COLONOSCOPY SUPPLIES YOU WILL NEED TO GET... You will not need a prescription for any of these items. One 10 oz bottle of Magnesium Citrate. Buy the GREEN or CLEAR bottle - NOT the red cherry flavor. If you have chronic constipation, buy two bottles, instead of one. Four Dulcolax tablets (Bisacodyl). Buy the LAXATIVE, NOT the stool softener. If you have chronic constipation, buy eight tablets, instead of four. Miralax (238 grams) 64 oz of Water and/or clear flavored drink *This is not an FDA approved colonoscopy prep. If you have any problems or questions, please call the office. PREP INSTRUCTIONS Instructions for prior to your procedure If you are taking blood thinners, you will need to discuss discontinuing these medications with the physician that prescribed them prior to your procedure. Avoid eating foods with nuts, seeds, corn and popcorn for at least 2 days before the procedure. Do not chew gum or tobacco after Midnight the night before your procedure. Instructions for the day before your colonoscopy The day before the procedure, you may have CLEAR LIQUIDS ONLY, which includes tea, black coffee with NO cream or sugar, 7-up/Sprite, apple juice without pulp, sports drinks, popsicles, Jell-O, broth or bouillon, but NOTHING RED OR PURPLE. You may NOT have milk, milk products, or any food. At 8:00am the day before the procedure, take 4 Dulcolax tablets with 8oz of water. If you have chronic constipation, also drink 10 oz of magnesium citrate at that time. At 12:00 noon the day before the procedure, drink 10 oz of magnesium citrate. If you are working, you may postpone it to 4:00pm. If you have chronic constipation, also take 4 more Dulcolax tablets with 8 oz of water at that time. At 6:00pm the evening before the procedure, mix the Miralax with 64 oz of water. Drink 32 oz within 4-6hrs. If you become nauseated, pause for 30-60 minutes until the nausea improves and then resume drinking the mixture. Try to avoid vomiting. The evening before the procedure, you may have clear liquids until midnight. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT, except for the Miralax mixture. Do not chew gum or tobacco after Midnight. Office 785-505-2250 Charles Brooks, MD
Instructions for the day of your colonoscopy Four hours before your arrival time, drink the remaining 32oz of Miralax mixture within a 2 hour period. You should be finished 2 hours before your arrival time. DO NOT DRINK ANYTHING MORE. Avoid taking any medications, unless otherwise directed by your physician. Wear comfortable clothing that is easy to remove. Do not bring a purse, billfold, money, or other valuable electronic equipment. What is a colonoscopy? A colonoscope is a long flexible tube that is about the thickness of a finger. It is inserted through the rectum into the large intestine (colon) and allows your physician to carefully examine the lining of the colon. Abnormalities suspected by X-Ray can be confirmed. Abnormalities which are too small to be seen by X ray may also be identified. If your doctor sees a suspicious area or needs to evaluate an area of inflammation in greater detail, he can pass an instrument through the colonoscope and take a small piece of tissue (a biopsy) for examination under the microscope. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. A small brush can also be used to collect cells from an abnormal area for examination under the microscope (similar to a Pap Smear). What is a polypectomy? During the course of the examination, a polyp may be found. Polyps are abnormal growths of tissue which vary in size from a tiny dot to several inches. If your doctor feels that removal of the polyp is indicated, he will pass a wire loop (snare) through the colonoscope and sever the attachment of the polyp from the intestinal wall by means of an electrical current. If additional polyps are detected, they may be removed as well. You should feel no pain during the removal of the polyp. Polyps are removed because they can cause bleeding or contain cancer. Although the majority of polyps are benign (noncancerous), a small percentage may contain an area of cancer or may develop into cancer. Removal of colon polyps, therefore, is an important means of prevention of colon cancer, which is a leading form of cancer in the United States. What preparation is required? For the best possible examination, the colon must be completely empty of waste material. Therefore, only clear liquids should be taken the day before the procedure. Discontinue blood thinners as recommended by the prescribing doctor to minimize the risk of bleeding. Be sure to let your doctor know if you are allergic to any medications or latex. A companion must accompany you and drive you home because you will be given medications to sedate you which will make you drowsy. You will not be allowed to drive after the procedure. Even though you may not feel tired, your judgment and reflexes may not be normal.
