Below are answers to the most frequently asked questions that we receive from our patients . You are always welcome to ask us directly if you have other questions or concerns.
What happens on my arrival to the facility?
During your first visit, you will be asked to register at our reception desk and to fill out a set of forms. The receptionist will also verify that we have correct demographic data such as your current address and contact information. She will also need to review your current insurance information – so be sure to bring your insurance cards with you. If you have HMO insurance that requires prior referral, she will also need to check that we received authorization for your visit.
You will then be taken by the nurse to an admission room where your vitals signs will be recorded. A comprehensive health history will be taken. This may take about 15 minutes, but is time well spent. You will be asked to recall details of your past medical history that puts things in perspective for the doctor. You will be asked to disrobe and put on a hospital gown. The nurse will be verifying that you have prepared properly for the procedure .An IV catheter will be inserted in your arm by the admitting nurse, in order for the physician to administer the IV sedation medications.
The doctor will then interview you and perform a focused physical examination. Just prior to your procedure , then the procedure will be performed as planned by your physician.
How do I prepare for my upper endoscopy procedure?
You need three things to prepare for a Gastroscopy examination (EGD):
An appointment for the examination.
An empty stomach. You must be fasting for 6 hours prior. No food or drink.
A driver to take you home since you will not be able to drive until the following morning. We ask that your driver come with you and plan to stay the entire time you are here which averages about 1 1/2 hours. This is about 2 hours less than the average length of stay at the hospital outpatient surgery department.
How do I prepare for my Colonoscopy?
The standard preparation for colonoscopy begins the morning of the prior day. After having a light breakfast, the rest of the day should consist only of a clear liquid diet. No solid food or milk products. Just tea or coffee (no cream) , Jell-O, clear broth, soft-drinks , Popsicles and water. Most patients will be asked to use the standard lavage solution (GoLytely, Colytely, Nulytely, PEG solution) which you drink the evening prior to your test. Don’t make any plans for that evening. You will be at home in your bathroom most of the time.
Should I take my normal medications before my test?
Yes. In general, it is best that you take all of your normal medications before and after your scope test. The exceptions would be those patients on diabetic medications (insulin or pills) and those who take medications to prevent clotting such as Coumadin, Plavix, and Ticlid. If you are diabetic or on these “blood thinners,” our doctor needs to review your medications and decide what should be done.
What happens if I start vomiting while I am taking the preparation solution?
If you are taking your laxative solution and develop symptoms of nausea or vomiting, stop the preparation process for an hour or so. Then, if you feel better, try to pick up where you left off. It works better if you slow down the drinking by taking smaller sips rather than drinking fast. A warmed towel or blanket on the abdomen helps. If you cannot complete the preparation, let your doctor’s office know. Your test may need to be rescheduled or an alternative preparation tried. If you develop severe abdominal pain during your preparation, stop and call the doctor’s . There is always a physician on call through the answering service.
I am drinking the preparation solution, and my bowels have not moved?
Be patient. This laxative solution rarely fails. Most patients have a bowel movement within an hour or two of starting the solution. Sometimes, there may be a delay. If you have drunk at least half of the solution (8 glasses) and your bowels have not moved, just stop for a while. If nothing happens in an hour, try taking a small disposable 4-oz Fleets enema. They are available at your drugstore. Please pick up the enemas at the store before you start your preparation. If you still have no results after all that , please contact your physician for an alternate preparation.
The instructions on the bottle of solution is different than the ones you gave me?
The doctor’s office provides most patients with printed instructions for their preparation. If you have those, follow them. If you didn’t receive any written instructions, simply follow the instructions on the bottle.
I lost my instructions on how to prepare for my scope test.
Please contact us or the doctor’s office, we will provide you with a new copy. Or simply follow the instructions on the bottle.
Can I put flavoring into my preparation solution?
Yes. If you were given the unflavored solution and wish to add some flavoring, it is OK. Ignore the warning on the label about not adding any flavoring and add one packet of Crystal Light Lemonade or Iced Tea Mix or Koolaid. These two flavors do not interfere with the preparation or testing. Do not add any brightly colored flavoring, such as red, green, or blue as these may interfere with the examination.
Wouldn’t my rectum be sore after having so many bowel movements during preparation?
It might be. The very nature of the cleanout process means that you will have many liquid bowel movements over several hours. This might cause some soreness around the anal area. You can minimize this by using soft toilet tissue , followed by a baby wipe after each bowel movement. Some patients report less problems if they apply an ointment such as 1% Hydrocortisone cream , zinc-oxide ointment , or a similar Vaseline base ointment to the anal area after each bowel movement. You might consider purchasing these items when you go to pick up your laxative solution.
Do I have to drink all 4 quarts of laxative preparation solution?
