RODNEY SURGICAL MODERN PROFESSIONAL LOCAL PREPARATION FOR ENDOSCOPIES

Transcription

1 RODNEY SURGICAL MODERN PROFESSIONAL LOCAL PREPARATION FOR ENDOSCOPIES

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3 INDEX What is endoscopy... page 1 Gastroscopy... page 1 Colonoscopy... page 3 Preparation for morning colonoscopy... page 3 Preparation for afternoon colonoscopy... page 4 Medications... page 6 Things to do prior to your appointment... page 6 Things to bring with you to your appointment... page 6 Suggested diet before flexible colonoscopy... page 7 After the colonoscopy/gastroscopy... page 8 Safety and risks... page 8 General information... page 9 Hand hygiene... page 10 Preparation for colonoscopy in back pocket of booklet Picosalax sachets Picosalax instructions i

4 Please do not hesitate to contact us if you have any queries or doubts about your appointment or these instructions. Follow instructions for either morning or afternoon colonoscopy OR morning or afternoon gastroscopy based on your admission time and the procedure you are having. Please ensure you read this document thoroughly before you start your preparation. Picosalax: Because this preparation will cause multiple bowel motions it is advisable that you remain within easy reach of toilet facilities, therefore you may be more comfortable in your home environment. Individual responses to laxatives do vary the preparation often works within 30 minutes but may take up to three hours. PAYMENT OF ACCOUNTS All patients are admitted on the understanding that they have made arrangements to pay the accounts. EFTPOS is available and we accept Mastercard and Visa. Cheques should be made out to Rodney Surgical Centre. Any balances unpaid after a month from the date of invoice may be referred to our debt collection service. If you have any difficulty with the prompt payment of your account please contact us. ii

5 PREPARATION FOR ENDOSCOPIES WHAT IS ENDOSCOPY? Endoscopy is a procedure (diagnostic or therapeutic) where a thin flexible tube (endoscope) is used to view the lining of your stomach/bowel. The image produced via the video processor is displayed on a television screen that allows an excellent view for your specialist. Special instruments can be passed down the endoscope to obtain a biopsy (a tiny tissue sample) or to remove polyps. All samples are sent to the laboratory for analysis. Colonoscopy is an endoscopy of the large bowel (colon). Gastroscopy is an endoscopy of the throat, stomach and duodenum GASTROSCOPY A gastroscopy is a visual examination using a narrow flexible telescope to view the oesophagus (swallowing tube), stomach and its lining. You will have the opportunity to speak with the doctor performing the procedure before the examination begins. Feel free to ask any questions you may have about the procedure, presenting symptoms, etc. The doctor will administer sedation just prior to the procedure. This helps to make the procedure easier for you. PREPARATION Your stomach needs to be completely empty for the examination. Please do not eat anything for at least six (6) hours before your appointment. You may drink water up to two hours before appointment. MORNING APPOINTMENT If your appointment is in the morning, it is very important that you do not eat anything from midnight the night before your examination. AFTERNOON APPOINTMENT If your appointment is in the afternoon you may have an early breakfast of tea, coffee or fruit juice, toast or low fibre cereal. It is very important you DO NOT drive or operate machinery or dangerous appliances for at least 12 hours after your procedure, as you will have had a sedative. 1

6 THE GASTROSCOPY PROCEDURE You will be taken into the procedure room and asked to lie down on a bed. A local anaesthetic is sprayed into the back of your mouth. Sedating medication is given to help you relax. This is optional but it does facilitate the procedure considerably. Most procedures take minutes. However your stay at the clinic will be approximately 1-2 hours. Gastroscopy involves passing the endoscope through the oesophagus, stomach and duodenum. oesophagus stomach duodenum 2

7 COLONOSCOPY PREPARATION FOR MORNING COLONOSCOPY A colonoscopy is a visual examination of the bowel using a narrow flexible telescope. It is an important examination used for the diagnosis and treatment of bowel conditions. These interventions may include taking small tissue samples (biopsies) and removal of polyps. If you suffer from any medical condition that may require specialised information or treatment during preparation/procedure, please contact Rodney Surgical Centre for advice. To obtain good views of the bowel lining, the bowel must be completely empty. This is achieved with the help of a preparation called Picosalax. You will need two (2) 16.1g sachets of Picosalax. This is a solution that completely cleanses the bowel. Two days before examination Begin low fibre diet (see page 7 of this leaflet for guidelines). One day before examination STOP ALL SOLID FOOD until after your procedure. Drink only clear fluids (see page 7) for breakfast, lunch and dinner. 12 noon (midday) Mix up the first sachet of Picosalax with 150mL water and drink it. Follow this with at least five drinks of clear liquid over the next few hours. 5.30pm Repeat Picosalax as per earlier dose. Follow with several glasses of water at least one glass (250ml) per hour, more if desired, to maintain hydration throughout your body. You may find it helpful to use the clear liquid diary included with this information as a guide to ensure adequate fluid intake (located at the back of this booklet). Note: If you have a dry mouth or feel dehydrated, drink more fluids or water with one teaspoon of sugar and half teaspoon salt per glass. Aim to drink 500mL per hour. Day of examination Clear fluids only today but stop all fluids two hours before appointment 3

