Endoscopy & Esophageal Manometry
1-Day Colonoscopy Prep ↓ 2-Day Colonoscopy Prep ↓ Approved Clear Liquids ↓ Medications to Pause ↓ HemWell™ Hemorrhoid Relief → MiVu™ Reflux Testing →
Colonoscopy
A colonoscopy uses a thin, flexible camera to examine the lining of the colon (large intestine). It's used for colorectal cancer screening and to look into symptoms such as bleeding, changes in bowel habits or abdominal pain. Polyps can often be removed during the same exam.
You'll need to follow our 1-Day or 2-Day Citrate of Magnesia bowel prep below beforehand. Patients receive comfortable sedation, so you must arrange for someone to accompany you and drive you home.
Official Charlotte Harbor Surgical Patient Instructions · Easy-to-Read Large Print
Colonoscopy Prep Instructions (Plain-English Step-by-Step Guide)
Getting your colon completely clean is the most important part of a safe, accurate colonoscopy. We have written these instructions in plain, everyday English so you can follow each step with confidence. Everything you need for your bowel prep is sold over the counter at any pharmacy—no prescription is needed.
1-Day Colonoscopy Prep
You start drinking your prep the morning BEFORE your colonoscopy.
- Uses two (2) 10 oz bottles of Citrate of Magnesia + four (4) 5 mg tablets of brand-name Dulcolax® Laxative
- Clear liquids all day the day before your procedure
2-Day Colonoscopy Prep
You drink 1 extra bottle TWO days before your colonoscopy at 9:00 AM, plus the full prep the day before.
- Uses three (3) 10 oz bottles of Citrate of Magnesia + four (4) 5 mg tablets of brand-name Dulcolax® Laxative
- Regular food 2 days before; clear liquids all day 1 day before
Not sure whether you are doing the 1-Day Prep or the 2-Day Prep? Check the top of the instruction sheet our office gave you, or call our office at (941) 391-5102 (Mon–Thu 7:30 am–4:00 pm, Fri 7:30 am–12:00 pm) and we will gladly check your chart.
⚠️ Important Rule: Follow ONLY Our Office’s Instructions — Do NOT Follow the Laxative Box!
Please follow the exact times and doses on this page given by your surgeon’s staff. Do NOT follow the directions printed on the Citrate of Magnesia bottle or the Dulcolax box. Taking the prep differently than instructed may leave your colon unclear and may cause your colonoscopy to be cancelled.
Step 1: What to Buy at the Pharmacy (No Prescription Needed)
You can buy all of your prep supplies right off the shelf in the laxative aisle and grocery aisle at any pharmacy or supermarket (such as Publix, Walgreens, CVS, or Walmart):
🛒 Shopping List for 1-Day Prep
- Two (2) 10-ounce bottles of Citrate of Magnesia (also called Magnesium Citrate).
Must have NO red coloring (pick clear or lemon-lime flavor). Put both bottles in the refrigerator the night before so they are ice-cold! - One (1) small box of brand-name Dulcolax® LAXATIVE tablets (5 mg each) — you will take four (4) tablets at 2:00 PM.
IMPORTANT: Buy brand-name Dulcolax® Laxative tablets — DO NOT use generic, and make sure the box says “Laxative” (bisacodyl 5 mg), not “Dulcolax Stool Softener.” - Plenty of Clear Liquids for the day before your procedure (see the Approved Clear Liquids box below — NO red coloring).
🛒 Shopping List for 2-Day Prep
- Three (3) 10-ounce bottles of Citrate of Magnesia (also called Magnesium Citrate).
Must have NO red coloring (pick clear or lemon-lime flavor). You will drink 1 bottle two days before and 2 bottles the day before. Chill each bottle in the refrigerator overnight! - One (1) small box of brand-name Dulcolax® LAXATIVE tablets (5 mg each) — you will take four (4) tablets at 2:00 PM the day before.
IMPORTANT: Buy brand-name Dulcolax® Laxative tablets — DO NOT use generic, and make sure the box says “Laxative” (bisacodyl 5 mg), not “Dulcolax Stool Softener.” - Plenty of Clear Liquids for the day before your procedure (see the Approved Clear Liquids box below — NO red coloring).
