Preparation for Procedures

General Preparation Information

Being prepared for you endoscopic exam is extremely important. There are several components to being prepared for your exam:

Reducing anxiety

Most patients feel at least some level of anxiety prior to any surgery or procedure. It can be helpful to hear about other’s experiences. Bringing a friend or family member along for support can also be helpful. Bringing a book, magazine or personal music player can also help distract you and help you relax. If you have ever had a bad experience with a procedure, a history of abuse, or suffer from severe anxiety, please discuss this with one of our caring staff members. We want your experience to be safe and comfortable for you!

Knowing what to expect can help alleviate some of your anxiety. We recommend you learn as much about the procedure as you can. Please read the following pages:

Medication and diet restrictions

Medication and diet restrictions prior to the exam are critical for your safety before, during and after your exam. Because endoscopy procedures are typically done with conscious sedation, it is important that your stomach is empty to minimize the risk of aspiration (vomiting stomach contents into your lungs which might cause pneumonia). The absolute minimum time between any solid food intake and the time of your procedure should be at least 6 hours. Clear liquids may not be consumed within 4 hours of starting your procedure. However, you may take a sip of water with any necessary pills the morning of your procedure.

Medications which increase your risk of bleeding (e.g. Coumadin, Plavix, aspirin, NSAID’s) are often held prior to an exam in case any tissue needs to be removed. However, stopping these medications may also be dangerous (e.g. if you have a mechanical heart valve or have had a coronary artery stent recently placed).  Medications which lower blood sugar (insulin or diabetese pills) may need to be decreased or held while you are fasting for your procedure to prevent dangerously low blood sugars.  To maximize the safety of your exam:

  • Notify your physician of ALL medications, supplements, vitamins and herbs (some herbs can increase your risk of bleeding) that you take.
  • Medications for diabetes (such as pills or insulin) need to be carefully reviewed. Often you will be advised to hold or decrease the dose the day prior and the morning of your exam (we’d rather you have one day of too high blood sugar than life-threateningly too low!).
  • Blood thinners or medications which interfere with your ability to form blood clots should also be carefully reviewed and possibly held prior to the procedure. Many medications have these effects, most notably aspirin, Plavix (clopidogrel), Coumadin (warfarin), and NSAID’s. It is very important that we know that you are taking these and for what reason.
  • If you have had any recent heart events (for example stenting or heart attack), lung events (pneumonia or blood clots), stroke, history heavy bleeding, or reaction to sedation, please notify us.
  • If you have ever been told you need to take antibiotics prior to procedures, please notify us.
  • If you have any questions or concerns about any of your medications and your ability to take these or the risk of NOT taking them in preparation for your procedure, please notify the office at least 1 week prior to your exam so that one of our physicians may review your concerns.

A few words about bowel preps

The colon typically has feces throughout it’s four to five foot length. When screening for colon cancer it is extremely important to have a well-cleansed colon so that the surface of the colon wall can be closely and carefully inspected. This maximizes your physician’s ability to find colon polyps, cancers, inflammation and flat or slightly depressed precancerous lesions. We rate colon cleansing as Excellent, Good, Fair or Inadequate. Since you may only need to undergo a colonoscopy every 10 years, it is worth the effort to make sure you get the best quality exam possible. The better the preparation, the better the exam. When a large amount of stool remains in the colon, this makes navigation more difficult, lengthens the time of the procedure, increases the risk of complications, and can ultimately prevent the discovery of even large polyps or other problems in the colon. Additionally a prep which is inadequate does little to assure you or your physician that all precancerous tissue has been discovered or removed.

With that said, people often describe the bowel cleansing as the most unpleasurable aspect of the entire colonoscopy process (because of sedation, most people are quite comfortable for the procedure itself!). Here are some tips to make the process as easy, comfortable and successful as possible:

A few days prior:

  • Decrease the amount of fiber in your diet.
  • Increase your fluid intake.
  • If you take chronic narcotic pain medications or have a history of chronic constipation these can be especially important. You may need to be on a clear liquid diet for at least two days.

The day before and day of your exam:

  • Drink plenty of fluids! Dehydration can occur from preparation-related diarrhea. This can result in heart or kidney problems.

If you have nausea or vomiting:

  • Slow down! Take smaller amounts less frequently. It may take longer to get through it, but it is important to complete the prep!
  • Keep the prep on ice or in the fridge.
  • You may add a Diet Crystal Light flavoring of your choice to most unflavored preps.
  • On rare occasions you may need to try an alternative medication, but should discuss this with your physician.

When can I stop my prep?

  • When you have completed the prescribed regimen.

What if my prep is not good enough?

  • If you have not had any bowel movements with the prep, were unable to tolerate the prep, or completed the prep as directed but are still having formed or semi-formed stool, please notify us as soon as possible so that we may provide further instructions.
  • If you are told that your preparation was fair or inadequate, we would likely recommend that you have a repeat colonoscopy sooner than usual and that you may need some alteration in the prep regimen the next time (eg TWO days of clear liquids, extra laxative doses).

 

Printable Preparation Instructions

These are the same documents mailed out to each patient when a procedure is scheduled.  If you did not receive your copy or would like another you may view or print them here.  If you are at all unsure which set of instructions applies to your procedure please Contact Us!

Common Preparations

Suprep

Clear Liquid Diet

Golytely Split Preparation

Miralax Split Preparation

Flexible Sigmoidoscopy With Sedation

EGD (Upper Endoscopy)

EUS (Endoscopic Ultrasound)

 

Special Preparations

2 Day Miralax Split Dose Prep  (Extended prep special ordered by your physician)

2 Day Golytely Split Dose Prep  (Extended prep special ordered by your physician)

Magnesium Citrate Preparation for Ileostomy

Capsule Enteroscopy Preparation

Flexible Sigmoidoscopy Without Sedation

Miralax Constipation Preparation

Golytley Constipation Preparation

ERCP Instructions

 

En Español

Suprep

Dieta de Liquidos Transparentes

Half-Lytely Preparación Para La Colonoscopia

Miralax Preparación Para La Colonoscopia

Miralax/Magnesium Citrate Preparación Para La Colonoscopia

Half-Lytely Dosis Dividida Preparación Para La Colonoscopia

Miralax Dosis Dividida Preparación Para La Colonoscopia

Instrucciones Para EGD (Endoscopia Alta)

 

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