8 PREPARATION FOR AFTERNOON COLONOSCOPY A colonoscopy is a visual examination of the bowel using a narrow flexible telescope. It is an important examination used for the diagnosis and treatment of bowel conditions. These interventions may include taking small tissue samples (biopsies) and removal of polyps. If you suffer from any medical condition that may require specialised information or treatment during preparation/procedure, please contact Rodney Surgical Centre for advice. To obtain good views of the bowel lining, the bowel must be completely empty. This is achieved with the help of a preparation called Picosalax. You will need two (2) 16.1g sachets of Picosalax. This is a solution that completely cleanses the bowel. Two days before examination Begin low fibre diet (see page 7 of this leaflet for guidelines). One day before examination A low fibre breakfast is allowed before 10.00am. AFTER 10.00AM, STOP ALL SOLID FOOD until after your procedure. Drink only clear fluids (see page 7) for lunch and dinner. 6.00pm Mix up the first sachet of Picosalax with 150mL water and drink it. Follow this with at least five drinks of clear liquid over the next few hours. Note: If you have a dry mouth or feel dehydrated, drink more fluids or water with one teaspoon of sugar and half teaspoon salt per glass. Aim to drink 500mL per hour. Day of examination 7.00am Repeat Picosalax as per earlier dose. Follow with several glasses of water at least one glass (250mL) per hour, more if desired, to maintain hydration throughout your body. You may find it helpful to use the clear liquid diary included with this information as a guide to ensure adequate fluid intake. Clear fluids only today, but stop all fluids two hours before appointment 4

9 PREPARATION FOR A COLONOSCOPY The bowel MUST be completely clear for the examination to be accurate. Therefore it is important that the instructions you are given are followed carefully. If you have any difficulties with the preparation please contact Rodney Surgical Centre On arrival: Please report to Reception A nurse will review your health details with you You will be asked to change into one of our gowns. THE COLONOSCOPY PROCEDURE Once you have changed into one of our gowns you will be taken into the procedure room. Sedating medication is given to help you relax. Colonoscopy involves passing the endoscope along the whole of the colon and rectum. Most procedures take minutes. However, your stay at the clinic will be approximately 1½ 2½ hours. Large bowel (colon) Small bowel 5

10 MEDICATIONS Please take all your usual medication (with water) at 6am on the morning of the procedure. Do not take your medications within one hour of taking the preparation. If you are taking iron tablets, please discontinue them one week prior to the test. If you are a diabetic and/or taking anticoagulant medication, it is important to notify Rodney Surgical Centre, as there may be special instructions for preparation. THINGS TO DO PRIOR TO YOUR APPOINTMENT IF YOU HAVE MEDICAL INSURANCE Southern Cross Please contact RSC for us to arrange your prior approval on your behalf. All other insurance companies - Please contact your medical insurance company to obtain a prior approval number or letter. Please note that the estimate provided is an approximation of costs based on routine procedures. The final cost may vary due to unforeseen procedures and/or additional requirements. Depending on your policy, you may be required to settle the account in full or pay a co-payment to RSC. Organise a family member or friend to drop you at Rodney Surgical Centre and collect you approximately 2 2½ hours after your appointment time. There is no need for them to stay our staff can phone them when you are ready to go home. We advise you to have a responsible adult to stay with you overnight. It is very important you DO NOT drive, or operate machinery or dangerous appliances for at least 12 hours following your procedure as you will have had a sedative. THINGS TO BRING WITH YOU TO YOUR APPOINTMENT Completed Admission Form if you have not returned to RSC prior to procedure. Any x-rays and/or barium studies relevant to your examination (if available). A list of regular medications. Your medical insurance prior approval number or letter (if relevant). Wear loose comfortable clothing. 6