Step 2: Medications to Pause & Ride Home (7 Days to 1 Day Before)
Certain everyday medicines make anesthesia unsafe or increase the risk of bleeding if your doctor removes a polyp. Follow this countdown carefully:
Stop All GLP-1 & Weight-Loss Medications 7 Days Prior
Why in plain English: These weekly injections and daily pills slow down how fast food leaves your stomach. If food stays in your stomach during anesthesia, it can come up into your lungs (called aspiration).
Stop 7 days before your procedure: Ozempic® / Wegovy® / Rybelsus® (semaglutide), Mounjaro® / Zepbound® (tirzepatide), Trulicity® (dulaglutide), Victoza® / Saxenda® (liraglutide), Byetta® / Bydureon® (exenatide), Adlyxin® (lixisenatide), and any other GLP-1 or weight-loss medication.
Prescription Blood Thinners — Check Your Exact Stop Date
Do NOT automatically stop all prescription blood thinners 5 days prior. Hold times depend on your specific medication and how quickly it leaves your body:
- Often held 2 days before: Eliquis® (apixaban) or Xarelto® (rivaroxaban)
- Often held 5 days (or as directed) before: Plavix® (clopidogrel), Coumadin® / Jantoven® (warfarin), Effient® (prasugrel), or Brilinta® (ticagrelor)
Always follow the exact number of days instructed by our office or your prescribing doctor. If you are unsure of your exact stop date, please call our office at (941) 391-5102.
Stop Aspirin & Over-the-Counter Anti-Inflammatory Pain Pills (NSAIDs) 5 Days Prior
Why in plain English: Aspirin and anti-inflammatory pain relievers thin your blood and can cause bleeding if your doctor removes a polyp during your colonoscopy.
Avoid for 5 days before your procedure: Aspirin, any Aspirin products, Ibuprofen, Motrin®, Excedrin®, Advil®, and Aleve®.
✓ What CAN I take if I have a headache or joint pain? You MAY take Tylenol® (acetaminophen).
Hold These Specific Diabetes Medications 4 Days Prior
Please hold the following diabetes pills 4 days before your procedure:
Invokana® (canagliflozin) · Farxiga® (dapagliflozin) · Jardiance® (empagliflozin) · Brenzavvy® (bexagliflozin) · Steglatro® (ertugliflozin)
Important for diabetics: Please monitor your blood sugars closely on the day of your bowel preparation and on the morning of your procedure.
Hold ADD or ADHD Medications 3 Days Prior
Hold all A.D.D. or A.D.H.D. medications (for example, Adderall®) for 3 days prior to your procedure or surgery.
Expect a Call from the Facility & Confirm Your Driver Going Home
- Facility Phone Call (About 1 Day Prior): Your procedure facility (Murdock Surgery Center or AdventHealth Port Charlotte) will call you approximately 1 day before your procedure to give you your exact arrival time and tell you which morning medications (if any) to take the morning of your procedure.
- You MUST Have a Driver & Companion: Because you will be given sedation (sleep medicine) for a comfortable exam, you will NOT be permitted to drive yourself home. You must arrange for a responsible adult to accompany you and drive you home.
Step 3: The Clear Liquid Diet (What You CAN and CANNOT Drink)
On the entire day before your colonoscopy (Breakfast, Lunch, and Dinner), you will be on a Clear Liquid Diet. In plain English, a “clear liquid” is a liquid you can see light through—with no pulp, no milk or cream, and no solid food. You may have any of the 14 items below throughout the day (you do not have to drink all of them). Diet and regular versions are both okay.
✅ OK to Drink & Eat (All Day the Day Before)
Choose from any of these 14 approved items — NO RED COLORING:
- Jell-O® (plain — no fruit inside, no red)
- Gatorade® (yellow, lemon-lime, clear/glacier — no red)
- Bouillon / Clear Broth (clear chicken, beef, or vegetable broth — liquid only, no noodles or meat)
- Apple Juice
- White Grape Juice
- Popsicles (no red, no fruit pieces or dairy)
- Fruit Ice / Italian Ice (without fruit pieces, no red)
- Ginger Ale
- Sprite®
- 7-Up®
- Pepsi® / Coke®
- Black Coffee (strictly WITHOUT cream, milk, half-and-half, or milk substitutes)
- Clear Tea (strictly WITHOUT cream, milk, or milk substitutes)
- Water (plain or carbonated)
🚫 DO NOT Eat or Drink
Strictly avoid all of the following:
- OMIT ANYTHING WITH RED COLORING: No red Jell-O, red Gatorade, red popsicles, cranberry juice, or red sports drinks. (Red dye stays on the colon wall and can look like blood during your exam!)
