Precautionary Colonoscopy

Colonoscopy

This guide is for patients who are going to have colonoscopy. It answers some of the most commonly asked questions. Please don’t hesitate to ask your doctor or nurse for more information.

What is a colonoscopy?
What do I do to prepare for a colonoscopy?
How is a colonoscopy performed?
What are the potential complications?
Who will perform the procedure?
How long is the recovery?
Are there specific instructions I should follow when I return home?

What is a Colonoscopy?

A colonoscopy is an examination of the lining of the colon with a lighted, flexible tube about the thickness of your finger. The doctor will insert the tube through your rectum, then up through your colon to check for abnormalities. If necessary, an instrument can be passed through the tube to take a small piece of tissue (a biopsy) for examination in the lab. Biopsies are done for many reasons and do not necessarily imply cancer. Often during this process of diagnosis, your doctor may perform other minor procedures, such as polyp removal.

Preparing for your test
Please contact your primary care physician or insurance company if prior referral is needed.

The procedure will take about 45 minutes, but expect the visit to the Medical Procedures Unit to last about four (4) hours to allow for preparation and recovery.

ONE WEEK (SEVEN DAYS) BEFORE YOUR TEST:
Arrange for a responsible person to accompany you to your appointment.

Do not take aspirin for one (1) week prior to your appointment. A few of these products include:

Aspirin
Anacin
Ascripton
Bufferin
Ecotrin
Exederin.

Do not take Plavix or non-steroidal anti-inflammatory drugs for two (2) days prior to your appointment as all of these drugs may increase bleeding. A few of these products are:

Advil
Aleve
Anaprox
Motrin
Naprosyn
Nuprin

Do not take iron or herbal supplements for one week prior to your procedure.

You may continue Celebrex. If you are unsure about the medications you are taking, ask your nurse or doctor.

Be sure to tell the doctor that ordered your test if you are on Coumadin or other blood thinners. You will need special instructions.

The day before your test:

1. You may eat your normal breakfast. Do not eat solid food after noon.
2. Drink only clear liquids for lunch and dinner. These include:

water
apple juice
white grape juice
black coffee
tea
lemon or lime Jell-O
chicken or beef broth
lemon or lime Kool-Aid
soda pops, including colas, 7-Up, Sprite or Fresca
You should have at least one (1) to two (2) quarts of fluid at midday, another one (1) to two (2) quarts of fluid in the evening and again one (1) hour before bedtime. You should drink as much fluid as possible, with a goal of one (1) to two (2) gallons on the day you drink the laxative.

Do not drink red, orange or purple liquids, including Jell-O.

3. In order for the doctor to see the lining of your colon, it must be free from stool. You will have to drink laxative solution (Moviprep) to clean out your bowel. Be sure to use Oral Saline Laxative, NOT an enema product. You should plan to take the laxative in two (2) separate doses approximately six (6) hours apart. We suggest you begin the first laxative dose at 2 p.m. to allow the effects of the prep to be completed by bedtime. Dose A: one litre of Moviprep in the evening before and one litre of Moviprep (Dose B)in the early morning of the day of the clinical procedure. Ensure consumption of Moviprep as well as any other clear fluids has finished at least one hour before the start of the clinical procedure.

Plan on being near a bathroom for the rest of the evening. Your bowels may begin to move in about 30-60 minutes. Feelings of nausea and bloating are common and resolve with time.

An A&D type ointment applied to the rectal area can help with any irritation. The goal is for your stool to be clear or light yellow water. Drinking at least a gallon of clear liquids during the evening will improve the quality of bowel cleansing.

The day of the test–important information
1. If you are unable to keep your appointment, please call the Medical Procedures Unit at(+43 1) 328 8777 or +43 664 14 12 277, option 1 as soon as possible.
2. You may drink liquids, such as water or black coffee, up to two (2) hours prior to your colonoscopy. If you are also scheduled for an upper endoscopy, you should have nothing to drink for three (3) hours prior to your appointment time.
3. You should take your usual morning medications other than those noted earlier. This is especially important for anti-hypertensive and heart medications. You may take pain medication with a few sips of water up to four (4) hours before the test.
4. Please bring the following when you come for your colonoscopy:

A list of all medications you are taking
A list of any allergies you have
Health insurance cards

A responsible adult to accompany you from the medical Procedures Unit after your procedure under sedo-analgesia. You will not be discharged until that person is here to take you from the Medical Procedures Unit.
5. Please leave jewelry at home.
6. Small children will be more comfortable at home.
7. If you have diabetes, you should request an early morning appointment. If you take oral diabetes medications (pills): Do not take it the morning of your test. Bring it with you. If you take insulin (one (1) or two (2) injections per day): Take one half of your usual dose of NPH, Lente or Novolin 70/30 or Lantus insulin and NO Regular or Humalog insulin the morning of your test. If you take evening insulin, follow these same instructions for your dose the evening before your test. If you take Ultralente insulin or are on three (3) or more injections per day, please contact the health care provider who manages your diabetes.

The procedure

In the preparatio area you will answer questions about your health history, current medicines and allergies. You will sign a consent form.

After you change into a hospital gown, a nurse will start an intravenous line (IV). The IV will be used to give you medication to make you more comfortable during the procedure.

The procedure will be performed in a room specially designed for endoscopic procedures. Equipment that will help the nurse and doctor monitor your heartbeat and breathing will be connected to you.

You will be asked to lie on your left side. You will then be sedated before the doctor passes the lubricated tube into your rectum. As the tube passes through the curves of your colon, you may feel pressure or discomfort. You will receive medication throughout the procedure to keep you comfortable. The doctor will put air (CO2-Insufflation) into your colon in order to see the lining.

You may have some bloating or abdominal discomfort from the air. You may feel as though you have to have a bowel movement. Pass the air if you feel the need. The doctor will remove as much air as possible after the procedure. If biopsy and/or polyp removal is necessary, you should experience no pain.

Potential complications
Complications are rare. However, there are potential complications associated with all medical procedures. These will be explained to you at the time you sign your consent for the procedure.

Recovery

After your procedure you will be taken to the recovery area in the Medical Procedures Unit. One family member may join you there. When you are ready to go home the nurse will discuss instructions and answer your questions. You will be given a copy of the procedure report. You may not drive yourself home. Be sure to bring a responsible adult licensed driver with you. A responsible adult will need to be with you when you are discharged from the recovery area. If your driver cannot accompany you for the entire procedure visit, please have them call(1) 328 8777, option 2 to confirm that they will be available when you are discharged.

At-home instructions
You will be given specific written instructions about resuming your medications and diet.

You may return to work or school the day after your test.
Do not drive a vehicle or operate machinery for at least 12 hours after your test.
Do not make any major legal or financial decisions the day of your test.
Do not drink alcoholic beverages for at least 12 hours following your procedure.

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