GASTROENTEROLOGY CENTER OF NORTHERN VIRGINIA LTD. PROCEDURE LOCATION: (If unsure of the exact place and time, please verify with the office) □ Virginia Hospital Center Arlington 1635 North George Mason Drive 2nd floor - GI out Patient Center, Gold Parking
□ Fairfax Hospital 3300 Gallows Road, Falls Church, VA Women’s & Children’s Center – Blue Entrance
□ Woodburn Endoscopy Center 3301 Woodburn Road, Suite 109 Annandale, Virginia
APPOINTMENT DATE: __________ ARRIVAL TIME: _________ PROCEDURE TIME: __________ Please notify the office if you have an Internal Defibrillator or Cardiac StentColonoscopy Preparation with Magnesium Citrate Things to purchase: Two 10 oz bottles of Magnesium Citrate (no red) and 1 box of Dulcolax 5 mg. (bisacodyl) laxative
tablets from your drug store. These are over the counter products, no prescription is required.
1. DISCONTINUE 5 DAYS IN ADVANCE OF YOUR PROCEDURE: all aspirin, ibuprofen or Advil type products,
blood thinners (Coumadin, Plavix, Aggrenox, Ticlid, Persantine.) If you take any of these medications for cardiac reasons, check with your regular doctor before stopping them. Tylenol may be used as needed. Your other necessary
medications are OK to take.
2. USE ONLY A CLEAR LIQUID DIET for ONE FULL DAY before the colonoscopy day beginning first thing in the
morning. Be sure to drink plenty to stay hydrated. You will not return to your regular diet with food until after your
3. At 2:00 p.m. THE AFTERNOON BEFORE your colonoscopy day, take 4 Dulcolax tablets with an 8 oz glass of any clear
liquid. Continue on your clear liquid diet. This is a laxative and should begin to work in approximately 3-6 hours. Do
4. At 5:00 p.m. THE AFTERNOON BEFORE the colonoscopy day, drink one full bottle of Magnesium Citrate followed by
8 ounces of water or clear liquid. This also is a laxative, be prepared to be very close to a bathroom. Continue on your
clear liquid diet. Make sure to drink frequently.
5. THE MORNING OF YOUR COLONOSCOPY, drink one full bottle of Magnesium Citrate again followed by 8 ounces
water or clear liquid just as you did the day before. You may continue clear liquids until 4 hours prior to your procedure
time, then nothing by mouth. Necessary medications early in the morning are OK. If your arrival time is at or before 7:00 a.m., drink the Magnesium Citrate at 4:00 a.m. If your arrival time is after 7:00 a.m., drink the Magnesium Citrate
Please have a responsible adult to drive you home after your procedure or you may take a cab only if accompanied by an
adult. You are not to drive for the rest of the day after your procedure.
Make sure you have provided all current insurance information and necessary referrals to our office in advance of your procedure.
Referrals apply only to HMO and Managed Care plans.
To cancel or reschedule give 5 business days advance notice to avoid a charge. Also download the “Colonoscopy frequently asked questions” and the “Clear liquid diet” for addition information.
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