- NO Solid Food at All on the day before your procedure (no breakfast, lunch, or dinner solids).
- NO Milk, Cream, or Non-Dairy Creamers: Do not put milk, half-and-half, powdered creamer, almond milk, oat milk, or soy milk in your coffee or tea.
- NO Orange Juice with Pulp, Smoothies, or Fruit Pieces.
- NO Alcoholic Beverages Allowed (Item #15: no beer, wine, or liquor).
- NOTHING by Mouth After Midnight the night before your procedure (unless instructed by the facility).
Step 4: Follow Your Exact Hour-by-Hour Prep Schedule
1-Day Colonoscopy Prep Schedule (Citrate of Magnesia)
Requires two (2) 10 oz bottles of Citrate of Magnesia + four (4) 5 mg brand-name Dulcolax® Laxative tablets.
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2 Nights BeforeEveningChill Your 2 Bottles in the Refrigerator Overnight
Put both 10 oz bottles of Citrate of Magnesia in the refrigerator the night before your prep day so they are cold and easier to drink tomorrow.
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1 Day BeforeAll Day (Wake-Up)Clear Liquid Diet ONLY — Breakfast, Lunch & Dinner (No Solid Food!)
From the moment you wake up the day before your procedure, eat NO solid food. Drink only from the Approved Clear Liquids list above (water, broth, apple juice, yellow/clear Gatorade, ginger ale, Sprite, 7-Up, Pepsi/Coke, black coffee or clear tea without cream, plain Jell-O, or popsicles). OMIT ANYTHING WITH RED COLORING. No alcohol.
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1 Day Before9:00 AMDrink Your 1st Bottle (10 oz) of Cold Citrate of Magnesia
At 9:00 AM, drink one full 10-ounce bottle of cold Citrate of Magnesia. Follow it with a full glass of water or approved clear liquid. (Stay near a comfortable bathroom as the laxative begins working.)
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1 Day Before2:00 PMTake Four (4) 5 mg Brand-Name Dulcolax® LAXATIVE Tablets All at Once
At 2:00 PM, swallow four (4) 5 mg Dulcolax® LAXATIVE tablets all at the same time with a glass of water or clear liquid. DO NOT USE GENERIC.
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1 Day Before6:00 PMDrink Your 2nd Bottle (10 oz) of Cold Citrate of Magnesia + Drink Clear Liquids Every Hour
At 6:00 PM, drink your second 10-ounce bottle of cold Citrate of Magnesia.
Very Important: Try to drink clear liquids every hour from 6:00 PM right up until bedtime to prevent low blood sugar and dehydration, and to flush your colon completely clean. -
Night Before12:00 MidnightSTOP — NOTHING after Midnight the Night Before Your Procedure
Do not eat or drink anything after 12:00 Midnight (including water, gum, or mints), unless the surgery center or hospital specifically instructed you to take an essential morning pill with a tiny sip of water. Bring your driver with you to the facility!
2-Day Colonoscopy Prep Schedule (Citrate of Magnesia)
Requires three (3) 10 oz bottles of Citrate of Magnesia + four (4) 5 mg brand-name Dulcolax® Laxative tablets.
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3 Nights BeforeEveningChill Bottle #1 in the Refrigerator Overnight
Put your first 10 oz bottle of Citrate of Magnesia in the refrigerator overnight so it is cold for 9:00 AM tomorrow.
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2 Days Before9:00 AMDrink Bottle #1 (10 oz) of Cold Citrate of Magnesia (Normal Diet Today!)
2 days prior to your procedure at 9:00 AM, drink one 10-ounce bottle of cold Citrate of Magnesia.
Good news: There is NO need to change your diet on this day—you may eat your regular meals 2 days before your procedure. That evening, put your remaining two (2) 10 oz bottles of Citrate of Magnesia in the refrigerator overnight. -
1 Day BeforeAll Day (Wake-Up)Clear Liquid Diet ONLY — Breakfast, Lunch & Dinner (No Solid Food!)
From the moment you wake up 1 day before your procedure, eat NO solid food. Have only items from the Approved Clear Liquids list above. OMIT ANYTHING WITH RED COLORING. No alcohol.