It depends on the preparation prescribed. If Magnesium Citrate is taken before the PEG solution, you may only need to drink the first 2 quarts of the PEG solution if the output has become clear. If the PEG solution is taken alone, all 4 quarts must be consumed. Don’t forget that you have 30 feet of digestive tract that we are trying to clean out from the top down. Even though it’s hard to believe, it takes this whole gallon of laxative solution to really do a good job. If you want an accurate examination, it is important that your preparation for the test is complete. If your colon is not well cleaned out, the test may have to be aborted and rescheduled for another day.
Should I hold my Aspirin and anticoagulants prior to my procedure?
Theoretically, aspirin and drugs like ibuprofen can inhibit blood clotting and make the risk of bleeding higher, especially if you are going to have a biopsy taken or polyp removed. If you are on daily aspirin or ibuprofen you must stop it at least 1-3 days before your test to get it out of your system. NOTE: If you are taking a daily aspirin to prevent a stroke or heart attack, don’t stop it without consulting your physician first .
If you are on anticoagulants, such as Coumadin, Plavix and similar medications, those need to be stopped 3-5 days before your procedure. Only your physician can make such a determination. Some high risk patients need to be placed on an alternate anti-coagulant regimen while being off their usual anticoagulant.
Why do I need to bring a driver to my scope test?
Scope examinations such as gastroscopy, colonoscopy, and endoscopic ultrasound require sedation to prevent pain and discomfort. These medications make the test quite simple for the patient, but do not wear off immediately. Because of this, you cannot drive your car at least 12 hours or until the following morning. Therefore, it is necessary for you to come with a friend or family member who can safely drive you home after your test is over. We ask that your driver come with you and stay the entire time you are at our center. This makes them available for questions, and allows the doctor to meet with them in the recovery room after your test to explain the results.
Will my scope test be painful?
No. That is the nice part. With the modern anesthetic sedatives, your examination should be painless. In fact, after their exams most patients ask, “When is the test going to start?” Of course, the price you pay for a painless test is the fact that you will not be able to work or drive the rest of the day. That is why you need a driver to take you home.
What should I expect during my scope test?
After your pre-operative assessment, you will be taken by stretcher to the Endoscopy Room. Don’t be surprised if it looks like an operating room. They look the same. The nurse will place you on equipment that monitors your heartbeat and blood pressure and gives you nasal oxygen. Don’t be alarmed. This is routine for everybody. You will then be asked to roll onto your left side on the padded stretcher. The doctor will then administer the sedative into your intravenous line, and that’s about all you can expect. The rest of the test is done while you are in a state called “conscious sedation.” This is not like general anesthesia such as heart surgery. But a pleasant semiconscious state in which you should feel no pain and be unaware of the actual test itself.
If the doctor finds a polyp during my test, will he remove it?
In most cases, yes. All of our doctors are trained in the latest endoscopic techniques. Most polyps can be removed at the time of colonoscopy. Rarely, a polyp is too big or too flat to remove and surgery is necessary. If the physician sees a very large polyp or a mass that cannot be safely removed through the scope, the patient will be referred to a surgeon to have it removed. The polyps that are removed will be sent to pathology for a closer examination.
Does a colonoscopy show that I have cancer?
Yes. In fact, colonoscopy is considered to be the most accurate way to determine the health of your colon. This includes checking for cancer, polyps, colitis, diverticulosis, and other less common lower digestive problems. The good news is that it is very rare for us to find colon cancer in an individual who is just coming in for a screening exam as a routine checkup. We often find polyps which are removed to PREVENT a colon cancer in the future.
How will I feel after my test?
After your test, you will probably have a dry mouth and feel drowsy, gassy, and hungry. The dry mouth and drowsiness are from the sedation. They will gradually wear off. The gassiness is from the air that is inflated into the digestive tract during the scope test. This helps your doctor see inside your stomach or colon. We try to remove most of the air after the procedure, but some of it just has to pass naturally. Of course, since fasting is part of the preparation, you will feel hungry. Our recovery room nurse will offer you some juice after your procedure.
Once you go home, you can pass the rest of the gas and are able to eat. Soon, you will be back to normal. Usually there is no real pain after a scope test nor sore throat after gastroscopy. The sedation given during your examination will likely prevent you from remembering exactly what the doctor had to say. However, you are given a full written report to take home and read once you are more alert.
How soon will I be able to eat after my test?
Immediately. As soon as you awaken in our recovery room, our nurse will offer you some juice. Once you go home, you can have a normal breakfast or lunch. Eat whatever you feel like. Just go slow at first. Use some common sense. Don’t try to make up for 3 missed meals all at once . If your physician wants you to be on a special diet after your procedure, it will be marked for you on your discharge instructions.
How long do I have to wait for the results of my test?
The results of a scope test are immediate. After you awaken from your sedation, the doctor will discuss the results of the test with you and your family. We also give you a written explanation of what was found and what treatment, if any, is anticipated. You will also have an opportunity to ask questions. Of course, any biopsies or samples taken for lab analysis will not be available that day. In that case, you will need to make a follow-up appointment with your physician. Another reason that you need a companion to come with you is that the medications make you groggy and you may forget what the doctor tells you after the test. It is best to have another set of ears with you.