What should you expect during the procedure? Your doctor will give you medications through a small plastic catheter in a vein (an IV) to make you relaxed and sleepy. While you are lying in a comfortable position, the colonoscope will be inserted into the rectum and gradually advanced through the colon while injecting air to distend the colon. The colonoscope will then be slowly withdrawn while the intestine is carefully examined. The procedure is usually well tolerated. Most patients sleep through the examination. There may be some discomfort during colonoscopy but it is usually mild. The procedure usually lasts 10-20 minutes. In rare cases, passage of the colonoscope through the entire colon cannot be achieved. A limited examination may be sufficient if the area of suspected abnormality is well visualized. What happens after the colonoscopy? You will be kept in the recovery area until most of the effects of the medications have worn off. You may feel bloated after the procedure because of the air that was introduced while examining the colon, so you will be encouraged to pass gas. You will be able to resume your diet after the colonoscopy, unless you are instructed otherwise. If a polyp has been removed, your doctor may restrict your diet, and/or some of your medications, for several days. Are there any complications from a colonoscopy and polypectomy? Colonoscopy and polypectomy are safe, but are associated with minimal risks when performed by your physician who has been specially trained and is very experienced in these endoscopic procedures. Complications are rare. One possible complication is perforation in which a tear through the wall of the bowel may allow leakage of intestinal fluids. This complication usually requires emergent surgery but may be managed with antibiotics and intravenous fluids in selected cases. Bleeding may occur from the site of a biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of electrical current) through the colonoscope. Rarely, transfusions or surgery may be required. Localized irritation of the vein may occur at the IV site. A tender lump may develop which may remain for several weeks to several months but goes away eventually. Other risks include drug reactions and complications from unrelated diseases, such as a heart attack or stroke. Respiratory arrest (stop breathing), cardiac arrest (heart stops), and death are extremely rare, but remain remote possibilities.
Why is a colonoscopy necessary? A colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by X-Ray can be confirmed and studied in detail. Even when X-Rays are negative, the cause of symptoms, such as rectal bleeding or change in bowel habits, may be found by colonoscopy. It is useful for the diagnosis and follow-up of patients with inflammatory bowel disease, as well. Colonoscopy s greatest impact is in its contribution to the control of colon cancer by polyp removal. Before colonoscopy became available, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant. Now, most polyps can be removed easily and safely without surgery. Periodic colonoscopy is a valuable tool for the follow-up of patients with previous polyps, colon cancer, or a family history of colon cancer. A colonoscopy is a safe and extremely worthwhile procedure which is very well tolerated. The decision to perform this procedure was based upon an assessment of your particular situation by your doctor. If you have any questions about your need for a colonoscopy, do not hesitate to speak to your doctor. The billing office will be happy to discuss the cost of the procedure, method of billing, and insurance coverage. We share a common goal - your good health and it can only be achieved through mutual trust, respect, and understanding. Information about the sedation you will receive You have been scheduled for a procedure that requires sedation with medications. The sedation involves the insertion of an IV into your arm and the administration of medications through the IV when the procedure is ready to begin. Propofol (an anesthetic), Demerol (a narcotic), Versed (a sedative) or Benadryl may be used. Other medications may be used if you have an allergy to these. These medications cause you to be drowsy and relaxed during the procedure, and also create some degree of amnesia of the procedure. Your heart rate, blood pressure and oxygen level will be monitored before, during and after the procedure to assure your safety. Although the effects of these medications are short lived, traces of these medications have been shown to stay in a person s system for up to 12 hours. Therefore, you must have someone stay with you to speak with your physician after the procedure and to drive you home. You will be restricted in what you may do for 12 hours after the procedure: 1. Absolutely NO DRIVING 2. No drinking of alcoholic beverages 3. Do NOT smoke unattended 4. Do not return to work or resume any work around the home or yard. Observing these restrictions following your procedure will greatly contribute to your safety.
HOW TO GET YOUR RESULTS Our clinical staff will contact you within 7-10 days with your results. At that time, if you need a follow-up appointment to discuss any ongoing symptoms, develop a plan of care, or discuss your test results in further detail, they will set up that appointment for you. If you have any questions, please call our office at 785-505-2250. BILLING INFORMATION Thank you for choosing Lawrence GI Consultants and Lawrence Memorial Hospital for your procedure. Your safety and your experience are our top priorities. Part of that experience is knowing ahead of time what charges may occur with your procedure. Since many people and many entities work as a team to provide your care, you may receive bills from multiple places. Lawrence GI Consultants bills for any provider fees from Dr. Brooks. Lawrence Anesthesia bills for any anesthesia utilized during your procedure. Lawrence Memorial Hospital bills for the use of the facility and supplies. You may receive a bill for pathology if pathology is required with your procedure. If other physicians are consulted you may receive a bill from them as well. Lawrence GI Consultants and Lawrence Memorial Hospital accept payment plans and also allow for charity writes offs due to income if you feel that applies to you. Below, you ll find contact information for several of these entities. Please contact them directly with any additional questions. Lawrence Memorial Hospital Patient accounts: 785-505-2922 Lawrence GI Consultants, LMH clinics, and LMH hospitalists: 877-767-8477 Anesthesia and Pain Management: 785-842-7026 Radiology Professional Services: 785-841-3211