HF 4756

Rectal Exam Under Anesthesia (With Pouch)

This Health Fact describes an exam of the rectum and ileal pouch while you are asleep under anesthesia.

Bowel Prep

You will need to do a bowel prep before the exam. The bowel prep is the MiraLAX prep.

MiraLAX Prep

You will need to purchase these items:

  • MiraLAX 4.1 ounce/119 grams

  • 2-32-ounce bottle of Gatorade or Powerade. (If diabetic, use Pedialyte)

The Day Before Surgery


Before 12:00 pm (noon): You may eat a light lunch.

  • After 12:00 pm (noon): Stop eating solid food and start a clear liquid diet. Clear liquids include:

  • Water, clear sports drinks like Gatorade®

  • Broth

  • Black coffee, tea, soda

  • Apple juice

  • Jell-O®

  • No creamers, milks or other dairy products

  • No red or purple liquids or Jell-O

  • No solid food

Bowel Prep

  1. 2:00 pm: In the early afternoon split the MiraLAX into the 2-32 bottles of chilled Gatorade or Powerade. (If diabetic, use Pedialyte)

  2. 4:00 pm: Drink the first 32-ounce bottle of the Gatorade/MiraLAX.
    Drink a glass full of the drink every 15 minutes until your stool is clear.

  3. 6:00 pm: If the stool is still not clear then drink the second 32-ounce Gatorade and MiraLAX mixture. Drink a glass full every 15 minutes. If stools clear, then you can stop drinking before you complete the second bottle. Keep drinking clear fluids until bedtime to prevent getting dehydrated.

  4. Before bed: Shower.

The Day of Surgery

  • Shower

  • Take your medicines as you were told by the colorectal surgery team.

  • Call if you have not gotten instructions.

  • You may drink clear liquids until 4 hours before you arrive for the procedure.

After the Exam

Your care after the exam will depend on the findings. If you had a dilation, you may be able to return to your normal routine in 1-2 days or you may need to follow more strict guidelines.


  • Activity as tolerated.

  • There may be restriction to activity depending what was done during the exam.

  • Follow up will be determined by the surgeon.

Pain Relief

You may have pain after your exam. Your doctor may order pain pills for you.

When to Call

  • Problems having a bowel movement.

  • Fever over 100.4 F for 2 readings taken by mouth 4 hours apart.

  • Pain not relieved by pain pills.

  • Bleeding that does not stop after 10 minutes of applied pressure to the rectal area.

Who to Call

Digestive Health Center:
(608) 242-2800 or 1-855-342-9900
After hours, weekends or holidays the number will be answered by the paging operator. Ask for the doctor on call. Leave your name and phone number with area code. The doctor will call you back.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.