11 We Advise NOT To Bring Valuables such as jewellery and cash. RSC is unable to take responsibility for the safe keeping of these items. We constantly strive to minimize patient waiting time but, as you may appreciate, we cannot always predict exactly how long each case will take. If you are kept waiting, please accept our apologies for this. Your appointment time will be at least 40 minutes prior to your procedure time to allow for our nursing admission process. SUGGESTED DIET BEFORE FLEXIBLE COLONOSCOPY LOW FIBRE DIET Rice bubbles or cornflakes Eggs (not fried), omelettes, plain tinned spaghetti White bread or toast (not high fibre) Plain crackers (not wholemeal or multigrain), plain scones (no sultanas, dates), plain biscuits (Arrowroot or Wine) Butter, margarine, cheese Honey, marmalade Marmite, Vegemite Fish, skinless chicken (not fried or highly seasoned) White rice, plain pasta, skinless potatoes or kumara NO fruit, vegetables, pips, seeds, red meat, brown bread, muesli. CLEAR FLUIDS You are encouraged to drink as much clear fluid as possible to help clear your bowel and prevent dehydration. For comfort or to give variation of taste, try alternating clear fluids during your bowel preparation, some suggestions below: Water Lemon flavoured energy drinks, colourless cordials and carbonated drinks Strained fruit juice, some soups (e.g. strained chicken noodle) Lemon ice blocks, light coloured jellies, barley sugars, boiled sweets Tea and coffee black only NO highly coloured drinks (i.e. red, purple, green). 7

12 PLEASE NOTE If you are feeling nauseous, ginger ale may help due to its natural anti-nausea properties. It is not unusual to feel cold or bloated when drinking the bowel preparation. Wear warm comfortable clothing and try short walks to help alleviate bloating. Vaseline or Zinc & Castor Oil cream can be wiped around the anus to reduce discomfort during bowel cleansing. Using baby wipes instead of toilet paper may also be helpful. It is important to drink the full amount of bowel preparation to achieve adequate cleansing of the bowel. Please contact Rodney Surgical Centre if you require further advice or assistance. AFTER THE COLONOSCOPY/GASTROSCOPY Following your procedure you will be wheeled into the recovery room where you will rest to allow the sedation to wear off. When you are awake, your specialist will discuss your examination results with you. Sometimes you do not clearly remember the discussion or even that the specialist spoke to you (due to the sedation) and hence a written summary may also be given to you for your reference. A detailed report will be sent from your specialist to your GP or referring doctor. A light snack will be served before you leave. Most people are able to resume normal activities the following day. Laboratory results from any biopsies taken will be sent to your GP or referring doctor and specialist to review (can take up to 10 days). SAFETY AND RISKS The colonoscope/gastroscope is completely cleaned and disinfected between each patient to avoid the risk of transmission of serious diseases such as HIV or hepatitis. Serious complications of colonoscopy are rare, at less than one in 3000 examinations. However, complications can occur and include the following: Colonoscopy/gastroscopy is considered to be a very accurate test. However, there is a risk that an abnormality may not be detected. Intolerance to the bowel preparation. Some people develop dizziness, headaches or vomiting. 8

13 Reaction to the sedatives or anaesthetics. This is very uncommon but is especially of concern in people who have severe heart disease or lung disease. Perforation (making a hole in the bowel). Significant bleeding, usually after polyp removal. It is possible, if these serious complications occur, that you may require surgery or a blood transfusion. Rare side effects can occur with any procedure. Death is extremely rare. If you wish to have further details please discuss this with your endoscopist before the procedure. If you have any of the following symptoms in the hours or days after colonoscopy/ gastroscopy you should contact your doctor s rooms immediately: severe abdominal pain, black tarry motions, persistent bleeding, fever or other symptoms that cause you concern. If you can not contact your Doctor or are concerned call 111 for an ambulance. GENERAL INFORMATION Patient Rights RSC is committed to delivering care in accordance with the code of the Health and Disability Services Consumers Rights. Your rights are: Respect and Privacy Fair treatment Dignity and Independence Appropriate standards Effective communication Information Choice and Consent, Support Rights during teaching and research Your complaints taken seriously 9

14 HAND HYGIENE When to wash your hands You should wash with soap and water: when the hands are visibly dirty before you eat before you prepare food items after touching raw meats like chicken or beef after contact with any body fluids like blood, urine or vomit after changing infant or adult diapers after touching animals and pets after using the restroom after removing medical gloves. How to wash your hands Wet hands with water. Apply soap. Rub hands vigorously for 15 seconds. Rinse well. Dry hands with soft paper towels. When to use alcohol handrubs For routine cleaning of hands anytime they are not visibly dirty. If you have contact with contaminated objects in the environment. Before and after you care for or have contact with someone who is very sick, very old or very young. After touching other persons intact skin (shaking hands, holding hands), especially when the other person has a cold or other illness. Whenever you want to decontaminate hands. 10

15 We are here Rodney Surgical Centre 77 Morrison Drive, Warkworth * upstairs (take lift or stairs) Tel or Fax info@rodneysurgicalcentre.co.nz x 11

16 RODNEY SURGICAL MODERN PROFESSIONAL LOCAL Tel or info@rodneysurgicalcentre.co.nz 77 Morrison Drive, Warkworth P.O. Box 317, Warkworth 0941 Rodney District, New Zealand 12