Instructions for Colonoscopy

Let your Primary Care or Referring Doctor know if::

• You are on anticoagulants (blood thinners) or aspirin-containing products.
• You have been told to take antibiotics prior to dental visits or diagnostic tests.
• You have bleeding tendencies.
• You are diabetic.
• You have special diet requirements.
• Please contact the doctor who ordered these medications for you for any changes that may be required before your procedure.

Please make arrangements for someone to drive you home after the procedure. A companion must accompany you because you will be given medication to help you relax. Even though you may not feel tired, your judgment may be impaired and your reflexes may be slower. You will not be allowed to drive or take a taxi alone after the procedure. It is recommended that you not leave town for 24 hours after the procedure. It is also recommended that you have a responsible adult with you for 12 hours following your procedure.

Please bring with you a list of your current medications and dosages. Please bring your colon x-rays with you if requested to do so.

Here are some answers to some common questions:

• What Should I do to Prepare?
• How is Colonoscopy Performed?
• What Do I Do After the Procedure?
• Are There Any Complications from Colonsocopy and Polypectomy?
• Causes for Concern

What Should I Do to Prepare?

Please follow the enclosed preparation sheet to prepare yourself for the examination.

• Colyte/Nulytely Prep (225K)
• Citrate of Magnesium Prep (225K)

Call our office at _______________ if you have questions.

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How Is Colonoscopy Performed?

When you arrive in the endoscopy suite, a nurse will take your vital signs (blood pressure, temperature and pulse) and insert an intravenous catheter into a vein in your hand. Your doctor may then prescribe medicine to relax you and help ease abdominal cramping. You will be lying on your left side. The colonoscope (a long flexible tube about the width of a finger) is inserted into the rectum and gradually advanced through the colon. The doctor will insert air into the colon. The air may cause pressure or a bloating feeling but will enable the doctor to see your colon more clearly. The colonoscope is then slowly withdrawn and the lining of the colon is carefully examined. Your doctor will remove polyps or take biopsies as necessary. Following your examination, there may be some discomfort, which quickly improves with the passing of gas. The entire procedure usually takes less than an hour. Your nurse will transport you back to the recovery area and continue monitoring you until you go home. You will be observed in the endoscopy suite for a period of time. You will be given written instructions at the time of discharge.

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What Do I Do After the Procedure?

You may resume your regular diet and activities according to the instructions below:

Colonoscopy without polypectomy or biopsy

• Return to your regular diet on the same day.
• Avoid strenuous exercise or driving for 12 hours after the procedure.
• Resume taking aspirin-containing medication or blood thinners on the same day.
• If you normally take anti-coagulants (blood thinners), the doctor will give you instructions at discharge about when to resume taking them.

Colonoscopy with polypectomy or biopsy

• Return to your regular diet on the same day unless instructed otherwise by your doctor. Do not eat nuts or popcorn for 72 hours.
• Avoid strenuous exercise or driving for 12 hours after the procedure.
• Avoid aspirin-containing medications for an additional seven days.
• If you normally take anti-coagulants (blood thinners), your doctor will give you instructions about when to resume taking them.

Results

All polyps (pieces of tissue) removed at the time of colonoscopy will be examined under the microscope by a pathologist. It typically takes seven days for us to get the results. We will call you with the results as soon as we get them. If you need follow up, you will receive a letter reminding you to call and schedule an appointment.

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Are There Any Complications from Colonsocopy and Polypectomy?

Colonoscopy and polypectomy are associated with very low risk when performed by doctors with special training and experience in these endoscopic procedures. One possible complication is perforation, which is a tear through the wall of the bowel that may allow leakage of intestinal fluids. Another complication is bleeding that may occur from the site of biopsy or polyp removal. It is usually minor and stops on its own, or it can be controlled by cauterization (application of electrical current) through the colonoscope. Rarely, surgery is necessary. A third complication is a localized irritation of the vein in your hand that may occur at the site of medication injection. A tender lump could develop and may remain for several weeks to several months. Elevation of the arm and hand on several pillows and local application of heat speeds recovery.

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Causes for Concern

Call your doctor if you have any of the following problems:

• Rectal bleeding greater than one cupful or lasting longer than one to two days
• Increasing abdominal pain lasting longer than 30 minutes
• Nausea or vomiting
• Fever or chills

If your doctor is not available, a doctor on call is available 24 hours a day, every day of the year, including holidays. After hours, call our office and the answering service will locate the doctor on call. In an emergency, try to contact us for advice before you go to the hospital. A telephone call may save you a lot of time, money, and discomfort.

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