Fazia Mir-Shaffi,MD, DABOM

Let’s talk prep baby! Apologies to my fellows for embarrassing them with that joke! 🙃 But this is an important topic! ✅ Isosmotic (PEG-based) Preps • High-volume (4L): GoLYTELY, CoLyte • Low-volume (2–3L): MoviPrep, Plenvu (contain ascorbic acid) ✔️ Preferred for most patients ⚠️ Avoid Plenvu/MoviPrep in G6PD deficiency & renal impairment/ CHF ⚡️ Hyperosmotic Preps • SuPrep (sodium sulfate–based): ~3L • Sutab: 24 tablets + 96 oz water ⚠️ Use caution in renal dysfunction, CHF, or electrolyte disturbances 🚫 Sodium Phosphate–Based Preps (e.g., OsmoPrep) * I’ve never used this 🤷🏻‍♀️ ❌ Avoid in:  • CHF (NYHA III/IV)  • ESRD or patients on diuretics  • IBD (can mimic flare/inflammation) 🔺 Black Box Warning: Seizures, phosphate nephropathy ❌ Non–FDA-Approved OTC Preps • Magnesium citrate – risk of fatal hypermagnesemia • PEG 3350 + bisacodyl mixed in sports drinks (e.g., Gatorade) ⚠️ Use only with caution; avoid in renal, CHF, or liver disease 💩 Split dosing = better prep quality & polyp detection. Also, I have a whole new level of appreciation & respect for patients who go through colonoscopies regularly after doing my own. That morning dose of split prep nearly broke me 😵‍💫… the struggle was real. Throwback to @AmyOxentenkoMD post on her experience, tips & tricks 👇 What are your best tips/tricks for surviving the prep? Drop them below ⬇️

Get involved early! You may not land the first committee you want and that’s ok! If you’re committed to showing up and staying engaged, doors will open. There’s always a way to contribute! 10 years later, it’s been an incredible journey of growth, mentorship, and community with @AmerGastroAssn #MedTwitter #GITwitter #AGAGastroSquad