-
1 Day Before9:00 AMDrink Bottle #2 (10 oz) of Cold Citrate of Magnesia
The day prior to your procedure at 9:00 AM, drink a 10-ounce bottle of cold Citrate of Magnesia (refrigerated overnight). Follow with a full glass of water or clear liquid.
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1 Day Before2:00 PMTake Four (4) 5 mg Brand-Name Dulcolax® LAXATIVE Tablets All at Once
At 2:00 PM, take four (4) 5 mg Dulcolax® LAXATIVE tablets, all at the same time, with water or clear liquid. DO NOT USE GENERIC.
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1 Day Before6:00 PMDrink Bottle #3 (Final 10 oz Bottle) of Cold Citrate of Magnesia + Clear Liquids Every Hour
At 6:00 PM, drink your final 10-ounce bottle of cold Citrate of Magnesia (refrigerated overnight).
Very Important: Try to drink clear liquids every hour from 6:00 PM right up until bedtime to prevent low blood sugar and dehydration. -
Night Before12:00 MidnightSTOP — Nothing to Eat or Drink by Mouth After Midnight
Nothing to eat or drink by mouth after 12:00 Midnight the night before your procedure (unless instructed by the facility for essential morning pills). Bring your driver with you to the facility!
Questions, Cancellations & Rescheduling Policy
If you have any questions about your prep or medications, please call Charlotte Harbor Surgical at (941) 391-5102 (Monday–Thursday 7:30 am–4:00 pm, Friday 7:30 am–12:00 pm).
- If you are unable to keep your office visit appointment, we ask for 24 hours’ notice.
- If you need to reschedule your colonoscopy / procedure / surgery, we ask for 48 hours’ notice.
- Cancellation charges may apply if timely notice is not given or if there are multiple cancellations/reschedules. A $50.00 rescheduling fee applies for any rescheduling of your procedure unless indicated by your provider.
Now Offering HemWell™ (Hemwellectomy) · Non-Thermal, Minimal-Pain Hemorrhoid Relief
Suffering from Bleeding, Itching, or Prolapsing Hemorrhoids? Ask About HemWell™
We now offer HemWell™ (Hemwellectomy)—an FDA-cleared, non-thermal, minimally invasive hemorrhoid treatment that gently shrinks internal hemorrhoids (Grades I through IV) from the inside without cutting, burning, stitches, or lengthy recovery.
- Done Right During Your Colonoscopy: Takes ~10–15 minutes while you are already comfortably asleep—no extra prep and no extra trip
- Minimal Pain & Little Downtime: Uses gentle, pacemaker-level microcurrent energy that preserves the sensitive rectal lining so most patients return to normal activity the same or next day
- Over 90% Effective in 1 Session: Treats all 4 grades (I–IV) and multiple hemorrhoids at once · Covered by Medicare & most major insurers (CPT 46945 / 46946)
Why Patients Choose HemWell™
| FDA-Cleared | All Grades I, II, III & IV |
|---|---|
| Comfort | Minimal Pain (no cutting or burning) |
| Recovery | Same Day / 1–2 Days |
| Sessions | Usually Just 1 (during colonoscopy) |
| Insurance | Medicare & Most Plans (CPT 46945/46946) |
EGD (upper endoscopy)
An EGD (esophagogastroduodenoscopy) uses a thin, flexible camera to examine the esophagus, stomach and the first part of the small intestine. It can help evaluate reflux, trouble swallowing, upper abdominal pain or bleeding, and it's often part of the evaluation before reflux, hiatal hernia or achalasia surgery. You'll be asked not to eat or drink after midnight beforehand, and you'll need a ride home after sedation.
MiVu™ reflux testing during EGD
If you are being checked for GERD, Dr. Tufts may add MiVu™ mucosal integrity testing to your EGD. A small sensor cap on the scope tip takes a few readings of the esophageal lining in minutes, with results during the procedure, no Bravo™ capsule left in the esophagus and no multi-day recording. Dr. Tufts will tell you if other reflux testing is still needed; insurance coverage varies.
