole prep and your stool is brown, thick, or not clear please call us for advice.
If you are nauseated or vomit with the prep, stop drinking to allow your stomach to settle and take the Zofran we provide.
You may not remember your conversation with your doctor after your procedure – we STRONGLY recommend your driver stays IN our facility to speak with the doctor after your test

Your procedure time will be approximately 90 minutes from the scheduled check-in time to discharge for procedures in the Meridian, Boise, and Canyon County Endoscopy Centers. Please coordinate with your driver to alleviate delays in discharge. Patients’ stay times for hospital procedures may be longer.
We cannot be responsible for your valuables (watches or various jewelry items). Please leave them at home.
Bring all insurance cards and a photo ID with you.
Please check with your insurance company regarding prior authorization.
Fee for services is required at time of check-in. Please be prepared to make a payment.
IGA recognizes that your time is valuable, and so is ours. If you need to cancel or reschedule an appointment, please do so more than 48 business hours prior to your scheduled appointment arrival time at 208-343-6458. Late cancellations and no shows may be assessed a $200 fee.

These instructions outline the small bowel / ileoscopy prep used at Idaho Gastroenterology Associates. Your printed handout is your primary guide. Always follow that plan and call if anything is unclear.

Small Bowel (Ileoscopy Prep)