Barrett’s esophagus surveillance
If you have Barrett’s esophagus, surveillance EGDs with systematic biopsies look for precancerous changes early. The TissueCypher® Barrett’s Esophagus Test may be recommended on those same biopsies to estimate your personal risk. Barrett’s esophagus & TissueCypher® →
Advanced polypectomy
Most polyps are small and are removed during a routine colonoscopy. Larger or flat polyps can be harder to remove and may need advanced polypectomy techniques. Removing them during endoscopy can help some patients avoid an operation. Removed tissue is sent to a pathologist.
Esophageal dilation
If part of the esophagus has become narrowed, for example from scarring caused by long-term reflux, food can get stuck. During an EGD, the narrowed area can be gently stretched with a balloon or dilator to make swallowing easier. Some patients need more than one dilation.
Feeding tube placement (PEG)
A PEG (percutaneous endoscopic gastrostomy) tube is a feeding tube placed through the skin of the abdomen into the stomach with the help of an endoscope. It may be recommended when someone can't safely eat or drink enough by mouth. The care team will teach you and your family how to use and care for the tube.
Esophageal manometry
Esophageal manometry measures how well the muscles of the esophagus and the valve at its lower end work when you swallow. A thin, flexible tube is passed through the nose into the esophagus while you take small sips of water. You're awake for the test so you can swallow on cue; the nose is usually numbed first.
Manometry can help explain trouble swallowing or chest discomfort, confirm a diagnosis of achalasia, and is often part of the evaluation before anti-reflux or hiatal hernia surgery. You'll get instructions about fasting and which medicines to pause beforehand.
We care for patients from Port Charlotte, Punta Gorda, North Port, Englewood and across Charlotte County and Southwest Florida.
Frequently asked questions
At what age should I get my first screening colonoscopy?
The U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend that adults at average risk begin colorectal cancer screening at age 45. You may need to start earlier, or be checked more often, if you have a personal or family history of colorectal cancer or polyps, inflammatory bowel disease, or certain inherited conditions. Screening decisions after age 75 are made individually with your doctor.
Is colonoscopy the only way to screen for colon cancer?
No. Stool-based tests and other exams are also recommended screening options. Colonoscopy is the only one that lets the doctor find and remove polyps during the same exam, and an abnormal result on any other screening test should be followed by a colonoscopy.
What is the difference between a screening and a diagnostic colonoscopy?
A screening colonoscopy is done when you have no symptoms. A diagnostic colonoscopy is done to look for the cause of symptoms such as bleeding or a change in bowel habits, or to follow up an abnormal test. Insurance may cover the two differently, so our office can help you check your benefits.
Will I be asleep during my colonoscopy?
You receive sedation so you are comfortable, and most patients remember little or nothing of the exam. Because of the sedation, you need an adult to drive you home and should not drive for the rest of the day.
How do I prepare for a colonoscopy?
You follow a bowel prep the day before (or two days before) so the colon is clean. Our office gives you written step-by-step 1-day or 2-day prep instructions, a clear-liquid diet list and guidance on which medications to pause.
What is an upper endoscopy (EGD)?
EGD (esophagogastroduodenoscopy) uses a thin, flexible camera passed through the mouth to look at the lining of the esophagus, stomach and first part of the small intestine. Small tissue samples (biopsies) can be taken during the exam.
Why might I need an EGD?
Common reasons include heartburn or reflux that does not get better with medicine, trouble or pain swallowing, food sticking, upper abdominal pain, nausea or vomiting, unexplained anemia, and evaluation before reflux or hiatal hernia surgery.
Do I need a bowel prep for an EGD?
No. For an EGD alone you only need an empty stomach, so you will be told not to eat or drink for a period of time before the procedure. If you are having a colonoscopy at the same time, you will also follow the colonoscopy prep.
Can I have an EGD and a colonoscopy on the same day?
In many cases, yes. When both are needed they can often be done one after the other during the same sedation.
What is recovery like after an EGD?
Most people feel a mild sore throat or some bloating for a short time. You need a driver because of the sedation, and most people return to normal activities the next day.
Schedule a consultation with Dr. Tufts
Call Charlotte Harbor Surgical in Port Charlotte. Mon–Thu 7:30 am–4:00 pm, Fri 7:30 am–12:00 noon.